背景:虚拟现实(VR)是一种计算机技术,可使用户沉浸在完全不同的现实中。VR在急性疼痛设置中的应用已经确立。然而,在慢性疼痛中,受VR影响的应用和结果参数不太清楚。
目的:本综述旨在系统地确定慢性疼痛患者与VR相关的所有结果参数。
方法:总共4个电子数据库(PubMed,Scopus,WebofScience,和Embase)进行了相关研究。进行了多水平随机效应荟萃分析,由此选择标准化的平均差作为效应大小,以表示VR干预之前和之后的测量之间的差异。
结果:最初的数据库搜索确定了1430项研究,其中41人(2.87%)最终纳入系统评价。已经发现VR对疼痛有影响的证据,功能,移动性,功能能力,心理结果,生活质量,神经心理学结果,和身体的感觉。基于三水平荟萃分析的总体效应大小(来自25项研究的总共194个效应大小)估计为1.22(95%CI0.55-1.89;z=3.56;P<.001),支持VR干预后的改进。对效果大小进行分类时,总体效应大小报告如下:1.60(95%CI0.83-2.36;z=4.09;P<.001)VR对疼痛的影响(n=31),1.40(95%CI0.13-2.67;z=2.17;P=0.03)功能(n=60),0.49(95%CI-0.71至1.68;z=0.80;P=.42)的流动性(n=24),功能容量(n=21)为0.34(95%CI-1.52至2.20;z=0.36;P=0.72)。
结论:本系统综述揭示了受VR技术干预影响的广泛结果变量,具有统计学意义的疼痛缓解和功能改善。这些发现表明,VR不仅适用于急性疼痛管理,还适用于慢性疼痛设置。因此,VR可能能够成为有希望的一线干预作为慢性疼痛患者的补充治疗。
背景:PROSPERO国际系统评价前瞻性注册CRD42021227016;https://www.crd.约克。AC.uk/prospro/display_record.php?RecordID=227016。
BACKGROUND: Virtual reality (VR) is a computer technology that immerses a user in a completely different reality. The application of VR in acute pain settings is well established. However, in chronic pain, the applications and outcome parameters influenced by VR are less clear.
OBJECTIVE: This
review aimed to systematically identify all outcome parameters that are reported in relation to VR in patients with chronic pain.
METHODS: A total of 4 electronic databases (PubMed, Scopus, Web of Science, and Embase) were searched for relevant studies. Multilevel random-effect meta-analyses were performed, whereby the standardized mean difference was chosen as the effect size to denote the difference between measurements before and after a VR intervention.
RESULTS: The initial database search identified 1430 studies, of which 41 (2.87%) were eventually included in the systematic
review. Evidence has been found for the effects of VR on pain, functioning, mobility, functional capacity, psychological outcomes, quality of life, neuropsychological outcomes, and physical sensations. The overall effect size (a total of 194 effect sizes from 25 studies) based on a three level meta-analysis was estimated at 1.22 (95% CI 0.55-1.89; z=3.56; P<.001), in favor of improvements after a VR intervention. When categorizing effect sizes, the overall effect sizes were reported as follows: 1.60 (95% CI 0.83-2.36; z=4.09; P<.001) for the effect of VR on pain (n=31), 1.40 (95% CI 0.13-2.67; z=2.17; P=.03) for functioning (n=60), 0.49 (95% CI -0.71 to 1.68; z=0.80; P=.42) for mobility (n=24), and 0.34 (95% CI -1.52 to 2.20; z=0.36; P=.72) for functional capacity (n=21).
CONCLUSIONS: This systematic
review revealed a broad range of outcome variables influenced by an intervention of VR technology, with statistically significant pain relief and improvements in functioning. These findings indicate that VR not only has applications in acute pain management but also in chronic pain settings, whereby VR might be able to become a promising first-line intervention as complementary therapy for patients with chronic pain.
BACKGROUND: PROSPERO International Prospective Register of Systematic Reviews CRD42021227016; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=227016.