目的 评价虚拟现实技术对帕金森病患者平衡和日常生活能力的影响。方法 计算机检索建库至2017年7月PubMed、Web of Science、EBSCO、Cochrane Library、Science Direct、万方数据医药期刊库、维普数据库和中国知网等资源,收集虚拟现实技术对帕金森患者影响的随机对照试验。采用RavMan 5.3软件进行统计处理。结果 共纳入文献9篇。虚拟现实技术能改善帕金森病患者的动态平衡能力[固定效应模型,WMD=1.87, 95%CI (0.85, 2.89), P=0.0003],提高日常生活活动能力[固定效应模型,SMD=0.41, 95%CI (0.01, 0.80), P=0.04],但感觉整合能力[随机效应模型,SMD=-0.18, 95%CI (-0.65, 0.28), P=0.44]和功能性步行能力[固定效应模型,WMD=-1.18, 95%CI (-2.38, 0.02), P=0.05]与对照组无显著性差异。结论 虚拟现实技术可改善帕金森病患者的平衡功能,提高日常生活活动能力,但对感觉整合和功能性步行能力等疗效仍需进一步研究。
Objective To evaluate the effects of virtual reality on balance and activities of daily living in patients with Parkinson's disease. Methods Randomized controlled trials (RCTs) about virtual reality for balance and activities of daily living in patients with Parkinson's disease were electronically searched in PubMed, Web of Science, EBSCO, Cochrane Library, Science Direct, Wanfang Data, VIP Database and China National Knowledge Infrastructure (CNKI) from the date of establishment to July, 2017. Data were analyzed with RevMan5.3 software. Results A total of nine RCTs were included. Virtual reality significantly improved the ability of dynamic balance (WMD=1.6, 95%CI [0.75, 2.46], P=0.0002) and activities of daily living (SMD=0.41, 95%CI[0.01, 0.80], P=0.04). However, the results of sensitivity organization test (SMD=-0.18, 95%CI [-0.65, 0.28], P=0.44) and walking ability (WMD=-1.18, 95%CI [-2.38, 0.02], P=0.05) were not statistically significant. Conclusion Virtual reality can improve the balance function and activities of daily living of patients with Parkinson's disease, however, the effects on sensitivity organization and walking ability still need further study.
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