中国组织工程研究

中国组织工程研究 ›› 2026, Vol. 30 ›› Issue (24): 6365-6372.doi: 10.12307/2026.167

• 组织构建循证医学 evidence-based medicine in tissue construction • 上一篇    下一篇

不同虚拟现实设备治疗脑卒中上肢运动功能障碍的网状Meta分析

聂  越1，宋淑华1，赵胜挺2，董杨洋1，杨柄鑫3   

  1. 1云南师范大学体育学院，云南省昆明市   650500；2昆明同仁医院康复医学科，云南省昆明市   650033；3云南新兴职业学院，云南省昆明市   650217
  • 收稿日期:2025-04-08 修回日期:2026-08-06 出版日期:2026-08-28 发布日期:2026-02-04
  • 通讯作者: 赵胜挺，副主任技师，昆明同仁医院康复医学科，云南省昆明市 650033
  • 作者简介:聂越，女，2000年生，云南省昭通市人，汉族，云南师范大学体育学院在读硕士。
  • 基金资助:

    云南省教育厅科学研究基金项目(2023J2138)，项目负责人：杨柄鑫

Network meta-analysis of different virtual reality devices for treating upper limb motor dysfunction after stroke

Nie Yue1, Song Shuhua1, Zhao Shengting2, Dong Yangyang1, Yang Bingxin3   

  1. 1School of Physical Education, Yunnan Normal University, Kunming 650500, Yunnan Province, China; 2Department of Rehabilitation Medicine, Kunming Tongren Hospital, Kunming 650033, Yunnan Province, China; 3Yunnan Xinxing Occupations Institute, Kunming 650217, Yunnan Province, China
  • Received:2025-04-08 Revised:2026-08-06 Online:2026-08-28 Published:2026-02-04
  • Contact: Zhao Shengting, Associate chief technician, Department of Rehabilitation Medicine, Kunming Tongren Hospital, Kunming 650033, Yunnan Province, China
  • About author:Nie Yue, MS candidate, School of Physical Education, Yunnan Normal University, Kunming 650500, Yunnan Province, China
  • Supported by:
    Scientific Research Fund Project of Yunnan Department of Education, No. 2023J2138 (to YBX)

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摘要：


文题释义：
虚拟现实：又称为临境技术，是通过仿真技术、多媒体技术、传感技术等多学科技术融合并以计算机为平台创建出多源信息融合的、交互式的三维立体环境，从而给用户带来身临其境的体验。
上肢运动功能：‌是指上肢通过骨骼、肌肉和关节的协调运动实现的各种动作能力，主要功能包括运动、抓握、感觉、保护、平衡和社交功能。

目的：脑卒中后上肢功能障碍是常见的并发症，严重影响患者的生活质量和日常活动能力。虚拟现实技术作为一种新兴的康复手段，能够有效促进神经重塑和功能恢复。此次研究系统评价不同虚拟现实设备对脑卒中患者上肢运动功能障碍的疗效。
方法：对中国知网、万方数据库、维普网、PubMed、Web of Science、Embase、Cochrane Library数据库进行检索。筛选所获文献，提取相关数据并进行质量评价工作。纳入研究对照组为常规康复治疗，试验组在对照组基础上进行虚拟现实康复训练。利用RevMan 5.4和Stata 18.0软件进行数据分析。
结果：①最终纳入12篇文献，571例患者；②Meta分析结果显示，虚拟现实组上肢Fugl-Meyer量表得分是常规组的7.29倍(MD=7.29，95%CI：5.60-8.98，P < 0.05)；虚拟现实组上肢动作研究量表得分是常规组的10.69倍(MD=10.69，95%CI：4.96-16.43，P < 0.05)；虚拟现实组改良Barthel指数得分是常规组的8.25倍(MD=8.25，95%CI：3.38-13.12，P < 0.05)；③亚组分析结果显示，50-59岁的患者在提高上肢
Fugl-Meyer量表评分方面效果更佳；病程为3个月以内的患者在提高上肢Fugl-Meyer量表评分方面更佳；干预周期≥4周时，上肢Fugl-Meyer量表评分提升效果最佳；④网状Meta分析显示，智能手套干预[MD=-1.05，95%CI(-1.85，-0.24)，P < 0.05]对上肢运动功能的改善最有效；Armeo Spring干预[MD=-1.19，95%CI(-1.87，-0.51)，P < 0.05]对上肢动作能力的改善最有效；Kinect干预[MD=-0.59，95%CI(-1.13，-0.06)，P < 0.05]对手部灵巧度的改善最有效；VREX干预[MD=-0.76，95%CI(-1.28，-0.23)，P < 0.05]对日常生活活动能力的改善最有效。
结论：改善上肢运动功能时首选智能手套系统；改善上肢协调能力时首选Armeo Spring系统；改善手部灵巧度时首选Kinect系统；改善日常生活活动能力时首选VREX系统。此次研究具有一定局限性，上述结论需理性参考。
https://orcid.org/0009-0004-4054-232X (聂越) 


中国组织工程研究杂志出版内容重点：干细胞；骨髓干细胞；造血干细胞；脂肪干细胞；肿瘤干细胞；胚胎干细胞；脐带脐血干细胞；干细胞诱导；干细胞分化；组织工程

关键词: 虚拟现实设备, 日常生活能力, 上肢协调能力, 个体差异, 系统评价

Abstract: OBJECTIVE: Upper limb dysfunction after stroke is a common complication that seriously affects the quality of life and daily activity of patients. Virtual reality technology, as an emerging rehabilitation method, can effectively promote neural remodeling and functional recovery. This study will systematically evaluate the therapeutic effects of different virtual reality devices on upper limb motor dysfunction in patients with stroke.
METHODS: The China National Knowledge Infrastructure (CNKI), WanFang Database, VIP website, PubMed, Web of Science, Embase, and the Cochrane Library were searched to retrieve relevant literature. Relevant data were extracted, and their quality was assessed. The control group received conventional rehabilitation treatment, while the experimental group received virtual reality rehabilitation training in addition to the treatment provided to the control group. Statistical analysis was performed using RevMan 5.4 and Stata 18.0 software.
RESULTS: (1) A total of 12 articles and 571 patients were included in the final analysis. (2) Meta-analysis results showed that the Fugl-Meyer Assessment-Upper Extremity score of the experimental group was 7.29 times higher than that of the control group [mean difference (MD) = 7.29, 95% confidence interval (CI) 5.60–8.98, P < 0.05]. The Action Research Arm Test score of the experimental group was 10.69 times higher than that of the control group (MD = 10.69, 95% CI 4.96–16.43, P < 0.05). Additionally, the Modified Barthel Index score of the experimental group was 8.25 times higher than that of the control group (MD = 8.25, 95% CI 3.38–13.12, P < 0.05). (3) The subgroup analysis results showed that patients aged 50-59 years had better improvements in Fugl-Meyer Assessment-Upper Extremity score. Patients with a disease duration of less than 3 months also showed greater improvements in Fugl-Meyer Assessment-Upper Extremity score. Furthermore, when the intervention period was ≥ 4 weeks, the improvement in Fugl-Meyer Assessment-Upper Extremity score was the most significant. (4) Network meta-analysis demonstrated that the smart glove intervention [MD = -1.05, 95% CI (-1.85, -0.24), P < 0.05] was the most effective for improving upper limb motor function. The Armeo Spring intervention [MD = -1.19, 95% CI (-1.87, -0.51), P < 0.05] was the most effective for enhancing upper limb coordination, while the Kinect intervention [MD = -0.59, 95% CI (-1.13, -0.06), P < 0.05] was most effective for improving hand dexterity. The VREX intervention [MD = -0.76, 95% CI (-1.28, -0.23), P < 0.05] was the most effective for improving activities of daily living. 
CONCLUSION: The smart glove system is the preferred choice for improving upper limb motor function. The Armeo Spring system is the preferred choice for enhancing upper limb coordination. The Kinect system is the preferred choice for improving hand dexterity. The VREX system is the preferred choice for enhancing daily living activities. This study has certain limitations, and the conclusions drawn should be considered as rational references.


Key words: virtual reality devices, daily living ability, upper limb coordination ability, individual differences, system evaluation

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