虚拟现实（VR）在神经系统疾病康复中的应用：治疗参数的系统评价和荟萃分析

Application of virtual reality (VR) in the rehabilitation of neurological disorders: a systematic review and meta-analysis of treatment parameters.

作者信息

Xiong Mingyue, Ng Manwa L, Lv Jiadong

机构信息

Department of Rehabilitation Medicine, The Central Hospital of Yongzhou, Yongzhou, Hunan, China.

Speech Science Laboratory, Faculty of Education, University of Hong Kong, Hong Kong, China.

出版信息

Acta Neurol Belg. 2025 Sep 18. doi: 10.1007/s13760-025-02891-z.

DOI:10.1007/s13760-025-02891-z

PMID:40965787

Abstract

PURPOSE

The present study evaluates the impact of virtual reality (VR) technology on balance function in patients with different neurological disorders, and explores the effects of diverse VR parameters on treatment efficacy.

METHODS

A comprehensive search of PubMed, Cochrane Library, EMBASE, Web of Science, and Scopus databases was conducted up to December 15, 2024. Data from 44 studies Involving 2,019 patients were independently screened and extracted by two researchers. Risk of bias was assessed using the Cochrane Collaboration's Risk of Bias Tool, and meta-analysis was performed using RevMan 5.4.1 software. The quality of evidence was evaluated using GRADE.

RESULTS

VR significantly improved balance ability in patients with different neurological disorders (SMD = 0.75; 95% CI: 0.62-0.87; Z = 11.96; p < 0.001), with the most pronounced effect in Parkinson's disease (SMD = 0.95; 95% CI: 0.67-1.22; Z = 6.75; p < 0.001). Significant improvements were also noted in static balance (SMD = 0.73; 95% CI: 0.42-1.04; Z = 4.59; p < 0.001), Berg Balance Scale (SMD = 0.76; 95% CI: 0.61-0.90; Z = 10.25; p < 0.001), Timed Up and Go (SMD = - 0.30; 95% CI: - 0.50 to - 0.09; Z = 2.87; p = 0.004), and Tinetti Scale (SMD = 0.53; 95% CI: 0.18-0.88; Z = 2.94; p = 0.003). However, improvements in the Activities-specific Balance Confidence scale (SMD = 0.29; 95% CI: - 0.04-0.61; Z = 1.72; p = 0.09) and Functional Reach Test scores (SMD = 0.17; 95% CI: - 0.30-0.63; Z = 0.70; p = 0.49) were not significant. Combining VR with other therapies yielded better results (SMD = 0.78; 95% CI: 0.63-0.93; Z = 10.29; p < 0.001). Treatments lasting no more than 30 min (SMD = 0.78; 95% CI: 0.63-0.94; Z = 9.73; p < 0.001) and Intervention periods not exceeding 6 weeks (SMD = 0.78; 95% CI: 0.61-0.95; Z = 9.02; p < 0.001) were more effective.

CONCLUSION

VR technology effectively improves balance In patients with neurological disorders. Optimal results are achieved with sessions under 30 min and intervention periods less than six weeks.

摘要

目的

本研究评估虚拟现实（VR）技术对不同神经系统疾病患者平衡功能的影响，并探讨不同VR参数对治疗效果的影响。

方法

截至2024年12月15日，对PubMed、Cochrane图书馆、EMBASE、Web of Science和Scopus数据库进行了全面检索。两名研究人员独立筛选并提取了44项涉及2019名患者的研究数据。使用Cochrane协作网的偏倚风险工具评估偏倚风险，并使用RevMan 5.4.1软件进行荟萃分析。使用GRADE评估证据质量。

结果

VR显著改善了不同神经系统疾病患者的平衡能力（标准化均数差[SMD]=0.75；95%可信区间[CI]：0.62 - 0.87；Z = 11.96；p < 0.001），在帕金森病中效果最为显著（SMD = 0.95；95% CI：0.67 - 1.22；Z = 6.75；p < 0.001）。在静态平衡（SMD = 0.73；95% CI：0.42 - 1.04；Z = 4.59；p < 0.001）、伯格平衡量表（SMD = 0.76；95% CI：0.61 - 0.90；Z = 10.25；p < 0.001）、定时起立行走测试（SMD = - 0.30；95% CI：- 0.50至- 0.09；Z = 2.87；p = 0.004）和Tinetti量表（SMD = 0.53；95% CI：0.18 - 0.88；Z = 2.94；p = 0.003）方面也有显著改善。然而，特定活动平衡信心量表（SMD = 0.29；95% CI：- 0.04 - 0.61；Z = 1.72；p = 0.09）和功能性前伸测试得分（SMD = 0.17；95% CI：- 0.30 - 0.63；Z = 0.70；p = 0.49）的改善并不显著。将VR与其他疗法相结合产生了更好的效果（SMD = 0.78；95% CI：0.63 - 0.93；Z = 10.29；p < 0.001）。持续时间不超过30分钟的治疗（SMD = 0.78；95% CI：0.63 - 0.94；Z = 9.73；p < 0.001）和干预期不超过6周的治疗（SMD = 0.78；95% CI：0.61 - 0.95；Z = 9.02；p < 0.001）更有效。