Irene Cortés-Pérez, Jose María Desdentado-Guillem, María Soledad Camacho-Delgado, María Del Rocío Ibancos-Losada, Esteban Obrero-Gaitán, Rafael Lomas-Vega
{"title":"前交叉韧带损伤后的虚拟现实疗法可有效减轻疼痛，改善膝关节功能、运动模式和动态平衡：系统回顾和荟萃分析。","authors":"Irene Cortés-Pérez, Jose María Desdentado-Guillem, María Soledad Camacho-Delgado, María Del Rocío Ibancos-Losada, Esteban Obrero-Gaitán, Rafael Lomas-Vega","doi":"10.1002/ksa.12477","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Virtual reality-based therapy (VRBT) may be an effective physical therapy complement employed in the rehabilitation of patients with anterior cruciate ligament (ACL) injury. This study aims to assess the effectiveness of VRBT in improving pain, knee function, strength, proprioception, flexion range of motion (ROM), and dynamic balance after ACL injury.</p><p><strong>Methods: </strong>We conducted this systematic review with meta-analysis following PRISMA criteria. Since inception to June 2024, we searched in PubMed Medline, WOS, SCOPUS, CINAHL and PEDro without publication date and language restrictions. Randomised controlled trials (RCTs), comprising only patients with ACL injury, that assess the effectiveness of VRBT compared to classical interventions on the outcomes of interest were included. PEDro scale was employed to analyze the methodological quality of the RCTs included. Cohen's standardised mean difference (SMD) and its 95% confidence interval (95% CI) was used to calculate the pooled effect in meta-analyses.</p><p><strong>Results: </strong>Nine RCTs, providing data from 330 participants (26.96 ± 3.11 years, 85% males) were included. The RCTs included showed good methodological quality (PEDro scale = 6.88 points), being, performance and detection biases, the most common biases reported. Meta-analyses showed that VRBT was more effective than classical interventions in reducing pain (SMD = -1.15; 95% CI -1.85 to -0.45; p = 0.001; I<sup>2</sup> = 0%), and increasing knee function (SMD = 1.71; 95% CI 0.93 to 2.5; p < 0.001; I<sup>2</sup> = 0%), strength (SMD = 0.82; 95% CI 0.4-1.23; p < 0.001; I<sup>2</sup> = 0%) and flexion ROM (SMD = 0.7; 95% CI 0.37-1.01; p < 0.001; I<sup>2</sup> = 0%). Additionally, VRBT improved postero-medial (SMD = 0.46; 95% CI 0.01-0.9; p = 0.045; I<sup>2</sup> = 15.1%) and postero-lateral CoP excursion (SMD = 0.75; 95% CI 0.3-1.21; p = 0.001; I<sup>2</sup> = 0%), being effective in improving dynamic balance.</p><p><strong>Conclusion: </strong>VRBT is an effective physical therapy complement to be included in the ACL's rehabilitation programmes due to reduces pain and increases knee function, strength, ROM and dynamic balance after ACL injury.</p><p><strong>Level of evidence: </strong>Level II evidence.</p>","PeriodicalId":3,"journal":{"name":"ACS Applied Electronic Materials","volume":null,"pages":null},"PeriodicalIF":4.3000,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Virtual reality-based therapy after anterior cruciate ligament injury effectively reduces pain and improves knee function, movement patterns, and dynamic balance: A systematic review and meta-analysis.\",\"authors\":\"Irene Cortés-Pérez, Jose María Desdentado-Guillem, María Soledad Camacho-Delgado, María Del Rocío Ibancos-Losada, Esteban Obrero-Gaitán, Rafael Lomas-Vega\",\"doi\":\"10.1002/ksa.12477\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Virtual reality-based therapy (VRBT) may be an effective physical therapy complement employed in the rehabilitation of patients with anterior cruciate ligament (ACL) injury. This study aims to assess the effectiveness of VRBT in improving pain, knee function, strength, proprioception, flexion range of motion (ROM), and dynamic balance after ACL injury.</p><p><strong>Methods: </strong>We conducted this systematic review with meta-analysis following PRISMA criteria. Since inception to June 2024, we searched in PubMed Medline, WOS, SCOPUS, CINAHL and PEDro without publication date and language restrictions. Randomised controlled trials (RCTs), comprising only patients with ACL injury, that assess the effectiveness of VRBT compared to classical interventions on the outcomes of interest were included. PEDro scale was employed to analyze the methodological quality of the RCTs included. Cohen's standardised mean difference (SMD) and its 95% confidence interval (95% CI) was used to calculate the pooled effect in meta-analyses.</p><p><strong>Results: </strong>Nine RCTs, providing data from 330 participants (26.96 ± 3.11 years, 85% males) were included. The RCTs included showed good methodological quality (PEDro scale = 6.88 points), being, performance and detection biases, the most common biases reported. Meta-analyses showed that VRBT was more effective than classical interventions in reducing pain (SMD = -1.15; 95% CI -1.85 to -0.45; p = 0.001; I<sup>2</sup> = 0%), and increasing knee function (SMD = 1.71; 95% CI 0.93 to 2.5; p < 0.001; I<sup>2</sup> = 0%), strength (SMD = 0.82; 95% CI 0.4-1.23; p < 0.001; I<sup>2</sup> = 0%) and flexion ROM (SMD = 0.7; 95% CI 0.37-1.01; p < 0.001; I<sup>2</sup> = 0%). Additionally, VRBT improved postero-medial (SMD = 0.46; 95% CI 0.01-0.9; p = 0.045; I<sup>2</sup> = 15.1%) and postero-lateral CoP excursion (SMD = 0.75; 95% CI 0.3-1.21; p = 0.001; I<sup>2</sup> = 0%), being effective in improving dynamic balance.</p><p><strong>Conclusion: </strong>VRBT is an effective physical therapy complement to be included in the ACL's rehabilitation programmes due to reduces pain and increases knee function, strength, ROM and dynamic balance after ACL injury.</p><p><strong>Level of evidence: </strong>Level II evidence.</p>\",\"PeriodicalId\":3,\"journal\":{\"name\":\"ACS Applied Electronic Materials\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.3000,\"publicationDate\":\"2024-09-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"ACS Applied Electronic Materials\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/ksa.12477\",\"RegionNum\":3,\"RegionCategory\":\"材料科学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ENGINEERING, ELECTRICAL & ELECTRONIC\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"ACS Applied Electronic Materials","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/ksa.12477","RegionNum":3,"RegionCategory":"材料科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENGINEERING, ELECTRICAL & ELECTRONIC","Score":null,"Total":0}
引用次数: 0
摘要
目的：在前交叉韧带（ACL）损伤患者的康复治疗中，基于虚拟现实的疗法（VRBT）可能是一种有效的物理疗法辅助手段。本研究旨在评估虚拟现实疗法在改善前交叉韧带损伤后的疼痛、膝关节功能、力量、本体感觉、屈曲运动范围（ROM）和动态平衡方面的效果：我们按照 PRISMA 标准进行了此次系统性回顾和荟萃分析。从开始到 2024 年 6 月，我们在 PubMed Medline、WOS、SCOPUS、CINAHL 和 PEDro 中进行了检索，没有出版日期和语言限制。纳入的随机对照试验（RCT）仅包括前交叉韧带损伤患者，这些试验评估了 VRBT 与传统干预相比对相关结果的有效性。采用PEDro量表对纳入的随机对照试验进行方法学质量分析。在荟萃分析中，采用科恩标准化平均差（SMD）及其95%置信区间（95% CI）来计算汇总效应：共纳入了 9 项研究，提供了 330 名参与者（26.96 ± 3.11 岁，85% 为男性）的数据。所纳入的研究性试验显示出良好的方法学质量（PEDro评分=6.88分），其中最常见的偏差是表现偏差和检测偏差。元分析表明，在减轻疼痛（SMD = -1.15; 95% CI -1.85 to -0.45；P = 0.001；I2 = 0%）、增强膝关节功能（SMD = 1.71; 95% CI 0.93 to 2.5；P 2 = 0%）、力量（SMD = 0.82; 95% CI 0.4-1.23；P 2 = 0%）和屈曲 ROM（SMD = 0.7; 95% CI 0.37-1.01；P 2 = 0%）方面，VRBT 比传统干预更有效。此外，VRBT 改善了后内侧（SMD = 0.46；95% CI 0.01-0.9；p = 0.045；I2 = 15.1%）和后外侧 CoP 偏移（SMD = 0.75；95% CI 0.3-1.21；p = 0.001；I2 = 0%），有效改善了动态平衡：前交叉韧带损伤后，VRBT可减轻疼痛，增强膝关节功能、力量、ROM和动态平衡，是前交叉韧带康复计划中有效的物理疗法补充：二级证据。
Virtual reality-based therapy after anterior cruciate ligament injury effectively reduces pain and improves knee function, movement patterns, and dynamic balance: A systematic review and meta-analysis.
Purpose: Virtual reality-based therapy (VRBT) may be an effective physical therapy complement employed in the rehabilitation of patients with anterior cruciate ligament (ACL) injury. This study aims to assess the effectiveness of VRBT in improving pain, knee function, strength, proprioception, flexion range of motion (ROM), and dynamic balance after ACL injury.
Methods: We conducted this systematic review with meta-analysis following PRISMA criteria. Since inception to June 2024, we searched in PubMed Medline, WOS, SCOPUS, CINAHL and PEDro without publication date and language restrictions. Randomised controlled trials (RCTs), comprising only patients with ACL injury, that assess the effectiveness of VRBT compared to classical interventions on the outcomes of interest were included. PEDro scale was employed to analyze the methodological quality of the RCTs included. Cohen's standardised mean difference (SMD) and its 95% confidence interval (95% CI) was used to calculate the pooled effect in meta-analyses.
Results: Nine RCTs, providing data from 330 participants (26.96 ± 3.11 years, 85% males) were included. The RCTs included showed good methodological quality (PEDro scale = 6.88 points), being, performance and detection biases, the most common biases reported. Meta-analyses showed that VRBT was more effective than classical interventions in reducing pain (SMD = -1.15; 95% CI -1.85 to -0.45; p = 0.001; I2 = 0%), and increasing knee function (SMD = 1.71; 95% CI 0.93 to 2.5; p < 0.001; I2 = 0%), strength (SMD = 0.82; 95% CI 0.4-1.23; p < 0.001; I2 = 0%) and flexion ROM (SMD = 0.7; 95% CI 0.37-1.01; p < 0.001; I2 = 0%). Additionally, VRBT improved postero-medial (SMD = 0.46; 95% CI 0.01-0.9; p = 0.045; I2 = 15.1%) and postero-lateral CoP excursion (SMD = 0.75; 95% CI 0.3-1.21; p = 0.001; I2 = 0%), being effective in improving dynamic balance.
Conclusion: VRBT is an effective physical therapy complement to be included in the ACL's rehabilitation programmes due to reduces pain and increases knee function, strength, ROM and dynamic balance after ACL injury.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
