虚拟现实及类虚拟现实技术用于脑震荡相关前庭和眼动功能障碍的评估与康复：一项系统综述。

文献信息

中文摘要

背景： 脑震荡后的前庭和眼动功能障碍可能导致持续性头晕、失衡、视觉运动敏感性和功能受限。虚拟现实（VR）及类VR技术被用于评估和康复，但其应用、设备和结局仍存在异质性。本综述评估了VR及类VR技术用于脑震荡相关前庭和眼动功能障碍的情况。
方法： 遵循PRISMA 2020和PROSPERO注册，检索了CENTRAL、MEDLINE、PsycINFO、PubMed和Scopus，从建库至2026年3月21日。在1,197条记录中，去重后剩余997条；评估了55篇全文，纳入10项研究。两名评价者独立筛选研究并提取数据。由于异质性，采用叙述性方法综合结果。
结果： 一项研究评估了基于VR的康复，九项研究检查了评估、验证或症状诱发。康复结局在常规治疗、基于VR的治疗和混合治疗组中均有改善，但VR并未一致显示优越性。评估研究表明，标准化视觉运动环境可能揭示静态测试中不明显的姿势、感觉整合或症状诱发反应。然而，结果因技术、恢复阶段、任务和结局而异。眼动追踪显示出较差的诊断区分能力，视觉扰动并未一致地证明脑震荡相关损害。
结论： VR可能作为标准化、可重复、生态相关评估和康复的有用辅助手段，但证据不支持单独使用或优于常规治疗。

英文摘要

BACKGROUND: Vestibular and oculomotor dysfunction after concussion may cause persistent dizziness, imbalance, visual motion sensitivity, and functional limitation. Virtual reality (VR) and technologies are used for assessment and rehabilitation, but applications, devices, and outcomes remain heterogeneous. This review evaluated VR and VR-like technologies for concussion-related vestibular and oculomotor dysfunction.
METHODS: Following PRISMA 2020 and PROSPERO registration, CENTRAL, MEDLINE, PsycINFO, PubMed, and Scopus were searched from inception to 21 March 2026. Of 1,197 records, 997 remained after deduplication; 55 full texts were assessed and 10 studies included. Two reviewers independently screened studies and extracted data. Owing to heterogeneity, findings were synthesized narratively.
RESULTS: One study evaluated VR-based rehabilitation and nine examined assessment, validation, or symptom provocation. Rehabilitation outcomes improved across conventional, VR-based, and hybrid therapy groups, without consistent superiority of VR. Assessment studies suggested that standardized visual-motion environments may reveal postural, sensory-integration, or symptom-provocation responses not evident during static testing. However, findings varied by technology, recovery stage, task, and outcome. Eye-tracking showed poor diagnostic discrimination, and visual perturbation did not consistently demonstrate concussion-related impairment.
CONCLUSION: VR may be a useful adjunct for standardized, repeatable, ecologically relevant assessment and rehabilitation, but evidence does not support stand-alone use or superiority over conventional therapy.