Abstract:

Objective To re-evaluate systematic reviews on the application of virtual reality（VR） technology in limb rehabilitation for stroke patients，providing evidence to support the implementation of VR. Methods Systematic searches were conducted in Web of Science，PubMed，CINAHL，Cochrane Library，Embase，CNKI，CBM，WanFang，and VIP databases from their inception until March 2025，identifying systematic reviews/meta-analyses investigating VR for limb rehabilitation in stroke patients. 2 researchers independently screened the literature. Methodological quality was evaluated using the Assessment of Mutiple System Reviews 2（AMSTAR 2） tool；reporting quality was evaluated according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses（PRISMA） guidelines；evidence quality was graded using the Grades of Recommendations Assessment，Development，and Evaluation（GRADE） system；literature overlap was assessed using the Corrected Covered Area（CCA） method. Results A total of 15 articles were included. According to AMSTAR 2，totally 3 reviews were of moderate quality，while the remainder were rated as low or very low quality. PRISMA scores ranged from 19.5 to 27.0 points. Based on GRADE，a review was classified as high quality，6 as moderate quality，and the remainder as low or very low quality. The CCA was 5.3%，indicating slight overlap. Conclusion VR contributes to the improvement of indicators such as upper limb motor function/mobility and lower limb balance in stroke patients. However，methodological limitations，including weak control of bias and inadequate handling of heterogeneity among included studies，restrict the overall quality of evidence. Further standardized，high-quality studies are needed to provide more reliable evidence to support clinical decision-making.

Key words: Stroke, Virtual Reality, Limb Rehabilitation, Overview of Systematic Reviews, Evidence-Based Nursing

摘要：

目的 对虚拟现实技术在脑卒中患者肢体康复中应用的系统评价进行再评价，为开展虚拟现实技术干预提供证据支持。方法 系统检索Web of Science、PubMed、CINAHL、Cochrane Library、Embase、中国知网、中国生物医学文献数据库、万方数据库和维普数据库中关于虚拟现实技术在脑卒中肢体康复中应用的系统评价/Meta分析，检索时限为建库至2025年3月。由2名研究者独立筛选文献，采用系统评价方法学质量评价工具2进行文献质量评价，采用系统评价/Meta分析报告规范进行报告质量评价，应用推荐分级的评估、制订与评价系统对证据进行汇总与分级，运用校正覆盖面积法评估文献重叠度。结果 共纳入15篇文献，3篇为中等质量，其余为低或极低质量。系统评价/Meta分析报告规范得分为19.5~27.0分。推荐分级的评估、制订与评价系统结果显示，1条为高等质量，6条为中等质量，其余均为低或极低质量。文献重叠度为5.3%，为轻度重叠。结论 虚拟现实技术有助于改善脑卒中患者的上肢运动功能/活动能力、下肢平衡功能等指标，受纳入研究偏倚控制薄弱、异质性处理不足等方法学质量缺陷的限制，仍需规范地开展高质量研究为临床决策提供更可靠的证据支持。

关键词: 脑卒中, 虚拟现实, 肢体康复, 系统评价再评价, 循证护理学