Abstract:

Objective To evaluate the effect of virtual reality（VR） technology on the rehabilitation of language function in patients with post-stroke aphasia（PSA） and to compare the effect differences between this method and conventional measures，in order to provide evidence for a more standardized and effective clinical application of VR technology. Methods 9 electronic databases，such as PubMed，CINAHL etc.，and clinical trials registry platforms were searched for randomized controlled trials about VR-based language training for PSA from inception until March 2022. There were 2 researchers who independently screened the literature，evaluated the quality and extracted information. Meta-analysis was implemented with Review Manager 5.4 software. Grades of recommendations assessment，development and evaluation（GRADE） were used for evidence quality rating. Results 9 studies involving 311 patients were included. Meta-analysis showed as following.（1）VR-based language training could increase spontaneous speech[SMD=0.88，95%CI（0.57，1.20），P<0.001]，naming[SMD=0.60，95%CI（0.30，0.90），P=0.001]，listening comprehension[SMD=0.81，95%CI（0.40，1.22），P=0.001]，retelling [SMD=0.55，95%CI（0.30，0.80），P<0.001] and the effectiveness of treatment[RR=1.43，95%CI（1.06，1.95），P=0.020] of PSA patients. （2）The effect of VR-based language training on aphasia severity is unclear[SMD=0.70，95%CI（0.01，1.39），P=0.050]. Conclusion The VR-based language training can provide positive influences on language function in patients with PSA，with significant improvement effects on spontaneous speech，naming，listening comprehension，and retelling. VR-based language training can improve the effectiveness of treatment，but the intervention effect on aphasia severity is unclear. Due to limited quantity and heterogeneity of the results，high quality randomized controlled trials are still needed to further verify the effect of VR-based language training on language function in patients with PSA.

Key words: Virtual Reality, Language Training, Post-Stroke Aphasia, Language Function, Rehabilitation Nursing, Meta-analysis

摘要：

目的 评价虚拟现实（virtual reality，VR）技术对卒中后失语（post-stroke aphasia，PSA）患者语言功能的康复疗效，比较该方法与常规语言康复训练的疗效差异，为临床更规范有效地应用VR技术提供证据。方法 检索PubMed、CINAHL等9个数据库及临床试验注册平台中关于VR语言训练治疗PSA的随机对照试验，检索时限为建库至2022年3月。由2名研究者独立筛选文献，评价文献质量及提取信息。采用RevMan 5.4软件进行Meta分析，并采用推荐分级的评价、制订与评估（grades of recommendations assessment，development and evaluation，GRADE）系统进行证据质量评级。结果 共纳入9篇文献，包括311例患者。Meta分析结果显示：VR语言训练能提高PSA患者的自发言语能力[SMD=0.88，95%CI（0.57，1.20），P<0.001]，命名能力[SMD=0.60，95%CI（0.30，0.90），P=0.001]，听理解能力[SMD=0.81，95%CI（0.40，1.22），P=0.001]，复述能力[SMD=0.55，95%CI（0.30，0.80），P<0.001]，PSA治疗有效率[RR=1.43，95%CI（1.06，1.95），P=0.020]，但在失语严重程度[SMD=0.70，95%CI（0.01，1.39），P=0.050]方面的干预效果尚不明确。结论 VR语言训练有助于改善PSA患者的语言功能，对改善自发言语、命名、听理解、复述能力均有效，并能提高PSA治疗有效率，但对失语严重程度的干预效果尚不明确。由于总体样本量较小及结果存在异质性，仍需开展高质量随机对照试验，进一步验证VR语言训练对PSA患者语言功能的疗效。

关键词: 虚拟现实, 语言训练, 卒中后失语, 语言功能, 康复护理, Meta分析