机器人联合虚拟现实对脑卒中病人运动功能和日常生活活动能力影响的Meta分析  

Effect of robot combined virtual reality on motor function and daily living ability of stroke patients:a Meta-analysis

作　　者：王颖俏 张亚敏[2] 李维苹 程斐然 裴菊红 豆欣蔓 王兴蕾[1,2] WANG Yingqiao;ZHANG Yamin;LI Weiping;CHENG Feiran;PEI Juhong;DOU Xinman;WANG Xinglei(School of Nursing,Lanzhou University,Gansu 730011 China)

机构地区：[1]兰州大学护理学院,甘肃730011 [2]兰州大学第二医院

出　　处：《循证护理》2024年第2期239-245,共7页Chinese Evidence-Based Nursing

基　　金：兰州大学第二医院“萃英科技创新”计划项目,编号:CY2020-HL01;甘肃省高等学校青年博士基金项目,编号:2022QB-008。

摘　　要：目的:通过Meta分析综合评价机器人联合虚拟现实训练对提高脑卒中病人运动功能和日常生活活动能力的效果,为机器人联合虚拟现实训练在临床康复中的应用提供决策依据。方法:计算机检索PubMed,Web of Science,the Cochrane Library,EMbase,中国知网、万方数据库、维普数据库、中国生物医学文献数据库中关于康复机器人联合虚拟现实对脑卒中病人运动功能和自理能力影响的随机对照试验,检索时限为建库至2022年10月。由2名研究员独立筛选评价文献并提取资料后,使用Review Manager 5.3软件进行Meta分析。结果:共纳入15项随机对照试验,涉及677例病人。Meta分析结果显示,相较于传统康复训练和单独机器人训练,机器人联合虚拟现实训练对脑卒中病人下肢运动[MD=3.52,95%CI(0.96,6.08),P=0.007]、改良Barthel指数[MD=6.67,95%CI(3.61,9.73),P<0.0001]和功能独立性测量得分[MD=5.91,95%CI(0.29,11.53),P=0.04]的改善效果较好,差异有统计学意义。两组上肢运动功能比较,差异无统计学意义[MD=3.40,95%CI(-1.62,8.43),P=0.18]。结论:现有证据表明,机器人联合虚拟现实训练可改善脑卒中病人的运动功能,提高日常生活活动能力,但其对上肢运动功能的改善效果还需进一步研究。Objective:To comprehensively evaluate the effect of robot combined virtual reality training on improving motor function and daily living ability of stroke patients through Meta-analysis,and to provide decision-making basis for the application of robot combined virtual reality training in clinical rehabilitation.Methods:Randomized controlled trials on the effects of rehabilitation robot combined with virtual reality on motor function and self-care ability of stroke patients were collected from PubMed,Web of Science,the Cochrane Library,EMbase,CNKI,WanFang Database,VIP,CBM.The search deadline was from database establishment to October 2022.After two researchers independently screened and evaluated the literature and extracted data,Review Manager 5.3 software was used for Meta-analysis.Result:A total of 15 randomized controlled trials were included,involving 677 patients.The Meta-analysis results showed that compared to traditional rehabilitation training and individual robot training,robot combined virtual reality training had better improvement effects on lower limb movement(MD=3.52,95%CI 0.96-6.08,P=0.007),improved Barthel index(MD=6.67,95%CI 3.61-9.73,P<0.0001),and functional independence measurement scores(MD=5.91,95%CI 0.29-11.53,P=0.04)in stroke patients,with statistically significant differences.There was no significant difference in upper limb motor function between the two groups(MD=3.40,95%CI-1.62-8.43,P=0.18).Conclusion:The existing evidence shows that robot combined virtual reality training can improve the motor function and enhance the ability of daily living in stroke patients,but its effect on the improvement of upper limb motor function needs further study.

关 键 词：脑卒中 虚拟现实 机器人 META分析 循证护理 

分 类 号：R743.3[医药卫生—神经病学与精神病学]