基于虚拟现实疗法的早期康复可增强全髋关节置换术后的髋关节功能及自我改善认知：一项系统评价与荟萃分析。

Early rehabilitation using virtual reality-based therapy can enhance hip function and self-perception of improvement following total hip arthroplasty: A systematic review and meta-analysis.

作者信息

García-Sánchez Manuel, Obrero-Gaitán Esteban, Piñar-Lara Marina, Osuna-Pérez María Catalina, Díaz-Fernández Ángeles, Cortés-Pérez Irene

机构信息

Faculty of Health Sciences, University of Jaén, Campus Las Lagunillas s/n, 23071 Jaén, Spain.

出版信息

Geriatr Nurs. 2024 Nov-Dec;60:593-601. doi: 10.1016/j.gerinurse.2024.10.020. Epub 2024 Oct 29.

DOI:10.1016/j.gerinurse.2024.10.020

PMID:39489945

Abstract

OBJECTIVE

To investigate the effectiveness of virtual reality-based therapy (VRBT) after total hip arthroplasty (THA).

METHODS

PubMed, SCOPUS, WOS, PEDro and CINAHL were consulted for results up to April 2024. Randomized controlled trials (RCTs) that assessed the effectiveness of VRBT (physical and cognitive videogames) in patients after THA were included. Pooled effect was assessed using standardized mean difference (SMD).

RESULTS

This systematic review included 5 RCTs with 287 patients. Meta-analyses showed that VRBT, specifically non-immersive virtual reality (NIVR), combined with physiotherapy can be effective in reducing hip disability (SMD=-0.46; P = 0.018) and increasing hip function (SMD = 0.6;P = 0.002) after THA. The qualitative synthesis suggested that cognitive exercises using NIVR can improve disability, physical function, cognitive abilities and subjective perception of improvement. In contrast, passive immersive VRBT did not seem to have an impact on pain and hip function.

CONCLUSION

Combining VRBT (mainly NIVR) with physiotherapy could be effective in early rehabilitation after THA.

摘要

目的

探讨虚拟现实疗法（VRBT）在全髋关节置换术（THA）后的有效性。

方法

检索截至2024年4月的PubMed、SCOPUS、WOS、PEDro和CINAHL数据库以获取相关结果。纳入评估VRBT（物理和认知类电子游戏）对THA术后患者有效性的随机对照试验（RCT）。采用标准化均数差（SMD）评估合并效应。

结果

本系统评价纳入了5项RCT，共287例患者。荟萃分析表明，VRBT，特别是非沉浸式虚拟现实（NIVR），联合物理治疗可有效降低THA术后的髋关节功能障碍（SMD=-0.46；P=0.018）并提高髋关节功能（SMD=0.6；P=0.002）。定性综合分析表明，使用NIVR进行认知训练可改善功能障碍、身体功能、认知能力和主观改善感受。相比之下，被动沉浸式VRBT似乎对疼痛和髋关节功能没有影响。