虛擬實境運動介入對衰弱老人提升下肢肌力和行走速度之成效：系統性文獻回顧和統合分析

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題名:	虛擬實境運動介入對衰弱老人提升下肢肌力和行走速度之成效：系統性文獻回顧和統合分析 Effectiveness of Virtual Reality Exercises Intervention on Improving Lower Extremity Muscle Strength and Gait Speed in Older Adults with Frailty Syndrome：A Systematic Review and Meta-Analysis
作者:	李月華 LEE, YUEH-HUA
貢獻者:	護理學系碩士班黃惠娟
關鍵詞:	衰弱老人;虛擬實境;統合分析;下肢肌力;行走速度 frailty elderly;virtual reality;meta-analysis;lower extremity muscle strength;gait speed
日期:	2021-12-24
上傳時間:	2022-08-18 10:57:23 (UTC+8)
摘要:	目的：探討虛擬實境運動介入對提升衰弱老人下肢肌力及行走速度之成效方法：本研究採用系統性文獻回顧和統合分析，總共搜尋6個電子資源資料庫包括：PubMed、CINAHL、Cochrane、Embase、Chinese Electronic Periodical Service、Chinese National Knowledge Infrastructure，關鍵字搜尋為衰弱前期或衰弱老人、虛擬實境，沒有任何日期、語言限制，採用Comprehensive Meta-Analysis 2.0統合分析軟體進行資料整理與分析，以隨機效果模型進行總和效果量估計，針對異質性分析使用I2統計值及Cochran Q值進行檢定，出版偏差採用Begg’s test檢定法、Egger’s test檢定法以及刪除填補法(Trim and fill)。結果：下肢肌力共納入8篇隨機控制試驗研究，9個效果量，隨機效果模型結果顯示，虛擬實境運動可增加衰弱老人下肢肌力Hedges' g=0.26(95% confidence interval 0.04~0.47，p=.018)；行走速度共納入7篇隨機控制試驗研究，7個效果量，Hedges' g=0.18(95% confidence interval 0.01~0.34，p=.031)，顯示接受虛擬實境運動對衰弱老人行走速度具改善成效；次群組分析發現，採用雙腿伸屈測量下肢肌力的研究，與採用坐、站測試的研究相比，更有效增加下肢肌力(Hedges' g=0.69，p=.002 vs. Hedges' g=0.12，p=.167)，兩組效果量達顯著差異（p=.016）；Begg’s test、Egger’s test和刪除填補法(Trim and fill)皆顯示下肢肌力有出版偏差，行走速度Begg’s test無出版偏差，Egger’s test和刪除填補法(Trim and fill)皆顯示有出版偏差。結論：虛擬實境運動對提升衰弱老人下肢肌力和行走速度具改善成效，然而，下肢肌力和行走速度或許具有出版偏差效應，未來仍需要更多隨機控制研究進一步確認虛擬實境運動能對衰弱老人族群下肢肌力和行走速度之改善成效。 Objective: To examine the effectiveness of virtual reality exercise intervention on improving lower extremity muscle strength and gait speed in older adults with frailty syndrome Methods: Six electronic databases including PubMed, CINAHL, Cochrane, Embase, Chinese Electronic Periodical Service, and Chinese National Knowledge Infrastructure were used to search eligible studies. Comprehensive Meta-Analysis 2.0 software was used to organize and analyze the data. A random-effects model was used to demonstrate the overall effect size, and the I2 statistic and Cochran Q test were performed to examine the heterogeneity among the included studies. The publication bias was determined by Begg's test, Egger's test, and trim and fill method. Results: In total, 8 randomized controlled trial studies with 9 effect sizes was used to identify the effect of virtual reality exercise intervention on improving lower limb muscle strength. The random-effect model showed that virtual reality exercise increased lower limb muscle strength (Hedges's g=0.26, 95% confidence interval 0.04-0.47). Regarding gait speed, 7 studies and 7 effect sizes indicated that virtual reality exercise can improve gait speed (Hedges's g=0.18, 95% confidence interval 0.01~0.34). Subgroup analysis found that studies using methods of isometric leg flexion and extension muscle strength measurements were more effective in increasing lower limb muscle strength compared to studies using sitting and standing tests (Hedges's g=0.69 vs. Hedges's g=0.12, p=.016). Begg's test, Egger's test and the Trim and fill method all showed published bias in lower limb muscle strength, while Begg's test showed no publication bias in gait speed and Egger's test and Trim and fill all showed publication bias. Conclusions: Virtual reality exercises could be considered as an effective intervention in improving lower limb muscle strength and gait speed in frail old population. More randomized controlled studies are needed to further confirm the effectiveness of virtual reality exercise on lower extremity muscle strength and gait speed in the frail old population.
描述:	碩士指導教授:黃惠娟委員:林玨赫委員:邱曉彥委員:黃惠娟
資料類型:	thesis
顯示於類別:	[護理學系] 博碩士論文

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