虚拟现实运动训练对老年人步态性能影响的Meta分析  

Effectiveness of virtual reality exercise training on gait performance in older adults:a Meta-analysis

作　　者：梁玉麟 张欢[1] 朱明月 李峥[1] Liang Yulin;Zhang Huan;Zhu Mingyue;Li Zheng(School of Nursing,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100144,China)

机构地区：[1]中国医学科学院北京协和医学院护理学院,北京100144

出　　处：《中华现代护理杂志》2025年第13期1773-1782,共10页Chinese Journal of Modern Nursing

基　　金：国家自然科学基金(72374215)。

摘　　要：目的系统评价虚拟现实运动训练对老年人步态性能的影响。方法计算机检索PubMed、Embase、Cochrane Library、Web of Science、中国知网、万方数据库、维普网和中国生物医学文献数据库中有关虚拟现实运动训练对老年人步态性能康复效果的随机对照试验,检索时限为建库至2025年1月10日。采用Cochrane随机对照试验偏倚风险评价工具RoB 2对纳入文献进行方法学质量评价,使用RevMan 5.4软件进行Meta分析。结果共纳入27篇文献。Meta分析结果显示,虚拟现实运动训练改善老年人功能性步行能力的效果优于传统运动(WMD=-0.83,95%置信区间:-1.31~-0.36,P<0.01)。然而,虚拟现实运动训练对改善老年人的步速、步幅、步频和动态步态参数方面效果不明显(P>0.05)。亚组分析结果显示,每周干预时长≥120 min时,虚拟现实运动训练改善老年人步速的效果优于传统运动(SMD=0.48,95%置信区间:0.04~0.92,P=0.03)。结论虚拟现实运动训练能够有效提升老年人的步行能力,但在改善精细化步态相关指标方面无优势。未来建议采用虚拟现实运动训练联合传统运动康复的形式对老年人进行干预。Objective To systematically evaluate the effect of virtual reality exercise training on gait performance in older adults.Methods Randomized controlled trials on the rehabilitation effects of virtual reality exercise training on gait performance in older adults were electronically searched in PubMed,Embase,Cochrane Library,Web of Science,China National Knowledge Infrastructure,Wanfang Data,VIP,and China Biology Medicine disc.The search period was from establishing of the database to January 10,2025.Version 2 of the Cochrane risk of bias tool for randomized trials(RoB 2)was used to evaluate the methodological quality of the included literature.Meta-analysis was performed using RevMan 5.4.Results A total of 27 articles were included.Meta-analysis showed that the effect of virtual reality exercise on improving the functional walking ability of older adults was better than traditional exercise[WMD=-0.83,95%CI(-1.31,-0.36),P<0.01].However,virtual reality exercise did not improve step speed,stride length,step frequency,and dynamic gait indices in older adults(P>0.05).Subgroup analysis showed that virtual reality exercise was more effective than traditional exercise in improving step speed in older adults when the length of the weekly intervention was≥120 min[SMD=0.48,95%CI(0.04,0.92),P=0.03].Conclusions Virtual reality exercise training effectively improves walking ability in older adults but has no advantage in improving refined gait-related indicators.Future interventions in the form of virtual reality exercise training combined with traditional exercise rehabilitation are recommended for older adults.

关 键 词：老年人 虚拟现实 运动 步态 META分析 

分 类 号：R493[医药卫生—康复医学]