Johan Wormser, Christophe Romanet, Marine Cachanado, Maëlle Youinou, Gilles Chatellier, Irene Torres Sánchez, François Philippart
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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.</p><p><strong>Results: </strong>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).</p><p><strong>Synthesis of results: </strong>No difference was found in dyspnoea (8 studies, 224 participants; SMD 0.02, 95% CI -0.82 to 0.86, I<sup>2</sup>=88.2%), exercise capacity (5 studies, 183 participants; MD 3.62, 95% CI -19.39 to 26.63, I<sup>2</sup>=39.8%) and in HRQOL (4 studies, 127 participants; MD -11.81, 95% CI -42.95 to 19.33, I<sup>2</sup>=98.9%). The data available were insufficient to conduct a pooled analysis for muscle function.</p><p><strong>Conclusions: </strong>Limitations of evidence: The evidence is very uncertain about virtual reality's effects on dyspnoea due to risk of bias, imprecision and heterogeneity.</p><p><strong>Interpretation: </strong>Further studies are needed and should explore various aspects of the application of immersive virtual reality.</p><p><strong>Prospero registration number: </strong>CRD42023443280.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"12 1","pages":""},"PeriodicalIF":3.4000,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Virtual reality in adults with respiratory diseases experiencing dyspnoea: a systematic review and meta-analysis.\",\"authors\":\"Johan Wormser, Christophe Romanet, Marine Cachanado, Maëlle Youinou, Gilles Chatellier, Irene Torres Sánchez, François Philippart\",\"doi\":\"10.1136/bmjresp-2024-002722\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>Our aim was to evaluate virtual reality's effects in dyspnoea's management.</p><p><strong>Methods: </strong>Information sources: Trials were identified through a systematic search carried out on MEDLINE, Web of Science, Scopus and CINAHL until 17 March 2025.</p><p><strong>Eligibility criteria: </strong>Eligible studies were controlled trials including adults with dyspnoea associated with respiratory diseases, for whom virtual reality was implemented and compared with another intervention. 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引用次数: 0
摘要
目的：我们的目的是评估虚拟现实在呼吸困难治疗中的效果。方法：信息来源：系统检索MEDLINE、Web of Science、Scopus和CINAHL，检索截止日期为2025年3月17日。入选标准：符合条件的研究是对照试验，包括与呼吸系统疾病相关的呼吸困难的成年人，对他们实施虚拟现实并与另一种干预进行比较。偏倚风险：使用ROB 2工具评估偏倚风险（ROB）。结果综合：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。效应大小分别用标准化平均差（SMD）或MD表示主要和次要结局（随机效应模型）。我们使用建议分级评估、发展和评价方法来判断证据的确定性。结果：纳入研究：13项研究被选中，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）。这些研究的偏倚风险为低（n=1）、部分关注（n=8）和高风险（n=4）。综合结果：在呼吸困难（8项研究，224名受试者；SMD为0.02,95% CI为-0.82至0.86,I2=88.2%）、运动能力（5项研究，183名受试者；MD为3.62,95% CI为-19.39至26.63,I2=39.8%）和HRQOL（4项研究，127名受试者；MD为-11.81,95% CI为-42.95至19.33,I2=98.9%）方面均无差异。现有的数据不足以对肌肉功能进行汇总分析。结论：证据的局限性：由于存在偏倚、不精确和异质性的风险，关于虚拟现实对呼吸困难的影响的证据非常不确定。解读：沉浸式虚拟现实应用的各个方面需要进一步的研究和探索。普洛斯彼罗注册号：CRD42023443280。
Virtual reality in adults with respiratory diseases experiencing dyspnoea: a systematic review and meta-analysis.
Objectives: Our aim was to evaluate virtual reality's effects in dyspnoea's management.
Methods: Information sources: Trials were identified through a systematic search carried out on MEDLINE, Web of Science, Scopus and CINAHL until 17 March 2025.
Eligibility criteria: 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.
Synthesis of results: 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.
Results: 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).
Synthesis of results: No difference was found in dyspnoea (8 studies, 224 participants; SMD 0.02, 95% CI -0.82 to 0.86, I2=88.2%), exercise capacity (5 studies, 183 participants; MD 3.62, 95% CI -19.39 to 26.63, I2=39.8%) and in HRQOL (4 studies, 127 participants; MD -11.81, 95% CI -42.95 to 19.33, I2=98.9%). The data available were insufficient to conduct a pooled analysis for muscle function.
Conclusions: Limitations of evidence: The evidence is very uncertain about virtual reality's effects on dyspnoea due to risk of bias, imprecision and heterogeneity.
Interpretation: Further studies are needed and should explore various aspects of the application of immersive virtual reality.
期刊介绍：
BMJ Open Respiratory Research is a peer-reviewed, open access journal publishing respiratory and critical care medicine. It is the sister journal to Thorax and co-owned by the British Thoracic Society and BMJ. The journal focuses on robustness of methodology and scientific rigour with less emphasis on novelty or perceived impact. BMJ Open Respiratory Research operates a rapid review process, with continuous publication online, ensuring timely, up-to-date research is available worldwide. The journal publishes review articles and all research study types: Basic science including laboratory based experiments and animal models, Pilot studies or proof of concept, Observational studies, Study protocols, Registries, Clinical trials from phase I to multicentre randomised clinical trials, Systematic reviews and meta-analyses.
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