基于虚拟现实的跌倒预防干预效果：系统评价与Meta分析

: Falls are recognized as a leading cause of injury, with approximately one in ten incidents resulting in physical injury. Although virtual reality (VR)-based interventions have been explored for fall prevention, systematic reviews and meta-analyses remain limited. This study aimed to assess research trends and evaluate the effectiveness of VR-based fall prevention through a systematic review and meta-analysis. : This review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive literature search was carried out in PubMed, EBMASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, and Korean databases from their inception through 31 December 2024. A total of 49 studies met the inclusion criteria, and a meta-analysis was conducted on 37 studies with available data using "R" 4.4.1 software. Effect sizes (ESs) and 95% confidence intervals (CIs) were calculated for key outcomes. : The VR-based interventions showed a statistically significant positive effect on falls self-efficacy, as measured by the Falls Efficacy Scale (FES) (ES = 0.28, 95% CI: 0.17-0.39, < 0.001). However, no significant reduction was observed in the number of falls (ES = -0.31, 95% CI: -0.80-0.17, = 0.20). Subgroup analysis by participant medical condition for the FES revealed the largest effects in the Parkinson's disease (PD) group (ES = 0.61), followed by the multiple sclerosis (MS) (ES = 0.34), the "other" group (ES = 0.25), and "healthy" participants (ES = 0.24). A statistically significant reduction in the number of falls was observed only in the MS group (ES = -0.56). : VR-based interventions are effective in improving falls self-efficacy, particularly among individuals with neurological conditions, such as Parkinson's disease and multiple sclerosis. However, evidence for a reduction in actual fall incidence remains limited. Further large-scale, long-term studies are needed to evaluate the sustained impact of VR interventions on fall prevention outcomes.

跌倒被认为是受伤的主要原因，约十分之一的跌倒事件会导致身体受伤。尽管基于虚拟现实（VR）的干预措施已被用于预防跌倒，但系统评价和荟萃分析仍然有限。本研究旨在通过系统评价和荟萃分析评估研究趋势并评估基于VR的跌倒预防效果。

本评价遵循系统评价和荟萃分析的首选报告项目（PRISMA）指南进行。在PubMed、EBMASE、护理及相关健康文献累积索引（CINAHL）、Cochrane图书馆以及韩国数据库中进行了全面的文献检索，检索时间从各数据库创建至2024年12月31日。共有49项研究符合纳入标准，使用“R”4.4.1软件对37项有可用数据的研究进行了荟萃分析。计算关键结局的效应量（ES）和95%置信区间（CI）。

基于VR的干预措施对跌倒自我效能感有统计学意义的积极影响，通过跌倒效能感量表（FES）测量（ES = 0.28，95% CI：0.17 - 0.39，P < 0.001）。然而，跌倒次数没有显著减少（ES = -0.31，95% CI：-0.80 - 0.17，P = 0.20）。按参与者健康状况对FES进行亚组分析显示，帕金森病（PD）组的效应最大（ES = 0.61），其次是多发性硬化症（MS）组（ES = 0.34）、“其他”组（ES = 0.25）和“健康”参与者（ES = 0.24）。仅在MS组观察到跌倒次数有统计学意义的减少（ES = -0.56）。

基于VR的干预措施在提高跌倒自我效能感方面是有效的，特别是在患有帕金森病和多发性硬化症等神经系统疾病的个体中。然而，实际跌倒发生率降低的证据仍然有限。需要进一步的大规模、长期研究来评估VR干预对跌倒预防结局的持续影响。