Effectiveness of virtual reality-based balance and gait in older adults with fear of movement: A systematic review and meta-analysis.

IF 1.5 Q3 REHABILITATION

Physiotherapy Research International Pub Date : 2023-10-01 Epub Date: 2023-07-10 DOI:10.1002/pri.2037

David Percy, Tyler Phillips, Fabian Torres, Michele Chaleunphonh, Paul Sung

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引用次数: 0

Abstract

Objective: To summarize the current evidence from randomized controlled trials (RCTs) regarding the effectiveness of Virtual Reality (VR) training and functional mobility in older adults with fear of movement. TYPE: Systematic review and meta-analysis of randomized clinical trials.

Methodology: An electronic search was performed using PubMed, Embase, Medline, SPORTDiscus, Scopus, and CINAHL. A data search from January 2015 to December 2022 and a manual electronic literature search were conducted to identify published RCTs. The effectiveness of VR-based balance training for balance and gait was evaluated in older adults with a fear of movement, which was measured by the Timed Up and Go (TUG) test and the Falls Efficacy Scale (FES). Three reviewers independently performed the study selection, and the quality assessment of the included studies was performed using the Physiotherapy Evidence Database (PEDro) scale. The reporting was based on the new Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) Guidelines.

Synthesis: The search product produced 345 results, from which 23 full text articles were studied. Seven RCTs of good methodological quality, including 265 participants, were included in the review. Overall, the studies reported that VR had a significant improvement on the TUG (Cohen's d = -0.91 [-1.38; -0.44], p = 0.001), while the FES was not significantly different (Cohen's d = -0.54 [-1.80; 0.71] p = 0.40). The average for PEDro scores (6.14) was good, and the risk of bias revealed that more than one-third of the studies correctly described the random sequence generation and allocation concealment procedures.

Conclusion: VR-based training is effective on balance or gait training based on the TUG; however, there were mixed results to improve FES scores following VR intervention. These inconsistent results might be limited due to variations in the studies, including heterogeneous training paradigms, sensitive outcome measures, small sample sizes, and short intervention durations, which limit the validity of our findings. Future investigations should compare different VR protocols to help establish better guidelines for clinicians.

查看原文本刊更多论文

基于虚拟现实的平衡和步态在有运动恐惧的老年人中的有效性：一项系统综述和荟萃分析。

目的：总结随机对照试验（RCTs）中关于虚拟现实（VR）训练和功能性移动在有运动恐惧的老年人中的有效性的最新证据。类型：随机临床试验的系统综述和荟萃分析。方法：使用PubMed、Embase、Medline、SPORTDiscus、Scopus和CINAHL进行电子搜索。进行了2015年1月至2022年12月的数据搜索和手动电子文献搜索，以确定已发表的随机对照试验。基于VR的平衡训练对运动恐惧的老年人的平衡和步态的有效性进行了评估，并通过定时上下（TUG）测试和跌倒效能量表（FES）进行了测量。三名评审员独立进行了研究选择，并使用物理治疗证据数据库（PEDro）量表对纳入的研究进行了质量评估。报告基于新的系统评价和荟萃分析首选报告项目（PRISMA）指南。综合：搜索产品产生345个结果，其中研究了23篇全文文章。包括265名参与者在内的7项方法学质量良好的随机对照试验被纳入审查。总体而言，研究报告VR对TUG有显著改善（Cohen’s d=-0.91[1.38；-0.44]，p=0.001），而FES没有显著差异（Cohen‘s d=-0.54[1.80；0.71]p=0.40）。PEDro评分的平均值（6.14）良好，偏倚风险显示，超过三分之一的研究正确描述了随机序列生成和分配隐藏程序。结论：基于VR的训练对基于TUG的平衡或步态训练是有效的；然而，VR干预后改善FES评分的结果喜忧参半。这些不一致的结果可能由于研究的变化而受到限制，包括异质性训练范式、敏感的结果测量、小样本量和短干预时间，这些都限制了我们研究结果的有效性。未来的研究应该比较不同的VR协议，以帮助为临床医生制定更好的指南。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Physiotherapy Research International REHABILITATION-

CiteScore

3.30

自引率

5.90%

发文量

期刊介绍： Physiotherapy Research International is an international peer reviewed journal dedicated to the exchange of knowledge that is directly relevant to specialist areas of physiotherapy theory, practice, and research. Our aim is to promote a high level of scholarship and build on the current evidence base to inform the advancement of the physiotherapy profession. We publish original research on a wide range of topics e.g. Primary research testing new physiotherapy treatments; methodological research; measurement and outcome research and qualitative research of interest to researchers, clinicians and educators. Further, we aim to publish high quality papers that represent the range of cultures and settings where physiotherapy services are delivered. We attract a wide readership from physiotherapists and others working in diverse clinical and academic settings. We aim to promote an international debate amongst the profession about current best evidence based practice. Papers are directed primarily towards the physiotherapy profession, but can be relevant to a wide range of professional groups. The growth of interdisciplinary research is also key to our aims and scope, and we encourage relevant submissions from other professional groups. The journal actively encourages submissions which utilise a breadth of different methodologies and research designs to facilitate addressing key questions related to the physiotherapy practice. PRI seeks to encourage good quality topical debates on a range of relevant issues and promote critical reflection on decision making and implementation of physiotherapy interventions.