Woo-Kyoung Yoo, Yongkyun Jung, Gyu Jin Kim, Shahid Bashir, Jihyun Park
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引用次数: 0
摘要
本荟萃分析结合了基于先前荟萃分析的最新研究,对虚拟现实(VR)训练和传统训练(CT)在脑卒中后康复中的最新比较。我们检索了3个国际电子数据库(MEDLINE、Embase和Cochrane图书馆)和一个韩国数据库(KoreaMed)来确定相关研究。从5218项研究中,通过系统评价和荟萃分析首选报告项目(PRISMA)方法选择了30项随机对照试验。其中上肢训练21项,下肢训练14项。根据VR类型进行亚组meta分析。使用Cochrane的RoB工具评估偏倚风险(risk of bias, RoB)。使用推荐、评估、发展和评价分级(GRADE)方法评估证据的确定性。结果分为上肢训练的上肢运动功能、精细运动功能和日常生活活动(ADLs),下肢训练的下肢运动功能、平衡和步态速度。荟萃分析的随机效应模型显示,VR训练在改善上肢运动功能、ADL和平衡方面明显优于CT。这项研究提供了低到中等确定性的证据,支持VR训练优于CT。临床医生和治疗师在选择VR进行脑卒中后功能恢复时,应考虑个体康复需求、目标、患者偏好和可用资源。
The Effects of Virtual Reality Training on Post-Stroke Upper and Lower Limb Function: A Meta-Analysis.
This meta-analysis presents an updated comparison between virtual reality (VR) training and conventional training (CT) in post-stroke rehabilitation by incorporating recent studies based on prior meta-analyses. We searched 3 international electronic databases (MEDLINE, Embase, and the Cochrane Library) and a Korean database (KoreaMed) to identify relevant studies. Out of 5,218 studies, 30 randomized controlled trials were selected through the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method. Among these, 21 focused on upper limb training and 14 on lower limb training. A subgroup meta-analysis was conducted based on the VR type. The risk of bias (RoB) was assessed using Cochrane's RoB tool. The certainty of the evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) method. The outcomes were categorized into upper limb motor function, fine motor function, and activities of daily living (ADLs) for upper limb training, and lower limb motor function, balance, and gait velocity for lower limb training. A random-effects model for the meta-analysis indicated that VR training showed significant superiority over CT in improving upper limb motor function, ADL, and balance. This study provides low- to moderate-certainty evidence supporting the superiority of VR training over CT. Clinicians and therapists should consider individual rehabilitation needs, goals, patient preferences, and available resources when selecting VR for post-stroke functional recovery.