虚拟现实技术在脑性瘫痪儿童青少年身体活动和健康中的应用：系统综述的系统综述

doi:10.3969/j.issn.1006-9771.2024.05.002

Abstract

Abstract:

Objective To systematically review the evidence from systematic reviews of the application models and health benefits of virtual reality (VR) technology in physical activities and health domains in children and adolescents with cerebral palsy (CP).

Methods PubMed, Embase, CINAHL, SPORTDiscus, Google Scholar, PsycINFO and CNKI were searched to collect and screen systematic reviews published from January, 2020 to March, 2024 on the application of VR technology in physical activities and health for children with CP. The relevant evidence was reported following PRISMA guidelines.

Results A total of eight English researches from China, Saudi Arabia, Indonesia and Brazil were included, involving 5 692 children and adolescents with CP, came primarily from interdisciplinary journals in clinical medicine, therapy and clinical risk management, games and gamification, and physical movement therapy. The subjects aged four to 18 years, with spastic hemiplegia and spastic diplegia. The VR technologies featured five typical application models: immersive environment simulation; interactive motion gamification; virtual training and coaching; AI-based activity data tracking and analysis, and motion capture and feedback, biofeedback integration and wearable technology applications; and augmented reality integration. Interventions lasted 15 to 90 minutes a time, one to 15 times a week, with intensities ranging from moderate to vigorous and durations from one to 24 weeks. The application of VR technology might increase the interest in participating in physical activities, enhance the interactive experience, through integration with wearable and biofeedback technologies, enable timely monitoring, tracking, analysis and feedback on children's activity statuses, improving their physical and functional abilities.

Conclusion VR technology including immersive environment simulation and interactive motion gamification may improve interest in physical activities, physical quality and functional abilities, promoting behavioral health, and enhancing overall health levels and quality of life of children and adolecents with CP.

Key words: cerebral palsy, children, adolescents, virtual reality, physical activity, systematic review

CLC Number:

R742.3

WANG Hongzhi, YANG Jian. Application of virtual reality technology in physical activity and health of children and adolescents with cerebral palsy: a systematic review of systematic reviews[J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(5): 505-512.

Figures/Tables 3

Table 1

Figure 1

Table 2

Basic characteristics of included literature"

纳入文献	国家	样本特征	健康/功能状况	干预类型	干预方案	健康结局指标
Tobaiqi等^[14](2023)	沙特阿拉伯	纳入文献n = 45 样本量n = 1580 年龄8~18岁	脑瘫	沉浸式环境模拟、动作捕捉和反馈；增强现实集成；虚拟训练和指导	干预方式：基于VR的运动游戏，包括踩踏固定自行车、阻力训练、水上训练、平衡训练干预频率：每次25~90 min，每周1~7次干预强度：中等~剧烈干预时间：4~20周	身体活动水平与健康行为社交/认知能力提升身体运动功能步速改善上肢运动的准确性、灵活性、活动范围和流畅性改善平衡功能改善手的精细运动功能改善活动未提及
Komariah等^[15](2024)	印度尼西亚	纳入文献n = 19 样本量n = 894 年龄5~16岁	脑瘫	沉浸式环境模拟、动作捕捉和反馈；基于人工智能的活动数据追踪与分析、动作捕捉和反馈、生物反馈集成和可穿戴技术应用	干预方式：基于VR的运动游戏干预频率：每次20~60 min，每周2~6次干预强度：中等~剧烈干预时间：4~12周	身体活动水平与健康行为未提及身体运动功能粗大运动功能改善上肢功能与上肢力量改善活动独立生活能力增强
Liu等^[16](2022)	中国	纳入文献n = 16 样本量n = 513 年龄10~18岁	脑瘫：痉挛性偏瘫和痉挛性双瘫	沉浸式环境模拟、动作捕捉和反馈；增强现实集成；交互式动感游戏化；虚拟训练和指导	干预方式： VR训练干预频率：每次15~60 min,每周2~6次干预强度：未提及干预时间：3~12周	身体活动水平与健康行为未提及身体运动功能平衡功能改善粗大运动功能改善活动未提及
Zhang 等^[17](2022)	中国	纳入文献n = 17 样本量n = 583 年龄5~12岁	脑瘫：痉挛性双瘫	沉浸式环境模拟、动作捕捉和反馈；增强现实集成；基于人工智能的活动数据追踪与分析、动作捕捉和反馈、生物反馈集成和可穿戴技术应用	干预方式： VR训练干预频率：每次20~60 min，每周2~6次干预强度：未提及干预时间：3~20周	身体活动水平与健康行为未提及身体运动功能手抓握功能改善粗大运动功能改善活动日常生活活动功能改善
Han等^[18](2023)	印度尼西亚	纳入文献n = 11 样本量n = 442 年龄5~12岁	脑瘫：痉挛性偏瘫和痉挛性双瘫	沉浸式环境模拟、动作捕捉和反馈；增强现实集成；交互式动感游戏化；虚拟训练和指导	干预方式：VR技术干预频率：每次25~60 min，每周10~15次干预强度：未提及干预时间：3~20周	身体活动水平与健康行为身体活动频率增加身体运动功能平衡功能改善手部精细操作功能显著改善，灵活性增强活动自理能力和功能独立性改善，如移动能力、社交交往和认知能力等
Fandim等^[19] (2021)	巴西	纳入文献n = 23 样本量n = 1364 年龄7~14岁	脑瘫	沉浸式环境模拟、动作捕捉和反馈；基于人工智能的活动数据追踪与分析、动作捕捉和反馈、生物反馈集成和可穿戴技术应用；交互式动感游戏化；虚拟训练和指导	干预方式：基于VR的运动康复干预频率：每次20~90 min，每周2~7次干预强度：中等~剧烈干预时间：4~20周	身体活动水平与健康行为未提及身体运动功能姿势控制和平衡功能改善步速提升下肢力量增强活动日常生活活动能力改善
Lopes 等^[20](2020)	巴西	纳入文献n = 5 样本量n = 27 年龄10~18岁	脑瘫	沉浸式环境模拟、动作捕捉和反馈；交互式动感游戏化	干预方式：VR技术干预频率：每次8~30 min，每周2~3次干预强度：未提及干预时间：6~24周	身体活动水平与健康行为身体活动参与频率增加身体运动功能运动协调能力增强感觉运动功能改善活动未提及
Pereira ^[21](2023)	巴西	纳入文献n = 14 样本量n = 289 年龄4~18岁	脑瘫	沉浸式环境模拟、动作捕捉和反馈；基于人工智能的活动数据追踪与分析、动作捕捉和反馈、生物反馈集成和可穿戴技术应用; 交互式动感游戏化；虚拟训练和指导	干预方式：VR技术、互动电脑游戏、沉浸式虚拟环境和可穿戴触觉设备等干预频率：每次45~90 min，每周1~5次干预强度：未提及干预时间：1~8周	身体活动水平与健康行为参与身体活动的动机变强身体运动功能手的精细运动功能(速度、敏捷性、双边协调性、力量)改善活动未提及

Table 2

References 30

[1]	BAXTER P, MORRIS C, ROSENBAUM P, et al. The definition and classification of cerebral palsy[J]. Dev Med Child Neurol, 2007, 49(s109): 1-44. pmid: 17371509
[2]	王筠婷, 宋贝贝, 赵迪. 脑性瘫痪儿童青少年全身振动干预的健康和功能结局:基于WHO-FICs的系统综述[J]. 中国康复理论与实践, 2023, 29(1): 55-63. doi: 10.3969/j.issn.1006-9771.2023.01.008
	WANG Y T, SONG B B, ZHAO D, et al. Health and functional outcome of whole body vibration for children and adolescents with cerebral palsy: a systematic review using WHO-FICs[J]. Chin J Rehabil Theory Pract, 2023, 29(1): 55-63.
[3]	M PIOVESANA A, ROSS S, LLOYD O, et al. Randomized controlled trial of a web-based multi-modal therapy program for executive functioning in children and adolescents with unilateral cerebral palsy[J]. Disabil Rehabil, 2017, 39(20): 2021-2028. doi: 10.1080/09638288.2016.1213899 pmid: 27665941
[4]	吴亮, 许秀, 罗亮. 运动康复和适应性身体活动对痉挛性脑性瘫痪儿童青少年心理运动功能、运动功能和动作发展的效益: 基于ICF的循证研究[J]. 中国康复理论与实践, 2024, 30(2): 148-156. doi: 10.3969/j.issn.1006-9771.2024.02.003
	WU L, XU X, LUO L. Effect of exercise rehabilitation and adapted physical activity on psychomotor skills, motor abilities and motor development in children and adolescents with spastic cerebral palsy: an evidence-based research using ICF[J]. Chin J Rehabil Theory Pract, 2024, 30(2): 148-156.
[5]	BOYD R N, BAQUE E, PIOVESANA A, et al. Mitii™ ABI: study protocol of a randomised controlled trial of a web-based multi-modal training program for children and adolescents with an acquired brain injury (ABI)[J]. BMC Neurol, 2015, 15(19): 140.
[6]	GRATTAN-SMITH P J, DALE R C. Chapter 40: Pediatric functional neurologic symptoms[M]// HALLETTM, STONEJ, CARSONA.Handbook of clinical neurology. Elsevier, 2016: 489-498.
[7]	MITCHELL L E, ZIVIANI J, BOYD R N. A randomized controlled trial of web-based training to increase activity in children with cerebral palsy[J]. Dev Med Child Neurol, 2016, 58(7): 767-773. doi: 10.1111/dmcn.13065 pmid: 26877078
[8]	ATASAVUN UYSAL S, BALTACI G. Effects of Nintendo Wii™ training on occupational performance, balance, and daily living activities in children with spastic hemiplegic cerebral palsy: a single-blind and randomized trial[J]. Games Health J, 2016, 5(5): 311-317.
[9]	喜悦, 杨剑. 不同身体活动对脑性瘫痪儿童青少年健康效益的系统综述[J]. 中国康复理论与实践, 2024, 30(2): 157-167. doi: 10.3969/j.issn.1006-9771.2024.02.004
	XI Y, YANG J. Physical activity intervention and its health benefits for children and adolescents with cerebral palsy: a systematic review[J]. Chin J Rehabil Theory Pract, 2024, 30(2): 157-167.
[10]	崔甜甜, 杨钰琳, 崔腾腾, 等. 不同强化训练对脑性瘫痪儿童上肢运动功能效果的网状Meta分析[J]. 中国康复理论与实践, 2024, 30(4): 437-448. doi: 10.3969/j.issn.1006-9771.2024.04.009
	CUI T T, YANG Y L, CUI T T, et al. Effect of different intensive training on upper limb motor function in children with cerebral palsy: a network meta-analysis[J]. Chin J Rehabil Theory Pract, 2024, 30(4): 437-448.
[11]	BOOTH A T C, BUIZER A I, MEYNS P, et al. The efficacy of functional gait training in children and young adults with cerebral palsy: a systematic review and meta-analysis[J]. Dev Med Child Neurol, 2018, 60(9): 866-883. doi: 10.1111/dmcn.13708 pmid: 29512110
[12]	DEWAR R, LOVE S, JOHNSTON L M. Exercise interventions improve postural control in children with cerebral palsy: a systematic review[J]. Dev Med Child Neurol, 2015, 57(6): 504-520. doi: 10.1111/dmcn.12660 pmid: 25523410
[13]	TINDERHOLT MYRHAUG H, ØSTENSJØ S, LARUN L, et al. Intensive training of motor function and functional skills among young children with cerebral palsy: a systematic review and meta-analysis[J]. BMC Pediatr, 2014, 14(5): 292.
[14]	TOBAIQI M A, ALBADAWI E A, FADLALMOLA H A, et al. Application of virtual reality-assisted exergaming on the rehabilitation of children with cerebral palsy: a systematic review and meta-analysis[J]. J Clin Med, 2023, 12(22): 7091.
[15]	KOMARIAH M, AMIRAH S, ABDURRAHMAN M F, et al. Effectivity of virtual reality to improve balance, motor function, activities of daily living, and upper limb function in children with cerebral palsy: a systematic review and meta-analysis[J]. Ther Clin Risk Manag, 2024, 20(14): 95-109.
[16]	LIU C, WANG X, CHEN R, et al. The effects of virtual reality training on balance, gross motor function, and daily living ability in children with cerebral palsy: systematic review and meta-analysis[J]. JMIR Serious Games, 2022, 10(4): e38972.
[17]	ZHANG Y, LI R, MIAO X, et al. Virtual motor training to improve the activities of daily living, hand grip, and gross motor function among children with cerebral palsy: meta-regression analysis[J]. Gait Posture, 2022, 91(1): 297-305.
[18]	HAN Y, PARK S. Effectiveness of virtual reality on activities of daily living in children with cerebral palsy: a systematic review and meta-analysis[J]. PeerJ, 2023, 11(31): e15964.
[19]	FANDIM J V, SARAGIOTTO B T, PORFÍRIO G J M, et al. Effectiveness of virtual reality in children and young adults with cerebral palsy: a systematic review of randomized controlled trial[J]. Braz J Phys Ther, 2021, 25(4): 369-386. doi: 10.1016/j.bjpt.2020.11.003 pmid: 33358737
[20]	LOPES J B P, DUARTE N A C, LAZZARI R D, et al. Virtual reality in the rehabilitation process for individuals with cerebral palsy and Down syndrome: a systematic review[J]. J Bodyw Mov Ther, 2020, 24(4): 479-483. doi: 10.1016/j.jbmt.2018.06.006 pmid: 33218550
[21]	PEREIRA K U, SILVA M Z, PFEIFER L I. The use of virtual reality in the stimulation of manual function in children with cerebral palsy: a systematic review[J]. Rev Paul Pediatr, 2023, 41(13): e2021283.
[22]	BURIN-CHU S, BAILLET H, LECONTE P, et al. Effectiveness of virtual reality interventions of the upper limb in children and young adults with cerebral palsy: a systematic review with meta-analysis[J]. Clin Rehabil, 2024, 38(1): 15-33.
[23]	SPOMER A M, CONNER B C, SCHWARTZ M H, et al. Audiovisual biofeedback amplifies plantarflexor adaptation during walking among children with cerebral palsy[J]. J Neuroeng Rehabil, 2023, 20(1): 164. doi: 10.1186/s12984-023-01279-5 pmid: 38062454
[24]	WANG N, LIU N, LIU S, et al. Effects of nonimmersive virtual reality intervention on children with spastic cerebral palsy: a meta-analysis and systematic review[J]. Am J Phys Med Rehabil, 2023, 102(12): 1130-1138.
[25]	GUINET A L, BOUYER G, OTMANE S, et al. Visual feedback in augmented reality to walk at predefined speed cross-sectional study including children with cerebral palsy[J]. IEEE Trans Neural Syst Rehabil Eng, 2022, 30: 2322-2331.
[26]	CHOI J Y, YI S H, AO L, et al. Virtual reality rehabilitation in children with brain injury: a randomized controlled trial[J]. Dev Med Child Neurol, 2021, 63(4): 480-487. doi: 10.1111/dmcn.14762 pmid: 33326122
[27]	CHIU H C, ADA L, BANIA T A. Mechanically assisted walking training for walking, participation, and quality of life in children with cerebral palsy[J]. Cochrane Database Syst Rev, 2020, 11(11): Cd013114.
[28]	何艳, 张琦, 胡晓诗, 等. 功能性电刺激康复踏车训练对痉挛型脑性瘫痪儿童下肢运动功能的效果[J]. 中国康复理论与实践, 2021, 27(12): 1464-1469. doi: 10.3969/j.issn.1006-9771.2021.12.013
	HE Y, ZHANG Q, HU X S, et al. Effect of functional electrical stimulation rehabilitation cycling on lower limb motor function in children with spastic cerebral palsy[J]. Chin J Rehabil Theory Pract, 2021, 27(12): 1464-1469.
[29]	ARNONI J L B, KLEINER A F R, LIMA C R G, et al. Nonimmersive virtual reality as complementary rehabilitation on functional mobility and gait in cerebral palsy: a randomized controlled clinical trial[J]. Games Health J, 2021, 10(4): 254-263. doi: 10.1089/g4h.2021.0009 pmid: 34370612
[30]	CHEN Y, GARCIA-VERGARA S, HOWARD A M. Effect of a home-based virtual reality intervention for children with cerebral palsy using Super Pop VR Evaluation Metrics: a feasibility study[J]. Rehabil Res Pract, 2015, 2015: 812348.

Application of virtual reality technology in physical activity and health of children and adolescents with cerebral palsy: a systematic review of systematic reviews

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