虚拟现实体育活动对脑卒中患者上肢功能影响的Meta分析

Meta-Analysis of the Impact of Virtual Reality Sports Activity on Upper Limb Function in Stroke Patients

目的:综合评价虚拟现实体育活动对脑卒中患者上肢功能康复的影响。方法:通过PubMed、Cochrane Library、Web of Science、Medline、中国知网(CNKI)等数据库检索自建库至2024年2月的相关文献,采用Sata17.0、RevMan5.3统计软件进行Meta分析。结果:共纳入10项研究,共涉及676名受试者,总体方法学质量较高,无明显发表偏倚。在虚拟现实体育活动干预下,与对照组相比,可有效改善Fugl-Meyer量表(FMA)评分(WMD=4.85,95%CI:4.29~5.41,P<0.001),改善Box and Block实验(BBT)评分(WMD=4.21,95%CI:-1.61~10.02,P=0.156),提高上肢运动速度(WMD=3.23,95%CI:0.44~6.02,P=0.023),间接提高功能独立性量表(FIM)评分(WMD=8.54,95%CI:5.30~11.79,P<0.001),但对提升上肢力量(SMD=0.02,95%CI:-0.53-0.57,P=0.944)和手功能(WMD=-0.74,95%CI:-1.28~-0.20,P=0.007)没有改善作用,对上肢活动频率和活动度改善情况尚不清楚。结论:虚拟现实技术应用在脑卒中上肢运动康复训练中,能有效改善上肢活动能力,提高运动量和运动质量,改善功能独立性,但在力量和活动度方面未产生积极影响,虚拟现实作为一种新兴临床干预手段,对于心血管疾病的预防和改善是一种有效的方法。

Objective:To comprehensively evaluate the impact of virtual reality sports activity on upper limb function rehabilitation of stroke patients.Methods:Relevant literatures from the self-built database up to February 2024 were retrieved through PubMed,Cochrane Library,Web of Science,Medline,CNKI and other databases,and Meta-analysis was performed using Sata17.0 and RevMan5.3 statistical software.Result:A total of 10 studies were included,involving a total of 676 participants,with high overall methodological quality and no significant publication bias.Compared with the control group,the virtual reality sports activity intervention can effectively improve the score of Fugl-Meyer Scale(FMA)(WMD=4.85,95%CI:4.29~5.41,P<0.001),and improve the score of Box and Block Experiment(BBT)(WMD=4.21,95%CI:-1.61~10.02,P=0.156),improved upper limb motor speed(WMD=3.23,95%CI:0.44~6.02,P=0.023),and indirectly improved Functional Independence Measure(FIM)score(WMD=8.54,95%CI:5.30~11.79,P<0.001).However,there was no improvement in upper limb strength(SMD=0.02,95%CI:-0.533~0.57,P=0.944)and hand function(WMD=-0.74,95%CI:-1.28~-0.20,P=0.007),and the improvement in upper limb activity frequency and range of motion was not clear.Conclusion:The application of virtual reality technology in the upper limb exercise rehabilitation training of stroke can effectively improve the upper limb activity ability,increase the amount of exercise and the quality of exercise,and improve functional independence,but has no positive impact on strength and mobility.Virtual reality,as a new clinical intervention means,is an effective method for the prevention and improvement of cardiovascular diseases.