梁明,魏珍,谢荣,等.虚拟现实技术改善脑卒中患者平衡与步行功能的系统评价[J].中华物理医学与康复杂志,2020,42(7):632-639
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| 虚拟现实技术改善脑卒中患者平衡与步行功能的系统评价 |
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| DOI：10.3760/cma.j.issn.0254-1424.2020.07.011 |
| 中文关键词: 脑卒中 虚拟现实 平衡 步行 Meta分析 |
| 英文关键词: Stroke Virtual reality Balance Walking Meta-analyses |
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| 中文摘要: |
| 目的 循证评价虚拟现实（VR）技术促进脑卒中患者平衡与步行功能康复的有效性。 方法 检索国内外有关VR技术治疗脑卒中患者平衡与步行障碍的临床随机对照试验（RCT），由两位评价者独立筛选文献、提取资料并评价纳入研究的偏倚风险后，运用RevMan软件对符合条件的所有结果进行Meta分析。 结果 最终纳入22篇RCT。Meta分析结果显示，VR组与常规组Berg平衡量表(BBS)评分比较，差异有统计学意义［加权均数差(WMD)=4.09，95％可信区间（CI）为（2.20, 5.97）］］。根据病程进行亚组分析，VR组与常规组患者恢复期BBS评分比较，差异有统计学意义［WMD=6.85，95％CI（2.90, 10.81）］， VR组与常规组患者后遗症期BBS评分比较，差异有统计学意义［WMD=3.31，95％CI（2.48, 4.14）］。VR组与常规组起立-行走试验(TUG)时间比较，差异有统计学意义［WMD=-2.79，95％CI（-4.88, -0.69）］。亚组分析显示， VR组与常规组患者恢复期TUG时间比较，差异无统计学意义［WMD=-4.30，95％CI（-9.28, 0.67）］， VR组与常规组患者后遗症期TUG时间比较，差异无统计学意义［WMD=-1.82，95％CI（-3.83, 0.18）］。 结论 对于不同病程的脑卒中患者，VR平衡训练结合常规训练能有效地促进其偏瘫下肢平衡功能的康复，且较常规康复训练有效，但在提高步行能力方面，两者无显著差别。 |
| 英文摘要: |
| Objective To get a systematic overview of the utility of virtual reality (VR) training for improving the balance and walking ability of hemiplegic stroke survivors. Methods Reports of randomized and controlled clinical trials of virtual reality′s utility for improving the balance and walking of stroke survivors were collected. Two researchers screened the reports independently, extracted data and assessed the risk of bias in the studies. The meta-analysis was performed using RevMan software. Results Ultimately 22 randomized and controlled trials were included. According to the meta-analysis, the VR training groups had significantly greater improvements than the control groups in terms of Berg′s Balance Scale and recovery stages ［Weighted mean difference (WMD)=4.09, 95％CI 2.20 to 5.97); WMD=3.31, 95％CI 2.48 to 4.14］. Moreover, there were significant differences in the average timed up & go between the VR and control groups in the recovery stage but not in the sequel stage. Conclusions Virtual reality training can improve the effectiveness of traditional therapy in promoting the recovery of balance after a stroke. However, there is no significant improvement in terms of promoting walking ability. |
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