虚拟现实技术联合作业治疗对脑卒中患者上肢运动功能康复效果的Meta分析

doi:10.3969/j.issn.1006-9771.2026.07.006

《中国康复理论与实践》 ›› 2026, Vol. 32 ›› Issue (7): 788-796.doi: 10.3969/j.issn.1006-9771.2026.07.006

虚拟现实技术联合作业治疗对脑卒中患者上肢运动功能康复效果的Meta分析

周广雪, 徐宁(), 施滨

山东中医药大学康复医学院，山东济南市 250355

收稿日期:2026-03-09 修回日期:2026-05-06 接受日期:2026-05-14 出版日期:2026-07-25 发布日期:2026-07-30
通讯作者: 徐宁，E-mail： xuning7172@126.com
作者简介:周广雪(2002-)，女，汉族，山东济宁市人，硕士研究生，主要研究方向：神经康复。
徐宁(1972-)，女，博士，教授，硕士研究生导师，主要研究方向：中西医结合康复、神经康复。
基金资助:
山东省社会科学规划与研究项目(20CZXJ06)

Effect of virtual reality combined with occupational therapy on upper limb motor function in patients with stroke: a meta-analysis

Zhou Guangxue, Xu Ning(), Shi Bin

College of Rehabilitation Medicine, Shandong University of Traditional Chinese Medicine, Ji'nan, Shandong 250355, China

Received:2026-03-09 Revised:2026-05-06 Accepted:2026-05-14 Published:2026-07-25 Online:2026-07-30
Supported by:
Social Science Planning and Research Project in Shandong Province(20CZXJ06)

摘要/Abstract

摘要：

目的系统评价虚拟现实技术(VR)联合作业治疗对脑卒中患者上肢运动功能的康复效果。

方法检索中国知网、维普、万方数据库、PubMed、Cochrane Library和Web of Science，收集有关VR结合作业治疗干预脑卒中患者上肢运动功能的随机对照试验，检索时限为建库至2026年4月。采用Cochrane干预措施系统评价手册5.1.0版和PEDro量表对纳入文献进行质量评价，采用RevMan 5.4软件进行Meta分析。

结果共纳入15篇文献，涉及636例研究对象。PEDro量表评分7~10分。VR结合作业治疗能改善Fugl-Meyer评定量表上肢部分评分(SMD = 0.64, 95%CI 0.28~1.01, P < 0.001)和上肢动作研究量表评分(SMD = 1.22, 95%CI 0.88~1.56, P < 0.001)，而Barthel指数/改良Barthel指数评分(SMD = 0.50, 95%CI -0.07~1.07, P = 0.087)、Jebsen-Taylor手功能测试评分(SMD = 0.32, 95%CI -0.29~0.93, P = 0.308)和盒块测试评分(SMD = 0.50, 95%CI -0.43~1.43, P = 0.289)无显著性差异。

结论 VR联合作业治疗可能改善脑卒中患者的上肢运动功能，但其对日常生活活动能力、手功能操作速度及抓握搬运能力的效果尚不确定。

关键词: 脑卒中, 虚拟现实技术, 作业治疗, 上肢运动功能, Meta分析

Abstract:

Objective To evaluate the effect of virtual reality (VR) combined with occupational therapy on upper limb motor function in patients with stroke.

Methods CNKI, VIP, Wanfang data, PubMed, the Cochrane Library and Web of Science were searched for randomized controlled trials investigating the effect of VR combined with occupational therapy on upper limb motor function in patients with stroke. The search covered the period from database inception to April, 2026. The methodological quality of the included studies was assessed using the Cochrane Risk of Bias Tool version 5.1.0 and PEDro scale. Meta-analysis was performed using RevMan 5.4.

Results A total of 15 studies involving 636 participants were included. The PEDro scores ranged from seven to ten. VR combined with occupational therapy significantly improved scores of Fugl-Meyer Assessment-Upper Extremities (SMD = 0.64, 95%CI 0.28 to 1.01, P < 0.001) and the Action Research Arm Test (SMD = 1.22, 95%CI 0.88 to 1.56, P < 0.001)， while no significant differences were found in Barthel Index/Modified Barthel Index scores (SMD = 0.50, 95%CI -0.07 to 1.07, P = 0.087), Jebsen-Taylor Hand Function Test scores (SMD = 0.32, 95%CI -0.29 to 0.93, P = 0.308), or Box and Block Test scores (SMD = 0.50, 95%CI -0.43 to 1.43, P = 0.289).

Conclusion VR combined with occupational therapy may improve the upper limb motor function in patients with stroke; however, its effects on activities of daily living, hand-movement speed, and grasping and object-transfer ability remain uncertain.

Key words: stroke, virtual reality, occupational therapy, upper limb motor function, meta-analysis

中图分类号:

R743.3

周广雪, 徐宁, 施滨. 虚拟现实技术联合作业治疗对脑卒中患者上肢运动功能康复效果的Meta分析[J]. 《中国康复理论与实践》, 2026, 32(7): 788-796.

Zhou Guangxue, Xu Ning, Shi Bin. Effect of virtual reality combined with occupational therapy on upper limb motor function in patients with stroke: a meta-analysis[J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(7): 788-796.

图/表 8

表1

图1

图2

图3

表2

表3

纳入研究基本特征"

纳入文献	国家	n(C/T)	性别(男/女)/n	年龄 (C/T)/岁	病程(C/T)	干预措施		干预频率	干预周期	结局指标
纳入文献	国家	n(C/T)	性别(男/女)/n	年龄 (C/T)/岁	病程(C/T)	C	T	干预频率	干预周期	结局指标
梁明等^[15](2013)	中国	17/16	23/10	(58.82±15.03)/(56.75±13.57)	(3.06±1.50)个月/(3.38±1.57)个月	常规OT	常规OT+VR训练	每次40 min，每天1次，每周5 d	3周	①②
Kim等^[16](2018)	韩国	11/12	17/6	(53.5±16.0)/(54.7±14.3)	(15.0±5.3) d/(23.7±14.8) d	常规OT+假VR	常规OT+VR训练	每次60 min，每天1次，每周5 d	2周	①②④
Faria等^[17](2018)	葡萄牙	12/12	15/9	(68.9±9.8)/(57.1±11.0)	(41.1±41.0)个月/(24.9±20.3)个月	常规OT	常规OT+VR训练	每次90~105 min，每天1次，每周2~3 d	1个月	①②
Kiper等^[18](2018)	意大利	68/68	80/56	(66.0±12.9)/(62.5±15.2)	(4.1±3.2)个月/ (4.4±2.8)个月	物理治疗+常规OT	物理治疗+常规OT+VR训练	每次120 min，每天1次，每周5 d	4周	①
Ögün等^[19](2019)	土耳其	32/33	51/14	(59.75±8.07)/(61.48±10.92)	(15.37±9.77) d/(14.72±7.38) d	物理治疗+常规OT	物理治疗+常规OT+VR训练	每次60 min，每天1次，每周3 d	6周	①⑤
Park等^[20](2019)	韩国	12/12	-	(51.5±16.7)/(53.5±13.0)	(533.5±635.3) d/(982.3±1473.3) d	常规OT	常规OT+VR训练	每次60 min，每天1次，每周5 d	4周	①②
Kang等^[21](2020)	韩国	11/12	12/11	(64.64±13.83)/(50.92±16.68)	(19.00±9.85) d/(30.75±20.01) d	常规OT	常规OT+VR训练	每次60 min，每天1次，每周5 d	2周	①③④
Mekbib等^[22](2021)	中国	11/12	17/6	(61.00±7.69)/(52.17±13.26)	(39.36±18.08) d/(36.92±22.04) d	常规OT	常规OT+VR训练	每次120 min，每天1次，每周4 d	2周	①②
Huang等^[23](2022)	中国台湾	15/15	10/20	(58.33±11.22)/(50.80±12.32)	(17.91±21.25)个月/36.20±42.38个月	常规OT	常规OT+VR训练	每次60 min，每天1次，每周2~3 d	6周	①
Shin等^[24](2022)	韩国	16/20	17/19	(63.69±8.58)/(57.00±12.78)	(76.6±28.5) d/(67.1±45.3) d	常规OT	常规OT+VR训练	每次60 min，每天1次，每周5 d	4周	①③
孟庆周等^[25](2022)	中国	32/32	49/15	(57.12±16.32)/(56.81±16.23)	(3.61±1.59)个月/(3.62±1.61)个月	常规OT	常规OT+VR训练	每次40 min，每天1次，每周5 d	3周	①②
Rodríguez-Hernández 等^[26] (2023)	西班牙	20/23	35/8	(63.6±12.2)/(62.6±13.5)	(54.2±30.4) d/(55.3±34.3) d	物理治疗+常规OT	物理治疗+常规OT+VR训练	每次150 min，每天1次，每周5 d	3周	①⑤
Amin等^[27](2024)	巴基斯坦	26/26	34/18	(49.8±9.9)/(51.8±12.9)		物理治疗+常规OT	物理治疗+常规OT+VR训练	每次48~80 min，每天1次，每周4 d	6周	①②④⑤
Choi等^[28](2024)	韩国	23/23	25/21	(59.30±10.26)/(55.69±9.74)	(9.13±2.46)个月/(8.34±2.16)个月	常规OT	常规OT+VR训练	每次40 min，每天1次，每周5 d	8周	①③
Ase等^[29](2025)	日本	7/7	12/2	(51.4±6.7)/(58.0±6.4)	(4.7±4.2)年/ (5.4±3.7)年	门诊OT	门诊OT+VR训练	每次30 min，每天1次，每周5 d	4周	①③④

表3

表4

表5

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纳入文献	明确的纳入与排除标准	随机分配	分配隐藏	基线相似	研究对象施盲	治疗师施盲	结果评估施盲	退出率<15%	意向治疗分析	组间统计结果分析	点测量和差异值	总分
梁明等^[15](2013)	√	√		√			√	√	√	√	√	7
Kim等^[16](2018)	√	√	√	√	√	√	√	√	√	√	√	10
Faria等^[17](2018)	√	√	√	√			√	√		√	√	7
Kiper等^[18](2018)	√	√	√	√	√	√	√	√	√	√	√	10
Ögün等^[19](2019)	√	√	√	√	√	√	√	√	√	√	√	10
Park等^[20](2019)	√	√	√	√	√	√	√	√		√	√	9
Kang等^[21](2020)	√	√	√	√	√	√	√	√	√	√	√	10
Mekbib等^[22](2021)	√	√	√	√	√	√	√	√		√	√	9
Huang等^[23](2022)	√	√	√	√	√	√	√	√	√	√	√	10
Shin等^[24](2022)	√	√	√	√	√	√	√	√		√	√	9
孟庆周等^[25](2022)	√	√		√			√	√	√	√	√	7
Rodríguez-Hernández等^[26](2023)	√	√	√	√	√	√	√	√	√	√	√	10
Amin等^[27](2024)	√	√	√	√	√	√		√	√	√	√	9
Choi等^[28](2024)	√	√		√	√	√	√	√	√	√	√	9
Ase等^[29](2025)	√	√		√	√	√	√	√	√	√	√	9

结局指标	纳入研究数/n	异质性检验		效应模型	Meta分析
结局指标	纳入研究数/n	I²	P值	效应模型	SMD(95%CI)	Z值	P值
FMA-UE	15^[15-29]	78%	< 0.001	随机	0.64(0.28~1.01)	3.46	< 0.001
ARAT	3^[19,26,27]	40%	0.187	固定	1.22(0.88~1.56)	7.01	< 0.001
BI/MBI	7^{[15-17,20,22,25,27]}	79%	< 0.001	随机	0.50(-0.07~1.07)	1.70	0.087
JTT	4^{[21,24,28,29]}	60%	0.057	随机	0.32(-0.29~0.93)	1.02	0.308
BBT	4^{[16,21,27,29]}	81%	0.001	随机	0.50(-0.43~1.43)	1.06	0.289

结局指标	亚组		纳入研究数/n	异质性检验		Meta分析
结局指标	亚组		纳入研究数/n	I²	P值	SMD(95%CI)	P值
FMA-UE	干预周期	≥ 4周	9^{[17-20,23,24,27-29]}	82%	< 0.001	0.62(0.11~1.13)	0.017
	干预周期	< 4周	6^{[15,16,21,22,25,26]}	72%	0.003	0.68(0.13~1.24)	0.016
	单次干预时间	≤ 45 min	4^{[15,25,28,29]}	78%	0.004	0.89(0.13~1.65)	0.021
	单次干预时间	> 45 min	11^{[16-24,26,27]}	79%	< 0.001	0.56(0.12~0.99)	0.012
BI/MBI	干预周期	≥ 4周	3^[17,20,27]	92%	< 0.001	0.68(-0.86~2.21)	0.385
	干预周期	< 4周	4^{[15,16,22,25]}	0%	0.670	0.36(0.03~0.69)	0.035
	单次干预时间	≤ 45 min	2^[15,25]	0%	0.370	0.26(-0.14~0.66)	0.204
	单次干预时间	> 45 min	5^{[16,17,20,22,27]}	84%	< 0.001	0.64(-0.24~1.52)	0.150

虚拟现实技术联合作业治疗对脑卒中患者上肢运动功能康复效果的Meta分析

Effect of virtual reality combined with occupational therapy on upper limb motor function in patients with stroke: a meta-analysis

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