Li Huanhuan, Zhou Lu, Liu Gao, Wang Lei, Zhao Qingwei, Xu Shaohong, Cai Enli
School of Nursing, Yunnan University of Traditional Chinese Medicine, 650500 Kunming, Yunnan, China.
J Integr Neurosci. 2025 May 23;24(5):27142. doi: 10.31083/JIN27142.
Stroke survivors often experience varying levels of psychological stress, depression, and anxiety, which can exacerbate their physical impairments and adversely affect their recovery process. Virtual reality (VR) technology has been proven to be effective for patients with depression, garnering significant interest from researchers focused on stroke rehabilitation. However, the precise impact of VR on stroke-related psychology remains unclear. This meta-analysis aimed to appraise the effect of VR on depression, anxiety, and the abilities of daily living in stroke survivors.
The research involved a search of six electronic databases, including the Cochrane Library, Embase, Web of Science, PubMed, CINAHL, and PsycINFO, from the inception of the databases to June 2, 2024. Two investigators independently screened the databases based on the inclusion and exclusion criteria, extracted data from the included studies, and tested their methodological quality using Cochrane's risk of bias tool. The intervention effect was estimated using Review Manager 5.4 to calculate the standard mean difference (SMD) and 95% confidence interval (CI).
This review identified 16 studies out of the 4439 records retrieved, consisting of a total of 756 stroke patients. Post-intervention analysis provided low certainty evidence that VR training reduced depression (SMD = -0.47; 95% CI: -0.88, -0.05, = 0.03), but there was no significant effect on anxiety (SMD = -0.25; 95% CI: -0.53, 0.03, = 0.08) and activities of daily living (SMD = 0.34; 95% CI: -0.05, 0.73, = 0.09). Subgroup analysis indicated that participants under 60 years old who received VR intervention had a significant reduction in depression scores (SMD = -1.13; 95% CI: -1.89, -0.37, = 0.004) compared with the control group. Those with moderate depression (SMD = -1.02; 95% CI = -1.96 to -0.07, = 0.04) and intervention that lasted more than 6 weeks (SMD = -1.16; 95% CI: -1.87, -0.44, = 0.002) also showed lower scores.
Due to heterogeneity concerns and the poor quality of included studies, our meta-analysis that provided evidence with very low certainty indicates that VR technology may be a beneficial approach for improving the psychological health issues faced by stroke survivors, helping to reduce their depression, but has no significant effect on reducing anxiety and improving their activities of daily life. However, additional comprehensive research is required to reinforce these conclusions. Specifically, future research needs to involve larger scale and more rigorous approaches, utilizing tailored VR interventions to further improve patient well-being. PROSPERO Registration: CRD42024575981, https://www.crd.york.ac.uk/PROSPERO/view/CRD42024575981.
中风幸存者常常经历不同程度的心理压力、抑郁和焦虑，这会加重他们的身体损伤，并对其康复进程产生不利影响。虚拟现实（VR）技术已被证明对抑郁症患者有效，引起了专注于中风康复的研究人员的极大兴趣。然而，VR对中风相关心理的确切影响仍不清楚。这项荟萃分析旨在评估VR对中风幸存者的抑郁、焦虑及日常生活能力的影响。
该研究检索了六个电子数据库，包括Cochrane图书馆、Embase、科学网、PubMed、护理学与健康领域数据库（CINAHL）和心理学文摘数据库（PsycINFO），检索时间从数据库建立至2024年6月2日。两名研究人员根据纳入和排除标准独立筛选数据库，从纳入研究中提取数据，并使用Cochrane偏倚风险工具评估其方法学质量。使用Review Manager 5.4估计干预效果，以计算标准化均数差（SMD）和95%置信区间（CI）。
本综述在检索到的4439条记录中确定了16项研究，共涉及756名中风患者。干预后分析提供了低确定性证据，表明VR训练可减轻抑郁（SMD = -0.47；95% CI：-0.88，-0.05，P = 0.03），但对焦虑（SMD = -0.2
