The use of virtual reality in the rehabilitation of aphasia: a systematic review

This systematic review explored how virtual reality (VR) has been used to rehabilitate aphasia. Empirical studies were included where VR was used to target language, well-being, or quality of life in adults with acquired language impairment. Degenerative communication disabilities were excluded. Seven health databases were searched in October 2021. Risk of Bias was assessed using published checklists and completeness of intervention reporting evaluated. Narrative synthesis described forms of VR, rationales given, outcome measures, communication functions targeted, characteristics of interventions, and outcomes achieved within the framework of impairment, activity, and participation. Fourteen studies, involving 229 participants, met the criteria. The studies employed four forms of VR with various rationales given. Interventions used published and novel protocols. Primary outcomes targeted language impairment (12/14), activity (1/14), and well-being (1/14) and achieved positive outcomes in impairment and activity. All studies were exploratory. Risk of bias was high. Findings are discussed in the context of gains achieved by VR in other health contexts and the multi-user gaming literature. Uses of VR in aphasia rehabilitation described in the literature are limited. Most applications target the remediation of language impairments. Opportunities to address activity, participation, and wider aspects of well-being are rare.IMPLICATIONS FOR REHABILITATIONResearch documenting the use of virtual reality (VR) to rehabilitate aphasia is limited and exploratory, so does not yet offer clear guidance for clinicians.Many of the identified studies have used known published protocols (e.g., naming therapy or scripts therapy) delivered through the novel VR format and focus on language impairment outcomes.VR offers clinicians a unique opportunity to address communication activity and participation through the use of multi-user virtual worlds, but this has only been explored by only two research teams. Research documenting the use of virtual reality (VR) to rehabilitate aphasia is limited and exploratory, so does not yet offer clear guidance for clinicians. Many of the identified studies have used known published protocols (e.g., naming therapy or scripts therapy) delivered through the novel VR format and focus on language impairment outcomes. VR offers clinicians a unique opportunity to address communication activity and participation through the use of multi-user virtual worlds, but this has only been explored by only two research teams.

本系统综述探讨了虚拟现实（Virtual Reality, VR）在失语症康复中的应用场景。本研究纳入了针对获得性语言障碍成人开展虚拟现实干预，以改善其语言能力、心理健康或生活质量的实证研究，排除退行性沟通障碍相关研究。2021年10月，研究团队检索了7个健康领域数据库，采用已发表的偏倚风险（Risk of Bias）清单评估研究偏倚风险，并对干预报告的完整性进行评价。本研究采用叙述性综合方法，基于损伤、活动与参与框架，梳理了虚拟现实的应用形式、干预依据、结局指标、靶向沟通功能、干预特征及已达成的研究结局。最终共有14项符合标准的研究被纳入，涉及229名受试者。这些研究采用了4种虚拟现实形式，并附带各类干预依据，同时使用了已发表及原创的干预方案。研究的主要结局靶向语言损伤（12/14）、活动能力（1/14）与心理健康（1/14），并在语言损伤与活动能力层面取得了积极结局。所有纳入研究均为探索性研究，偏倚风险较高。本研究结合虚拟现实在其他健康领域的应用成果及多用户游戏相关文献对研究结果进行了讨论。现有文献中，虚拟现实用于失语症康复的场景十分有限，多数应用均聚焦于语言损伤的康复训练。针对活动能力、参与度及更广泛心理健康维度的康复应用则较为罕见。
康复启示：目前记录虚拟现实用于失语症康复的研究数量有限且均为探索性研究，因此尚未能为临床医师提供明确的实践指导。多数纳入研究所采用的是通过新型虚拟现实载体交付的成熟已发表干预方案（例如命名治疗或语句治疗），且主要关注语言损伤相关结局。虚拟现实可为临床医师提供独特的契机，通过多用户虚拟世界开展沟通活动与参与度相关康复，但目前仅有两个研究团队对该方向进行了探索。 目前记录虚拟现实用于失语症康复的研究数量有限且均为探索性研究，因此尚未能为临床医师提供明确的实践指导。多数纳入研究所采用的是通过新型虚拟现实载体交付的成熟已发表干预方案（例如命名治疗或语句治疗），且主要关注语言损伤相关结局。虚拟现实可为临床医师提供独特的契机，通过多用户虚拟世界开展沟通活动与参与度相关康复，但目前仅有两个研究团队对该方向进行了探索。