5种智能康复技术对脑卒中上肢功能障碍患者上肢功能及日常生活能力影响的网状Meta分析  

Network Meta-analysis of the effects of five intelligent rehabilitation technologies on the upper limb function and activities of daily living of stroke patients with upper limb dysfunction

作　　者：曹倩倩 曾莉[2] 毛赛璐 李启鸿 张欣宇 宋洁芳 Cao Qianqian;Zeng Li;Mao Sailu;Li Qihong;Zhang Xinyu;Song Jiefang(School of Medicine,Tongji University,Shanghai 200092,China;Department of Nursing,Tongji Hospital of Tongji University,Shanghai 200065,China;Neurosurgical Intensive Care Unit,Shanghai Tenth People's Hospital&Tenth People's Hospital of Tongji University,Shanghai 200072,China;Department of Neurosurgery,Tongji Hospital of Tongji University,Shanghai 200065,China)

机构地区：[1]同济大学医学院,上海200092 [2]同济大学附属同济医院护理部,上海200065 [3]同济大学附属上海市第十人民医院神经重症监护室,上海200072 [4]同济大学附属同济医院神经外科,上海200065

出　　处：《中华现代护理杂志》2025年第10期1329-1337,共9页Chinese Journal of Modern Nursing

基　　金：国家自然科学基金(72004162);上海申康医院发展中心医企融合创新支撑技能培训专项(SHDC2023CRS007);上海市残疾人联合会康复政策研究专项(2023ZC1005)。

摘　　要：目的本研究旨在探索沉浸式虚拟现实(imVR)、不完全沉浸式虚拟现实(Nf-imVR)、增强现实、脑机接口、康复机器人(RT)5种不同的智能康复技术对脑卒中上肢功能障碍患者上肢功能与日常生活能力的干预效果。方法计算机检索PubMed、Web of Science、Embase、Cochrane Library、中国知网、万方数据库中不同智能康复技术对脑卒中上肢功能障碍患者干预效果的RCT,并辅以手工等其他检索方式,检索时限均为建库至2024年5月31日。提取数据并进行方法学质量评价,运用Stata 17.0软件进行网状Meta分析。结果共纳入34篇文献,共1926例患者,包含5种智能康复技术,对照组均为剂量匹配的常规物理训练。网状Meta分析结果显示,与剂量匹配的常规物理训练相比,在提高上肢功能方面,脑机接口技术效果最佳,其余依次为imVR、RT、Nf-imVR、增强现实;在提高日常生活能力方面,脑机接口技术效果依旧最佳,其余依次为imVR、RT、增强现实、Nf-imVR。上肢功能与日常生活能力的聚类排序依次为脑机接口>imVR>RT>Nf-imVR>增强现实。结论智能康复技术在改善脑卒中上肢功能障碍患者的上肢功能及日常生活能力具有优势,并且脑机接口技术的优势明显。Objective This study aims to explore the intervention effects of five different intelligent rehabilitation technologies,namely immersive virtual reality(imVR),non-fully immersive virtual reality(Nf-imVR),augmented reality,brain-computer interface(BCI),and rehabilitation robot(RT),on the upper limb function and activities of daily living of stroke patients with upper limb dysfunction.Methods A computer-based search was conducted in PubMed,Web of Science,Embase,Cochrane Library,China National Knowledge Infrastructure,and Wanfang Databases for randomized controlled trials(RCT)on the intervention effects of different intelligent rehabilitation technologies on stroke patients with upper limb dysfunction.Manual search and other retrieval methods were also supplemented.The retrieval time limit was from the establishment of the databases to May 31,2024.Data were extracted and the methodological quality was evaluated,and a network Meta-analysis was performed using Stata 17.0 software.Results A total of 34 articals were included,involving 1926 patients,and the studies included five intelligent rehabilitation technologies.The control groups all received dose-matched conventional physical training.The results of the network Meta-analysis showed that,compared with the dose-matched conventional physical training,in terms of improving upper limb function,the BCI had the best effect,followed by imVR,RT,Nf-imVR,and augmented reality in sequence;in terms of improving activities of daily living,the BCI still had the best effect,followed by imVR,RT,augmented reality,and Nf-imVR in sequence.The clustering ranking of upper limb function and activities of daily living was BCI>imVR>RT>Nf-imVR>augmented reality in turn.Conclusions Intelligent rehabilitation technologies have advantages in improving the upper limb function and activities of daily living of stroke patients with upper limb dysfunction,and the BCI has obvious advantages.

关 键 词：卒中 虚拟现实 增强现实 脑机接口 康复机器人 

分 类 号：R47[医药卫生—护理学]