虚拟现实技术对老年人平衡功能康复效果的Meta分析

doi:10.3969/j.issn.1006-9771.2020.03.003

摘要/Abstract

摘要：

目的系统评价虚拟现实技术对老年人平衡功能康复的有效性。方法从中国知网、万方数据、中国生物医学文献数据库、维普、Web of Science、PubMed、Clinical Science、EMBASE、Science Direct、Medline、Cohrane Library对照实验中心注册数据库和谷歌学术,检索2009年至2019年虚拟现实平衡康复训练与常规康复训练对照治疗老年人平衡功能障碍的临床随机对照试验,筛选文献、提取资料并评价纳入研究的偏倚风险,运用RevMan软件进行Meta分析。结果最终纳入20项临床随机对照试验。对所有年龄段老年人,Berg平衡量表(BBS)评分有显著性差异(WMD = 2.33, 95%CI 0.88~3.78);对 < 75岁老年人,BBS评分有显著性差异(WMD = 2.59, 95%CI 0.22~4.97);对 > 75岁老年人,BBS评分有显著性差异(WMD = 2.69,95%CI 1.82~3.57)。对所有年龄段老年人,计时起立-行走试验(TUGT)时间有显著性差异(WMD = -0.96, 95%CI -1.65~-0.28);对 < 75岁老年人,TUGT时间有显著性差异(WMD = -1.06, 95%CI -1.98~-0.15);对 > 75岁老年人,TUGT时间无显著性差异(WMD = -0.81, 95%CI -1.98~0.37)。结论虚拟现实平衡功能训练能有效促进老年人平衡及步行功能康复。

关键词: 老年人, 平衡, 虚拟现实, 康复, Meta分析

Abstract:

Objective To systematically evaluate the effects of virtual reality (VR) training on balance function for old adults. Methods The randomized controlled trials between VR training and routine rehabilitation for balance function for old adults were retrieved from databases of CNKI, Wangfang data, CBM, VIP, Web of Science, PubMed, Clinical Science, EMBASE, Science Direct, Medline, Cohrane Library and Google Scholar. The literatures were screened, data were extracted and the risk of bias were assessed, and analysed with RevMan. Results A total of 20 randomized controlled trials were included. Compared with the routine rehabilitation, VR training promoted recovery in score of Berg Balance Scale (BBS) for all the old adults (WMD = 2.33, 95%CI 0.88 to 3.78), those < 75 years old (WMD = 2.59, 95%CI 0.22 to 4.97) and > 75 years old (WMD = 2.69,95%CI 1.82 to 3.57). VR training also promoted recovery in time of Timed "Up & Go" Test (TUGT) for all the old adults (WMD = -0.96, 95%CI -1.65 to -0.28) and those < 75 years old (WMD = -1.06, 95%CI -1.98 to -0.15), but those > 75 years old (WMD = -0.81, 95%CI -1.98 to 0.37). Conclusion VR training may promote the recovery of balance and walking for old adults.

Key words: aged, balance, virtual reality, rehabilitation, meta-analysis

中图分类号:

R493

梁明,魏珍,谢荣,徐奕鹏,侯甜,陶静,王宝霞,方瑞. 虚拟现实技术对老年人平衡功能康复效果的Meta分析[J]. 《中国康复理论与实践》, 2020, 26(3): 278-284.

LIANG Ming,WEI Zhen,XIE Rong,XU Yi-peng,HOU Tian,TAO Jing,WANG Bao-xia,FANG Rui. Virtual Reality Training for Balance Function for Old Adults: A Meta-analysis[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2020, 26(3): 278-284.

图/表 8

图1

表1

纳入研究基本特征"

纳入研究	地区	样本量(n)		平均年龄(岁)		实验方案		结局指标	改良Jadad 质量评分
纳入研究	地区	实验组	对照组	实验组	对照组	实验组	对照组	结局指标	改良Jadad 质量评分
Daniel	美国	8	7	80.0	72.6	VR每次45 min,每周3次,共15周	常规康复每次45 min,每周3次,共15周	TUGT	4
Yeşilyaprak等	土耳其	7	11	70.1	73.1	VR每次40 min,每周3次,共6周	常规康复每次40 min,每周3次,共6周	BBS、TUGT	5
Hagedorn等	美国	15	12	81.5	81.1	VR每次90 min,每周2次,共12周	常规康复每次90 min,每周2次,共12周	BBS、TUGT	4
Williams等	苏格兰	15	6	76.8	76.5	VR每周2次,共12周	常规康复每周2次,共12周	BBS	3
Laver等	澳大利亚	22	22	85.2	84.6	VR每次25 min,每周5次	常规康复每次25 min,每周5次	TUGT	7
Lai等	台湾	15	15	70.6	74.8	VR每次30 min,每周3次,共6周	常规康复每次30 min,每周3次,共6周	BBS、TUGT	6
Schwenk等	美国	17	16	84.3	84.9	VR每次45 min,每周2次,共4周	常规康复每次45 min,每周2次,共4周	TUGT	5
Ku等	韩国	18	16	64.7	65.0	VR每次30 min,每周3次,共4周	常规康复每次30 min,每周3次,共4周	BBS、TUGT	5
Lee等	韩国	21	19	76.15	75.71	VR每次60 min,每周2次,共6周	常规康复每次60 min,每周2次,共6周	BBS、TUGT	5
Singh等	新加坡	18	18	61.12	64.00	VR每次40 min,每周2次,共6周	常规康复每次40 min,每周2次,共6周	TUGT	4
Delbroek等	比利时	10	10	86.9	87.5	VR每次18~30 min,每周2次,共6周	常规康复每次18~30 min,每周2次,共6周	TUGT	7
Franco等	美国	11	10	79.8	76.9	VR每次10~15 min,每周2次,共3周	常规康复每次10~15 min,每周2次,共3周	BBS	4
Jung等	韩国	8	8	74.3	73.6	VR每次30 min,每周2次,共8周	常规康复每次30 min,每周2次,共8周	BBS、TUGT	4
Jorgensen等	丹麦	28	30	75.9	73.7	VR每次35 min,每周2次,共10周	常规康复每次35 min,每周2次,共10周	TUGT	6
Pluchino等	美国	12	14	70.72	76.00	VR每次60 min,每周2次,共8周	常规康复每次60 min,每周2次,共8周	TUGT	4
Tsang等	香港	39	40	82.3	82.0	VR每次60 min,每周3次,共6周	常规康复每次60 min,每周3次,共6周	BBS、TUGT	6
Park等	韩国	12	12	66.5	65.2	VR每次30 min,每周3次,共8周	常规康复每次30 min,每周3次,共8周	TUGT	4
Schoene等	澳大利亚	15	17	77.5	78.4	VR每次90 min,每周2~3次,共8周	常规康复每次90 min,每周2~3次,共8周	TUGT	4
Merriman等	爱尔兰	17	17	74.06	73.41	VR每次30 min,每周2次,共5周	常规康复每次30 min,每周2次,共5周	BBS	4
Hsieh等	台湾	31	29	76.4	80.0	VR每次60 min,每周2次,共24周	常规康复每次60 min,每周2次,共24周	TUGT	3

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表2

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纳入研究	随机序列生成	分配隐藏	参与盲法	评定者盲法	数据完整性	选择性报告	其他偏倚	证据质量
Daniel	是	否	否	否	是	不清楚	是	B
Yeşilyaprak等	是	是	否	否	是	是	是	B
Hagedorn等	否	否	否	否	是	是	不清楚	B
Williams等	否	否	否	否	否	是	不清楚	B
Laver等	是	是	是	是	是	是	是	A
Lai等	是	是	是	否	是	是	不清楚	B
Schwenk等	是	是	否	否	是	不清楚	不清楚	B
Ku等	是	是	否	否	是	是	不清楚	B
Lee等	是	是	否	否	是	是	是	B
Singh等	是	否	否	否	是	是	不清楚	B
Delbroek等	是	是	是	是	是	是	是	A
Franco等	是	否	否	否	是	不清楚	不清楚	B
Jung等	是	否	否	否	是	不清楚	不清楚	B
Jorgensen等	是	是	是	否	是	是	是	B
Pluchino等	是	否	否	否	是	不清楚	不清楚	B
Tsang等	是	是	是	否	是	是	是	B
Park等	是	否	否	否	是	是	是	B
Schoene等	是	否	否	否	是	不清楚	是	B
Merriman等	是	否	否	否	是	不清楚	不清楚	B
Hsieh等	不清楚	否	否	否	是	不清楚	是	B