Wormser Johan, Romanet Christophe, Cachanado Marine, Youinou Maëlle, Chatellier Gilles, Torres Sánchez Irene, Philippart François
Department of Intensive Care, Paris Saint-Joseph Hospital, Paris, France.
Respiratory Rehabilitation, Paris Saint-Joseph Hospital, Paris, France.
BMJ Open Respir Res. 2025 Sep 10;12(1):e002722. doi: 10.1136/bmjresp-2024-002722.
Our aim was to evaluate virtual reality's effects in dyspnoea's management.
Information sources: Trials were identified through a systematic search carried out on MEDLINE, Web of Science, Scopus and CINAHL until 17 March 2025.
Eligible studies were controlled trials including adults with dyspnoea associated with respiratory diseases, for whom virtual reality was implemented and compared with another intervention. Risk of bias: Risk of bias (ROB) was assessed using the ROB 2 tool.
The primary outcome was dyspnoea. Secondary outcomes included exercise capacity, health-related quality of life (HRQOL) and muscle function. Effect size was expressed using standardised mean difference (SMD) or MD for primary and secondary outcomes, respectively (random-effects model). We used the Grading of Recommendations Assessment, Development and Evaluation approach to judge the certainty of evidence.
Included studies: 13 studies were selected, including 483 adults and using non-immersive tools (n=7) or immersive tools (n=6). Risk of bias in these studies was low (n=1), some concerns (n=8) and high risk (n=4).
No difference was found in dyspnoea (8 studies, 224 participants; SMD 0.02, 95% CI -0.82 to 0.86, I=88.2%), exercise capacity (5 studies, 183 participants; MD 3.62, 95% CI -19.39 to 26.63, I=39.8%) and in HRQOL (4 studies, 127 participants; MD -11.81, 95% CI -42.95 to 19.33, I=98.9%). The data available were insufficient to conduct a pooled analysis for muscle function.
Limitations of evidence: The evidence is very uncertain about virtual reality's effects on dyspnoea due to risk of bias, imprecision and heterogeneity.
Further studies are needed and should explore various aspects of the application of immersive virtual reality.
CRD42023443280.
我们的目的是评估虚拟现实在呼吸困难管理中的作用。
信息来源：通过对MEDLINE、科学网、Scopus和CINAHL进行系统检索，直至2025年3月17日来确定试验。
符合条件的研究为对照试验，包括患有与呼吸系统疾病相关呼吸困难的成年人，对其实施虚拟现实并与另一种干预措施进行比较。偏倚风险：使用ROB 2工具评估偏倚风险（ROB）。
主要结局为呼吸困难。次要结局包括运动能力、健康相关生活质量（HRQOL）和肌肉功能。主要和次要结局的效应量分别使用标准化均数差（SMD）或均数差（MD）表示（随机效应模型）。我们采用推荐分级评估、制定和评价方法来判断证据的确定性。
纳入研究：选择了13项研究，包括483名成年人，使用非沉浸式工具（n = 7）或沉浸式工具（n = 6）。这些研究中的偏倚风险较低（n = 1）、存在一些担忧（n = 8）和高风险（n = 4）。
在呼吸困难方面未发现差异（8项研究，224名参与者；SMD 0.02，95%CI -0.82至0.86，I = 88.2%）、运动能力方面（5项研究，183名参与者；MD 3.62，95%CI -19.39至26.63，I = 39.8%）以及HRQOL方面（4项研究，127名参与者；MD -11.81，95%CI -42.95至19.33，I = 98.9%）。现有数据不足以对肌肉功能进行汇总分析。
证据局限性：由于存在偏倚风险、不精确性和异质性，关于虚拟现实对呼吸困难影响的证据非常不确定。
需要进一步的研究，并且应该探索沉浸式虚拟现实应用的各个方面。
PROSPERO注册号：CRD42023443280。
