Is Virtual Reality Effective in Orthopedic Rehabilitation? A Systematic Review and Meta-Analysis

物理疗法 医学 荟萃分析 康复 骨科手术 奇纳 心理干预 梅德林 物理医学与康复 外科 内科学 政治学 精神科 法学
作者
Mohammed Gumaa,Aliaa Rehan Youssef
出处
期刊:Physical therapy [Oxford University Press]
卷期号:99 (10): 1304-1325 被引量:119
标识
DOI:10.1093/ptj/pzz093
摘要

Virtual reality (VR) is an interactive technology that allows customized treatment and may help in delivering effective person-centered rehabilitation.The purpose of this review was to systematically review and critically appraise the controlled clinical trials that investigated VR effectiveness in orthopedic rehabilitation.Pubmed, CINAHL, Embase, PEDro, REHABDATA, and Sage publications were searched up to September 2018. In addition, manual searching and snowballing using Scopus and Web of Science were done.Two reviewers screened studies for eligibility first by title and abstract and then full text.Articles were categorized into general or region-specific (upper limbs, lower limbs, and spine) orthopedic disorders. Study quality was assessed using the Evaluation Guidelines for Rating the Quality of an Intervention Study scoring. Meta-analysis quantified VR effectiveness, compared with no treatment, in back pain.Nineteen studies were included in the quality assessment. The majority of the studies were of moderate quality. Fourteen studies showed that VR did not differ compared with exercises. Compared with the no-treatment control, 5 studies favored VR and 3 other studies showed no differences. For low back pain, the meta-analysis revealed no significant difference between VR and no-treatment control (n = 116; standardized mean difference = -0.21; 95% confidence interval = -0.58 to 0.15).Limitations included heterogeneity in interventions and the outcome measures of reviewed studies. Only articles in English were included.The evidence of VR effectiveness is promising in chronic neck pain and shoulder impingement syndrome. VR and exercises have similar effects in rheumatoid arthritis, knee arthritis, ankle instability, and post-anterior cruciate reconstruction. For fibromyalgia and back pain, as well as after knee arthroplasty, the evidence of VR effectiveness compared with exercise is absent or inconclusive.

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