CAJ | 학술논문

　　目的系统评价虚拟现实技术对脑卒中患者上下肢运动功能康复的效果。方法计算机检索PubMed、Cochrane Cen-tral Register of Controlled Trials、中国知网、维普、万方数据库中关于虚拟现实技术改善脑卒中患者运动功能障碍的随机对照试验。搜索时限从建库至2013年1月。按照Cochrane系统评价员手册推荐方法逐一评价纳入研究的质量，提取有效数据，对符合质量要求的文献数据采用RevMan 5.0软件对最终纳入文献数据进行统计学分析。结果最终纳入20篇文献，其中上肢运动功能相关13篇，下肢运动功能相关7篇。Meta分析结果显示，虚拟现实技术疗法对Fugl-Meyer评定法(FMA)上肢部分(WMD=4.27,95%CI：2.47~6.06, Z=4.67, P<0.00001)及盒子和阻碍物测试(BBT)(WMD=9.29,95%CI：5.24~13.34, Z=4.50, P<0.00001)与常规康复治疗比较，其差异均有统计学意义。而Berg平衡量表(BBS)(WMD=1.63,95%CI：-0.83~4.09, Z=1.30, P=0.20)和步行速度(WMD=0.01,95%CI：-0.14~0.17, Z=0.18, P=0.86)与常规康复治疗比较，其差异无统计学意义。纳入文献质量的Jadad评分，低质量16篇，高质量4篇。结论虚拟现实技术能明显改善脑卒中后患者上肢运动功能，但对于脑卒中患者下肢运动功能的恢复无明显疗效。
　　목적계통평개허의현실기술대뇌졸중환자상하지운동공능강복적효과。방법계산궤검색PubMed、Cochrane Cen-tral Register of Controlled Trials、중국지망、유보、만방수거고중관우허의현실기술개선뇌졸중환자운동공능장애적수궤대조시험。수색시한종건고지2013년1월。안조Cochrane계통평개원수책추천방법축일평개납입연구적질량，제취유효수거，대부합질량요구적문헌수거채용RevMan 5.0연건대최종납입문헌수거진행통계학분석。결과최종납입20편문헌，기중상지운동공능상관13편，하지운동공능상관7편。Meta분석결과현시，허의현실기술요법대Fugl-Meyer평정법(FMA)상지부분(WMD=4.27,95%CI：2.47~6.06, Z=4.67, P<0.00001)급합자화조애물측시(BBT)(WMD=9.29,95%CI：5.24~13.34, Z=4.50, P<0.00001)여상규강복치료비교，기차이균유통계학의의。이Berg평형량표(BBS)(WMD=1.63,95%CI：-0.83~4.09, Z=1.30, P=0.20)화보행속도(WMD=0.01,95%CI：-0.14~0.17, Z=0.18, P=0.86)여상규강복치료비교，기차이무통계학의의。납입문헌질량적Jadad평분，저질량16편，고질량4편。결론허의현실기술능명현개선뇌졸중후환자상지운동공능，단대우뇌졸중환자하지운동공능적회복무명현료효。
Objective To evaluate the effect of virtual reality on motor function in patients with stroke. Methods PubMed, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure (CNKI), VIP Database for Chinese Technical Periodicals and Wanfang Data were searched for the randomized controlled trials (RCTs) of virtual reality on motor function in patients with stroke from the date of establishment to January 2013. The included studies were evaluated according to the method recommended by the Co-chrane Collaboration. RevMan 5.0 software was used to analyze the extracted data. Results 20 trials were included (13 trials about the upper extremity function and 7 trials about the lower extremity function). Compared with conventional training, the virtual reality training signifi-cantly increased the score of Fugl-Meyer assessment (FMA) (WMD=4.27, 95%CI:2.47~6.06, Z=4.67, P<0.00001) and Box and Block Test (BBT) (WMD=9.29, 95%CI: 5.24~13.34, Z=4.50, P<0.00001). However, the results of Berg balance scale (BBS) (WMD=1.63, 95%CI:-0.83~4.09, Z=1.30, P=0.20) and walking speed (WMD=0.01, 95%CI:-0.14~0.17, Z=0.18, P=0.86) were not statistically significance for the lower extremity function. According to the Jadad Score of included studies, 16 of them were of low quality and only 4 of them were of high quality. Conclusion The virtual reality training could improve the upper extremity function in patients with stroke, but not for the lower extremity function.