Abstract：
BACKGROUND: Multiple sclerosis (MS) is a disabling neurological disease that causes cognitive impairment and mental problems that occur in all MS phenotypes but are most common in patients with secondary progressive MS. Various degrees of cognitive impairment and mental health concerns are common among patients with MS (PwMS). Virtual reality (VR)-based rehabilitation is an innovative approach aimed at enhancing cognitive function and mood in PwMS. This study aims to perform a meta-analysis to assess the effects of VR-based rehabilitation on cognitive function and mood in PwMS.
METHODS: Using PubMed, Embase, the Cochrane Library, Web of Science, and the Physiotherapy Evidence Database (PEDro), a thorough database search was performed to identify randomized controlled trials (RCTs) examining the effects of VR on PwMS. Trials published until October 31, 2023, that satisfied our predetermined inclusion and exclusion criteria were included. Data were extracted, literature was examined, and the methodological quality of the included trials was assessed. StataSE version 16 was used for the meta-analysis.
RESULTS: Our meta-analysis included 461 patients from 10 RCTs.
METHODS: The Montreal Cognitive Assessment (MoCA) (weighted mean difference [WMD]=1.93, 95 % confidence interval [CI]=0.51-3.36, P = 0.008, I² = 75.4 %) the Spatial Recall Test (SPART) (WMD=3.57, 95 % CI=1.65-5.50, P < 0.001, I² = 0 %), immediate recall (standard mean difference [SMD]=0.37, 95 % CI=0.10-0.64, P = 0.007, I² = 0 %) and delayed recall ([SMD]=0.30, 95 % CI=0.06-0.54, P = 0.013, I² = 35.4 %) showed improvements in comparison to the control group in terms of global cognitive function immediate recall, delayed recall, and visuospatial abilities.
RESULTS: Compared to the control group, anxiety improved (standard mean difference [SMD]=0.36, 95 % CI=0.10-0.62, P = 0.007, I² = 43.1 %). However, there were no significant differences in processing speed, attention, working memory or depression.
CONCLUSIONS: This systematic review provides valuable evidence for improving cognitive function and mood in PwMS through VR-based rehabilitation. In the future, VR-based rehabilitation may be a potential method to treat cognitive function and emotional symptoms of MS.
BACKGROUND: PROSPERO; identifier: CRD42023474467.
METHODS: Using PubMed, Embase, the Cochrane Library, Web of Science, and the Physiotherapy Evidence Database (PEDro), a thorough database search was performed to identify randomized controlled trials (RCTs) examining the effects of VR on PwMS. Trials published until October 31, 2023, that satisfied our predetermined inclusion and exclusion criteria were included. Data were extracted, literature was examined, and the methodological quality of the included trials was assessed. StataSE version 16 was used for the meta-analysis.
RESULTS: Our meta-analysis included 461 patients from 10 RCTs.
METHODS: The Montreal Cognitive Assessment (MoCA) (weighted mean difference [WMD]=1.93, 95 % confidence interval [CI]=0.51-3.36, P = 0.008, I² = 75.4 %) the Spatial Recall Test (SPART) (WMD=3.57, 95 % CI=1.65-5.50, P < 0.001, I² = 0 %), immediate recall (standard mean difference [SMD]=0.37, 95 % CI=0.10-0.64, P = 0.007, I² = 0 %) and delayed recall ([SMD]=0.30, 95 % CI=0.06-0.54, P = 0.013, I² = 35.4 %) showed improvements in comparison to the control group in terms of global cognitive function immediate recall, delayed recall, and visuospatial abilities.
RESULTS: Compared to the control group, anxiety improved (standard mean difference [SMD]=0.36, 95 % CI=0.10-0.62, P = 0.007, I² = 43.1 %). However, there were no significant differences in processing speed, attention, working memory or depression.
CONCLUSIONS: This systematic review provides valuable evidence for improving cognitive function and mood in PwMS through VR-based rehabilitation. In the future, VR-based rehabilitation may be a potential method to treat cognitive function and emotional symptoms of MS.
BACKGROUND: PROSPERO; identifier: CRD42023474467.
摘要：
背景：多发性硬化症（MS）是一种致残的神经系统疾病，可导致认知障碍和精神问题，在所有MS表型中都会发生，但在继发性进行性MS患者中最常见。不同程度的认知障碍和心理健康问题在MS（PwMS）患者中很常见。基于虚拟现实（VR）的康复是一种创新方法，旨在增强PwMS的认知功能和情绪。这项研究旨在进行荟萃分析，以评估基于VR的康复对PwMS认知功能和情绪的影响。
方法：使用PubMed，Embase,Cochrane图书馆,WebofScience,和物理治疗证据数据库(PEDro)，我们进行了彻底的数据库搜索,以确定研究VR对PwMS影响的随机对照试验(RCT).截至2023年10月31日发布的试验符合我们预定的纳入和排除标准。数据被提取，文献被检查，并对纳入试验的方法学质量进行评估.StataSE版本16用于荟萃分析。
结果：我们的荟萃分析包括来自10个随机对照试验的461例患者。
方法：蒙特利尔认知评估（MoCA）（加权平均差[WMD]=1.93，95％置信区间[CI]=0.51-3.36，P=0.008，I²=75.4％）空间召回测试（SPART）（WMD=3.57，95％CI=1.65-5.50，P<0.001，I²=0％），立即召回（标准平均差[SMD]=0.37，95％CI=0.10-0.64，P=0.007，I²=0％）和延迟召回（[SMD]=0.30，95％CI=0.06-0.54，P=0.013，I²=35.4％）与对照组相比，在整体认知功能立即召回方面有所改善，延迟召回，和视觉空间能力。
结果：与对照组相比，焦虑改善（标准均差[SMD]=0.36，95％CI=0.10-0.62，P=0.007，I²=43.1％）。然而,处理速度没有显著差异，注意,工作记忆或抑郁。
结论：本系统综述为通过基于VR的康复改善PwMS的认知功能和情绪提供了有价值的证据。在未来,基于VR的康复可能是治疗MS认知功能和情绪症状的潜在方法。
背景：PROSPERO；标识符：CRD42023474467。
方法：使用PubMed，Embase,Cochrane图书馆,WebofScience,和物理治疗证据数据库(PEDro)，我们进行了彻底的数据库搜索,以确定研究VR对PwMS影响的随机对照试验(RCT).截至2023年10月31日发布的试验符合我们预定的纳入和排除标准。数据被提取，文献被检查，并对纳入试验的方法学质量进行评估.StataSE版本16用于荟萃分析。
结果：我们的荟萃分析包括来自10个随机对照试验的461例患者。
方法：蒙特利尔认知评估（MoCA）（加权平均差[WMD]=1.93，95％置信区间[CI]=0.51-3.36，P=0.008，I²=75.4％）空间召回测试（SPART）（WMD=3.57，95％CI=1.65-5.50，P<0.001，I²=0％），立即召回（标准平均差[SMD]=0.37，95％CI=0.10-0.64，P=0.007，I²=0％）和延迟召回（[SMD]=0.30，95％CI=0.06-0.54，P=0.013，I²=35.4％）与对照组相比，在整体认知功能立即召回方面有所改善，延迟召回，和视觉空间能力。
结果：与对照组相比，焦虑改善（标准均差[SMD]=0.36，95％CI=0.10-0.62，P=0.007，I²=43.1％）。然而,处理速度没有显著差异，注意,工作记忆或抑郁。
结论：本系统综述为通过基于VR的康复改善PwMS的认知功能和情绪提供了有价值的证据。在未来,基于VR的康复可能是治疗MS认知功能和情绪症状的潜在方法。
背景：PROSPERO；标识符：CRD42023474467。
