PDF(Pubmed)
Abstract：
BACKGROUND: Many studies have started integrating virtual reality (VR) into neurorehabilitation for children with cerebral palsy (CP). The results of the effects of VR on motor skill learning, including the short- to long-term results of relevant studies, must be pooled in a generic framework.
OBJECTIVE: This systematic review and meta-analysis aimed to investigate the short- to long-term effects of therapies including VR on motor skill learning in children with CP.
METHODS: Two examiners followed the inclusion and exclusion criteria of the \"Participant, Intervention, Control, and Outcome\" framework. Randomized controlled trials (RCTs) and non-RCTs were considered if they compared VR-included interventions with control groups on motor functions and daily life activities in children with CP. PubMed, ScienceDirect, Embase, and IEEE Xplore databases were searched. The modified Downs and Black assessment was used to assess the methodological quality of the included studies. Meta-analyses and subgroup analyses for RCTs were conducted whenever possible.
RESULTS: A total of 7 RCTs, 2 non-RCTs, and 258 children with CP were included. The priority focus of 78% (7/9) of the studies was upper limb functions. There was a significant short-term effect of adding VR to conventional therapies on upper limb functions when compared with conventional therapies (P=.04; standardized mean difference [SMD]=0.39, 95% CI 0.01-0.76). The overall medium- to long-term effects showed a trend toward favoring the VR group, although the difference was not statistically significant (P=.06; SMD=0.37, 95% CI -0.02 to 0.77). For balance (P=.06; SMD=1.04, 95% CI -0.04 to 2.12), gross motor functions (P=.30; SMD=2.85, 95% CI -2.57 to 8.28), and daily life activities outcomes (P=.21; SMD=0.29, 95% CI -0.16 to 0.74), the overall effect in the short term also showed a trend toward favoring the VR group, but these results were not statistically significant.
CONCLUSIONS: VR seems to have additional benefits for motor skill learning in children with CP. Studies with follow-up outcomes of VR training focusing on balance and gross motor functions in patients with CP were quite limited. Future research on balance and gross motor function outcomes should target particularly long-term results of therapies including VR on motor skill learning.
BACKGROUND: PROSPERO International Prospective Register of Systematic Reviews CRD42021227734; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021227734.
OBJECTIVE: This systematic review and meta-analysis aimed to investigate the short- to long-term effects of therapies including VR on motor skill learning in children with CP.
METHODS: Two examiners followed the inclusion and exclusion criteria of the \"Participant, Intervention, Control, and Outcome\" framework. Randomized controlled trials (RCTs) and non-RCTs were considered if they compared VR-included interventions with control groups on motor functions and daily life activities in children with CP. PubMed, ScienceDirect, Embase, and IEEE Xplore databases were searched. The modified Downs and Black assessment was used to assess the methodological quality of the included studies. Meta-analyses and subgroup analyses for RCTs were conducted whenever possible.
RESULTS: A total of 7 RCTs, 2 non-RCTs, and 258 children with CP were included. The priority focus of 78% (7/9) of the studies was upper limb functions. There was a significant short-term effect of adding VR to conventional therapies on upper limb functions when compared with conventional therapies (P=.04; standardized mean difference [SMD]=0.39, 95% CI 0.01-0.76). The overall medium- to long-term effects showed a trend toward favoring the VR group, although the difference was not statistically significant (P=.06; SMD=0.37, 95% CI -0.02 to 0.77). For balance (P=.06; SMD=1.04, 95% CI -0.04 to 2.12), gross motor functions (P=.30; SMD=2.85, 95% CI -2.57 to 8.28), and daily life activities outcomes (P=.21; SMD=0.29, 95% CI -0.16 to 0.74), the overall effect in the short term also showed a trend toward favoring the VR group, but these results were not statistically significant.
CONCLUSIONS: VR seems to have additional benefits for motor skill learning in children with CP. Studies with follow-up outcomes of VR training focusing on balance and gross motor functions in patients with CP were quite limited. Future research on balance and gross motor function outcomes should target particularly long-term results of therapies including VR on motor skill learning.
BACKGROUND: PROSPERO International Prospective Register of Systematic Reviews CRD42021227734; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021227734.
摘要：
背景：许多研究已经开始将虚拟现实（VR）整合到脑瘫（CP）儿童的神经康复中。VR对运动技能学习影响的结果，包括相关研究的短期到长期结果，必须集中在通用框架中。
目的：本系统综述和荟萃分析旨在研究包括VR在内的疗法对CP患儿运动技能学习的短期和长期影响。
方法：两名审查员遵循“参与者”的纳入和排除标准，干预,Control,和成果“框架。如果将包含VR的干预措施与对照组对CP儿童的运动功能和日常生活活动进行比较，则考虑使用随机对照试验（RCTs）和非RCTs。PubMed,ScienceDirect,Embase,和IEEEXplore数据库进行了搜索。使用改良的Downs和Black评估来评估纳入研究的方法学质量。尽可能进行随机对照试验的Meta分析和亚组分析。
结果：共7项RCT，2个非随机对照试验，258名CP儿童被纳入。78%（7/9）的研究重点是上肢功能。与常规疗法相比，在常规疗法中添加VR对上肢功能有明显的短期影响（P=.04；标准化平均差[SMD]=0.39，95％CI0.01-0.76）。总体的中长期影响显示出有利于VR组的趋势，尽管差异无统计学意义（P=.06；SMD=0.37，95％CI-0.02至0.77）。对于余额(P=.06；SMD=1.04，95%CI-0.04至2.12)，粗大运动功能(P=0.30；SMD=2.85，95%CI-2.57至8.28)，和日常生活活动结果(P=.21；SMD=0.29，95%CI-0.16至0.74)，短期内的整体效果也显示出有利于VR组的趋势，但这些结果没有统计学意义.
结论：VR似乎对CP儿童的运动技能学习有额外的益处。针对CP患者的平衡和粗大运动功能的VR训练随访结果的研究非常有限。未来关于平衡和粗大运动功能结果的研究应特别针对包括VR在内的运动技能学习疗法的长期结果。
背景：PROSPERO国际系统评价前瞻性注册CRD42021227734;https://www.crd.约克。AC.uk/prospro/display_record.php?ID=CRD42021227734。
目的：本系统综述和荟萃分析旨在研究包括VR在内的疗法对CP患儿运动技能学习的短期和长期影响。
方法：两名审查员遵循“参与者”的纳入和排除标准，干预,Control,和成果“框架。如果将包含VR的干预措施与对照组对CP儿童的运动功能和日常生活活动进行比较，则考虑使用随机对照试验（RCTs）和非RCTs。PubMed,ScienceDirect,Embase,和IEEEXplore数据库进行了搜索。使用改良的Downs和Black评估来评估纳入研究的方法学质量。尽可能进行随机对照试验的Meta分析和亚组分析。
结果：共7项RCT，2个非随机对照试验，258名CP儿童被纳入。78%（7/9）的研究重点是上肢功能。与常规疗法相比，在常规疗法中添加VR对上肢功能有明显的短期影响（P=.04；标准化平均差[SMD]=0.39，95％CI0.01-0.76）。总体的中长期影响显示出有利于VR组的趋势，尽管差异无统计学意义（P=.06；SMD=0.37，95％CI-0.02至0.77）。对于余额(P=.06；SMD=1.04，95%CI-0.04至2.12)，粗大运动功能(P=0.30；SMD=2.85，95%CI-2.57至8.28)，和日常生活活动结果(P=.21；SMD=0.29，95%CI-0.16至0.74)，短期内的整体效果也显示出有利于VR组的趋势，但这些结果没有统计学意义.
结论：VR似乎对CP儿童的运动技能学习有额外的益处。针对CP患者的平衡和粗大运动功能的VR训练随访结果的研究非常有限。未来关于平衡和粗大运动功能结果的研究应特别针对包括VR在内的运动技能学习疗法的长期结果。
背景：PROSPERO国际系统评价前瞻性注册CRD42021227734;https://www.crd.约克。AC.uk/prospro/display_record.php?ID=CRD42021227734。
