背景:患有感音神经性听力损失(SNHL)的儿童和青少年经常经历运动技能障碍,特别是在平衡和步态方面,由于内耳损伤导致的潜在前庭功能障碍。因此,一些研究提出将基于虚拟现实的游戏用作治疗目的的技术资源,旨在改善该人群的平衡和步态。
目的:本系统评价的目的是评估随机或准随机对照试验的证据质量,这些试验采用基于虚拟现实的游戏来增强SNHL儿童和青少年的平衡和/或步态。
方法:对9个数据库进行了全面搜索,包括在2023年7月1日前以任何语言发表的文章。采用以下纳入标准:随机或准随机对照试验,包括两组临床诊断为双侧SNHL的志愿者,6-19岁,缺乏身体,认知,或前庭功能障碍以外的神经功能缺损,并利用基于虚拟现实的游戏作为干预来改善平衡和/或步态结果。
结果:最初,通过搜索共发现5984篇文章。在删除副本并筛选标题和摘要之后,八项研究仍有待完整阅读,其中3项试验符合本系统评价的资格标准.纳入的试验显示,关于平衡结果的证据质量非常低,没有一个试验评估步态。荟萃分析未显示SNHL青少年使用传统平衡练习和基于虚拟现实的游戏之间平衡改善的显着差异(效果大小:-0.48;[CI:-1.54至0.57];p=0.37;I2=0%)。
结论:基于虚拟现实的游戏有望成为一种潜在的技术,可用于恢复SNHL儿童和青少年的平衡。然而,鉴于试验方法学上的局限性以及目前有关该主题的证据质量总体较低,在解释本系统评价中分析的试验结果时,应谨慎行事。
BACKGROUND: Children and adolescents with sensorineural hearing loss (SNHL) often experience motor skill disturbances, particularly in balance and gait, due to potential vestibular dysfunctions resulting from inner ear damage. Consequently, several studies have proposed the use of virtual reality-based games as a technological resource for therapeutic purposes, aiming to improve the balance and gait of this population.
OBJECTIVE: The objective of this systematic review is to evaluate the quality of evidence derived from randomized or quasi-randomized controlled trials that employed virtual reality-based games to enhance the balance and/or gait of children and adolescents with SNHL.
METHODS: A comprehensive search was conducted across nine databases, encompassing articles published in any language until 1 July 2023. The following inclusion criteria were applied: randomized or quasi-randomized controlled trials involving volunteers from both groups with a clinical diagnosis of bilateral SNHL, aged 6-19 years, devoid of physical, cognitive, or neurological deficits other than vestibular dysfunction, and utilizing virtual reality-based games as an intervention to improve balance and/or gait outcomes.
RESULTS: Initially, a total of 5984 articles were identified through the searches. Following the removal of duplicates and screening of titles and abstracts, eight studies remained for full reading, out of which three trials met the eligibility criteria for this systematic review. The included trials exhibited a very low quality of evidence concerning the balance outcome, and none of the trials evaluated gait. The meta-analysis did not reveal significant differences in balance improvement between the use of traditional balance exercises and virtual reality-based games for adolescents with SNHL (effect size: -0.48; [CI: -1.54 to 0.57]; p = 0.37; I2 = 0%).
CONCLUSIONS: Virtual reality-based games show promise as a potential technology to be included among the therapeutic options for rehabilitating the balance of children and adolescents with SNHL. However, given the methodological limitations of the trials and the overall low quality of evidence currently available on this topic, caution should be exercised when interpreting the results of the trials analyzed in this systematic review.