Virtual reality in stroke rehabilitation: Still more virtual than real
Virtual reality in stroke rehabilitation: Still more virtual than real
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DOI：
10.1080/09638280600960909
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发表时间：
2007-01-01
影响因子：
2.2
通讯作者：
McDonough, S. M.
中科院分区：
文献类型：
--
作者：
Crosbie, J. H.;Lennon, S.;McDonough, S. M.
目的.评估虚拟现实（VR）在卒中康复中的实用性。电子检索Medline、Proquest、AMED、CINAHL、EMBASE和PsychInfo数据库，检索时间为1980年至2005年2月，检索关键词：虚拟现实、康复、卒中、物理治疗/物理治疗和偏瘫。符合研究纳入标准的文章需要：（i）在英语同行评审期刊上发表，（ii）涉及在卒中康复环境中使用VR;（iii）报告损伤和/或活动导向结局指标。两名评估员使用美国脑瘫和发育医学学会（AACPDM）分级系统独立评估每个研究的质量。11篇论文符合纳入标准：5篇涉及上肢康复，3篇涉及步态和平衡，2篇涉及认知干预，1篇涉及上肢和下肢康复。3例被判定为AACPDM I级/弱，2例III级/弱，3例IV级/弱，3例V级证据质量。所有文章均涉及干预前后; 3项随机对照试验获得统计学显著性，其余8项研究发现基于VR的治疗有益。所有研究均未报告任何显著不良反应。VR是一种潜在的令人兴奋和安全的中风康复工具，但其证据基础过于有限的设计和电力问题，允许其价值的明确评估。因此，虽然本次审查的结果总体上是积极的，但就研究质量而言，证据水平仍然较弱。需要以严格对照研究的形式进行进一步研究。
Purpose. To assess the utility of virtual reality ( VR) in stroke rehabilitation.Method. The Medline, Proquest, AMED, CINAHL, EMBASE and PsychInfo databases were electronically searched from inception/1980 to February 2005, using the Keywords: Virtual reality, rehabilitation, stroke, physiotherapy/physical therapy and hemiplegia. Articles that met the study's inclusion criteria were required to: ( i) be published in an English language peer reviewed journal, ( ii) involve the use of VR in a stroke rehabilitation setting; and ( iii) report impairment and/or activity oriented outcome measures. Two assessors independently assessed each study's quality using the American Academy for Cerebral Palsy and Developmental Medicine (AACPDM) grading system.Results. Eleven papers met the inclusion criteria: Five addressed upper limb rehabilitation, three gait and balance, two cognitive interventions, and one both upper and lower limb rehabilitation. Three were judged to be AACPDM Level I/Weak, two Level III/Weak, three Level IV/Weak and three Level V quality of evidence. All articles involved before and after interventions; three randomized controlled trials obtained statistical significance, the remaining eight studies found VR-based therapy to be beneficial. None of the studies reported any significant adverse effects.Conclusion. VR is a potentially exciting and safe tool for stroke rehabilitation but its evidence base is too limited by design and power issues to permit a definitive assessment of its value. Thus, while the findings of this review are generally positive, the level of evidence is still weak to moderate, in terms of research quality. Further study in the form of rigorous controlled studies is warranted.