虚拟现实技术用于轻度认知障碍患者康复的Meta分析

Application of virtual reality technology in patients with mild cognitive impairment:Meta analysis

目的系统评价虚拟现实技术用于轻度认知障碍患者的康复效果,为规范有效康复训练提供参考。方法计算机检索Web of Science、PubMed、Cochrane Library、Embase、中国知网、万方数据库、维普数据库及中国生物医学文献数据库有关虚拟现实技术对轻度认知障碍患者干预效果的随机对照试验,检索时限为建库至2022年12月。符合质量标准的文献采用RevMan5.4软件进行Meta分析。结果共纳入16篇文献,747例轻度认知障碍患者。Meta分析结果显示,与常规认知训练或护理措施相比,虚拟现实认知训练可以提高轻度认知障碍患者的总体认知功能[SMD=0.97,95%CI(0.44,1.50),P<0.05],亚组分析显示,干预周期<8周[SMD=1.79,95%CI(0.50,3.00),P<0.05],干预总时长≥15 h[SMD=1.49,95%CI(0.64,2.33),P<0.05],半沉浸式虚拟现实技术[SMD=3.59,95%CI(3.34,3.85),P<0.05]效果更显著;虚拟现实认知训练改善执行功能[SMD=-0.89,95%CI(-1.62,-0.15),P<0.05];注意力[SMD=0.81,95%CI(0.24,1.39),P<0.05];生活质量[SMD=0.61,95%CI(0.33,0.88),P<0.05];但在记忆功能方面差异无统计学意义[SMD=0.38,95%CI(-0.19,0.95),P>0.05]。结论虚拟现实技术可以提高轻度认知障碍患者的总体认知功能。建议采用半沉浸式虚拟现实干预,干预周期少于8周,总时长至少15 h;虚拟现实技术对执行功能、注意力、生活质量有改善作用,但无法强化其记忆功能。

Objective To systematically evaluate the effect of Virtual Reality(VR)on the rehabilitation of patients with Mild Cognitive Impairment(MCI),and to provide a reference for conducting standardized and effective rehabilitation training.Methods Randomized Controlled Trials studies(RCTs)concerning the intervention effect of VR on patients with MCI were retrieved from the electronic databases of Web of Science,PubMed,Cochrane Library,Embase,CNKI,WanFang Data,VIP and SinoMed from the establishment of the database to December 2022.Then Meta analysis was performed using the RevMan 5.4 software.Results Sixteen RCTs were included,involving 747 participants.Meta analysis results indicated that,compared with conventional cognitive training or usual care measures,VR cognitive training improved overall cognitive function in patients with MCI[SMD=0.97,95%CI(0.44,1.50),P<0.05],subgroup analysis showed that,intervention course<8 weeks[SMD=1.79,95%CI(0.50,3.00),P<0.05],total duration≥15 hours[SMD=1.49,95%CI(0.64,2.33),P<0.05],semi-immersive VR[SMD=3.59,95%CI(3.34,3.85),P<0.05]had significantly better effects;VR cognitive training enhanced executive function[SMD=-0.89,95%CI(-1.62,-0.15),P<0.05],attention[SMD=0.81,95%CI(0.24,1.39),P<0.05],and quality of life[SMD=0.61,95%CI(0.33,0.88),P<0.05],while there wasn′t significant difference in memory function[SMD=0.38,95%CI(-0.19,0.95),P>0.05].Conclusion VR technology can improve the overall cognitive function of MCI patients.A semi-immersive VR intervention is recommended,with an intervention period of less than 8 weeks and a total duration of at least 15 hours.VR also enhances patients′executive function,attention,and quality of life,but it does not improve memory function.