Virtual reality exposure therapy for neuro-psychomotor recovery in adults: a systematic review

To analyse the virtual reality applications in the subjects’ neuro-psychomotor functions rehabilitation with motor and/or neuropsychiatric impairment. The search was carried out in nine databases (Scopus, PubMed, Web of Science, ScienceDirect, Cochrane Library, CINAHL, PsycINFO, LILACS, and SciELO), from December 2017 to March 2019. An additional manual search was performed, taking into consideration references of the included papers, through the same eligibility criteria. The methodological quality of the included papers was evaluated using the Physiotherapy Evidence Database (PEDro). One hundred and twenty-two papers were selected by the initial screening, but only 33 studies participated in the final inclusion in the study (11 clinical trials and 14 experimental studies). The data extracted were: the proposed objective, the sample population, the neurological condition treated, the VR modality used in the procedures and the study intervention period. Virtual reality supports the rehabilitation process of neuro-psychomotor functions, allowing potential gains in the patients’ recovery. Therefore, its development facilitates its availability and access in the future.Implications for rehabilitationIt has minimal adverse effects during the virtual therapies performance, such as the presence of vertigo related to cybersickness conditions, suggesting virtual reality as a safe rehabilitation tool, compared to other therapies.Virtual reality use is useful and effective in helping the rehabilitation process of motor, cognitive and psychosocial functions.It plays a role as an adjunctive and complementary therapy in the neuro-psychomotor rehabilitation process to obtain a clinically significant result. It has minimal adverse effects during the virtual therapies performance, such as the presence of vertigo related to cybersickness conditions, suggesting virtual reality as a safe rehabilitation tool, compared to other therapies. Virtual reality use is useful and effective in helping the rehabilitation process of motor, cognitive and psychosocial functions. It plays a role as an adjunctive and complementary therapy in the neuro-psychomotor rehabilitation process to obtain a clinically significant result.

本研究旨在分析虚拟现实（Virtual Reality, VR）在伴运动和/或神经精神障碍受试者的神经心理运动功能康复中的应用。研究检索范围涵盖9个数据库，包括Scopus、PubMed、Web of Science、ScienceDirect、Cochrane Library、CINAHL、PsycINFO、LILACS及SciELO，检索时限为2017年12月至2019年3月。此外，本研究依据相同的纳入排除标准，对纳入文献的参考文献开展了手动补充检索。
采用物理治疗证据数据库（Physiotherapy Evidence Database, PEDro）对纳入文献的方法学质量进行评价。初步筛查共获得122篇文献，最终纳入33项研究，其中包含11项临床试验与14项实验研究。
本研究提取的研究资料包括：拟定研究目标、研究样本人群、所治疗的神经系统病症类型、干预过程中使用的虚拟现实干预方式，以及研究干预周期。
研究结果表明，虚拟现实可支持神经心理运动功能的康复进程，助力患者实现潜在的康复获益。因此，该技术的发展有助于未来提升其可及性与应用普及率。

康复应用启示：
虚拟现实治疗过程中不良反应发生率极低，仅存在与数字晕动症（cybersickness）相关的眩晕症状，相较于其他康复治疗手段，虚拟现实可被视为一种安全的康复工具。
虚拟现实的应用可有效辅助运动、认知与社会心理功能的康复进程，具备良好的实用性与有效性。
其可作为神经心理运动康复过程中的辅助与补充疗法，以获得具有临床意义的康复效果。