虚拟现实技术在全膝、全髋关节置换患者术后康复中应用效果的Meta分析

Effect of virtual reality technology in postoperative rehabilitation of patients with total knee and hip arthroplasty replacement:a Meta-analysis

目的:系统评价虚拟现实技术在全膝、全髋关节置换患者术后康复中的应用效果。方法:计算机检索PubMed、Embase、Web of Science、Cochrane Library、中国知网、中国生物医学文献数据库、维普网和万方数据库中虚拟现实技术在全膝、全髋关节置换患者术后康复中应用的随机对照试验,检索时限为建库至2021年11月25日。由2名研究者独立进行文献筛选、质量评价和资料提取。采用RevMan 5.4软件进行Meta分析。结果:最终纳入9篇文献,共668例患者。Meta分析结果显示,与传统康复方式相比,虚拟现实技术可降低患者的疼痛评分(MD=-0.64,95%CI:-0.86~-0.42,P<0.001),改善关节功能(MD=-4.46,95%CI:-5.85~-3.07,P<0.001;MD=9.78,95%CI:6.61~12.95,P<0.001;SMD=1.84,95%CI:0.85~2.83,P<0.001),增加关节活动范围(MD=7.25,95%CI:6.48~8.02,P<0.001),提高患者的平衡功能(MD=6.20,95%CI:5.01~7.38,P<0.001)和生活质量(SMD=1.30,95%CI:0.90~1.71,P<0.001)。结论:虚拟现实技术可以改善全膝、髋关节置换术后患者的关节功能、关节活动范围和平衡功能,提高生活质量,降低疼痛评分;但现有证据无法证实虚拟现实技术对患者心理功能、积极性等的影响,未来需进一步探讨。

Objective To systematically evaluate the effect of virtual reality technology in postoperative rehabilitation of patients with total knee and hip arthroplasty replacement.Methods Randomized controlled trials of the effect of virtual reality technology in postoperative rehabilitation of patients with total knee and hip arthroplasty replacement were searched through PubMed,Embase,Web of Science,Cochrane Library,China National Knowledge Infrastructure,CBM,VIP and Wanfang data.The retrieval period was from the establishment of database to November 25,2021.Literature screening,information extraction and quality evaluation were conducted by 2 researchers.RevMan 5.4 software was used for Meta-analysis.Results A total of 9 literatures and 668 patients were included.The Meta-analysisresults showed that virtual reality technology compared with traditional rehabilitation methods could reduce pain score(MD=-0.64,95%CI:-0.86--0.42,P<0.001),improve joint function(MD=-4.46,95%CI:-5.85--3.07,P<0.001;MD=9.78,95%CI:6.61-12.95,P<0.001;SMD=1.84,95%CI:0.85-2.83,P<0.001),increase joint range of motion(MD=7.25,95%CI:6.48-8.02,P<0.001),improve patient's balance function(MD=6.20,95%CI:5.01-7.38,P<0.001)and quality of life(SMD=1.30,95%CI:0.90-1.71,P<0.001).Conclusions Virtual reality technology can improve joint function,range of motion,balance function and quality of life of patients with total knee and hip arthroplastyreplacement,reduce pain scores.However,the existing evidence cannot prove the effect of virtual reality technology on psychological function,enthusiasm and interest of patients,and further discussion is needed in the future.