Virtual reality for limb motor function, balance, gait, cognition and daily function of stroke patients: A systematic review and meta‐analysis

2021 ◽  
Author(s):  
Bohan Zhang ◽  
Dan Li ◽  
Yue Liu ◽  
Jiani Wang ◽  
Qian Xiao
Keyword(s):  
Systematic Review ◽  
Virtual Reality ◽  
Motor Function ◽  
Meta Analysis ◽  
Stroke Patients ◽  
Daily Function

scholarly journals Effects of Virtual Reality-Based Intervention on Cognition, Motor Function, Mood, and Activities of Daily Living in Patients With Chronic Stroke: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Vol 13 ◽  
Author(s):  
Yong Gao ◽  
Lu Ma ◽  
Changsheng Lin ◽  
Shizhe Zhu ◽  
Lingling Yao ◽  
...  
Keyword(s):  
Systematic Review ◽  
Virtual Reality ◽  
Activities Of Daily Living ◽  
Motor Function ◽  
Daily Living ◽  
Meta Analysis ◽  
Chronic Stroke ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Global Cognition

Background: The efficacy of virtual reality (VR)-based intervention for improving cognition in patients with the chronic stage of stroke is controversial. The aims of this meta-analysis were to evaluate the effect of VR-based training combined with traditional rehabilitation on cognition, motor function, mood, and activities of daily living (ADL) after chronic stroke.Methods: The search was performed in the Cochrane Library (CENTRAL), EBSCO, EMBASE, Medline (OVID), Web of Science databases, PubMed, CINAHL Ovid, and Scopus from inception to May 31, 2021. All included studies were randomized controlled trials (RCTs) examining VR-based intervention combined with traditional rehabilitation for chronic stroke. The main outcomes of this study were cognition, including overall cognition (combined with all cognitive measurement results), global cognition (measured by the Montreal Cognitive Assessment, MoCA, and/or Mini-Mental State Examination, MMSE), and attention/execution. The additional outcomes were motor function, mood, and ADL. Subgroup analyses were conducted to verify the potential factors for heterogeneity.Results: Six RCTs including 209 participants were included for systematic review, and five studies of 177 participants were included in meta-analyses. Main outcome analyses showed large and significant effect size (ES) of VR-based training on overall cognition (g = 0.642; 95% CI = 0.134–1.149; and P = 0.013) and attention/execution (g = 0.695; 95% CI = 0.052–1.339; and P = 0.034). Non-significant result was found for VR-based intervention on global cognition (g = 0.553; 95% CI = −0.273–1.379; and P = 0.189). Additional outcome analyses showed no superiority of VR-based intervention over traditional rehabilitation on motor function and ADL. The ES of VR-based intervention on mood (g = 1.421; 95% CI = 0.448–2.393; and P = 0.004) was large and significant. In the subgroup analysis, large effects for higher daily intensity, higher weekly frequency, or greater dose of VR intervention were found.Conclusion: Our findings indicate that VR-based intervention combined with traditional rehabilitation showed better outcomes for overall cognition, attention/execution, and depressive mood in individuals with chronic stroke. However, VR-based training combined with traditional rehabilitation showed a non-significant effect for global cognition, motor function, and ADL in individuals with chronic stroke.

scholarly journals Effect of Transcranial Direct Current Stimulation Combined with Rehabilitation on Arm and Hand Function in Stroke Patients: A Systematic Review and Meta-Analysis

Healthcare ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1705
Author(s):  
Joo-Hyun Lee ◽  
Yu-Jin Jeun ◽  
Hae Yean Park ◽  
Young-Jin Jung
Keyword(s):  
Systematic Review ◽  
Virtual Reality ◽  
Effect Size ◽  
Meta Analysis ◽  
Hand Function ◽  
Reality Therapy ◽  
Controlled Trials ◽  
Stroke Patients ◽  
Randomized Controlled ◽  
Upper Extremity Function

Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation technique that may enhance motor recovery after stroke. We performed a systematic review and meta-analysis to assess the efficacy of tDCS combined with rehabilitation on arm and hand function after stroke. Electronic databases were searched from their inception to September 2021. We performed a systematic review of selected randomized controlled trials, and methodological qualities were measured using the PEDro (Physiotherapy Evidence Database) scale. We calculated the standardized mean difference for effect size using the Comprehensive Meta-Analysis 3.0 software. We selected 28 studies for the systematic review and 20 studies for the meta-analysis. The overall effect size was 0.480 (95% CI [0.307; 0.653], p < 0.05), indicating a moderate effect size of tDCS combined with rehabilitation for upper extremity function in stroke survivors. The tDCS with occupational therapy/physical therapy (0.696; 95% CI [0.390; 1.003], p < 0.05) or virtual reality therapy (0.510; 95% CI [0.111; 0.909], p < 0.05) was also significantly more effective than other treatments. This meta-analysis of 20 randomized controlled trials provides further evidence that tDCS combined with rehabilitation, especially occupational therapy/physical therapy and virtual reality therapy, may benefit upper extremity function of the paretic upper limb in stroke patients.

scholarly journals Virtual Reality Systems for Upper Limb Motor Function Recovery in Patients With Spinal Cord Injury: Systematic Review and Meta-Analysis (Preprint)

2020 ◽  
Author(s):  
Amaranta De Miguel-Rubio ◽  
M Dolores Rubio ◽  
Alvaro Alba-Rueda ◽  
Alejandro Salazar ◽  
Jose A Moral-Munoz ◽  
...  
Keyword(s):  
Systematic Review ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Virtual Reality ◽  
Physical Therapy ◽  
Motor Function ◽  
Upper Limb ◽  
Meta Analysis ◽  
Current Evidence ◽  
Cord Injury

BACKGROUND Patients with spinal cord injury (SCI) usually present with different motor impairments, including a deterioration of upper limb motor function (ULMF), that limit their performance of activities of daily living and reduce their quality of life. Virtual reality (VR) is being used in neurological rehabilitation for the assessment and treatment of the physical impairments of this condition. OBJECTIVE A systematic review and meta-analysis was conducted to evaluate the effectiveness of VR on ULMF in patients with SCI compared with conventional physical therapy. METHODS The search was performed from October to December 2019 in Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, Medline, Physiotherapy Evidence Database (PEDro), PubMed, and Cochrane Central Register of Controlled Trials. The inclusion criteria of selected studies were as follows: (1) comprised adults with SCI, (2) included an intervention with VR, (3) compared VR intervention with conventional physical therapy, (4) reported outcomes related to ULMF, and (5) was a controlled clinical trial. The Cochrane Collaboration’s tool was used to evaluate the risk of bias. The RevMan 5.3 statistical software was used to obtain the meta-analysis according to the standardized mean difference (SMD) and 95% CIs. RESULTS Six articles were included in this systematic review. Four of them contributed information to the meta-analysis. A total of 105 subjects were analyzed. All of the studies used semi-immersive or nonimmersive VR systems. The statistical analysis showed nonsignificant results for the Nine-Hole Peg Test (SMD –0.93, 95% CI –1.95 to 0.09), muscle balance test (SMD –0.27, 95% CI –0.82 to 0.27), Motricity Index (SMD 0.16, 95% CI −0.37 to 0.68), Jebsen-Taylor Hand Function Test (JTHFT) subtests (writing, SMD –0.10, 95% CI –4.01 to 3.82; simulated page turning, SMD –0.99, 95% CI –2.01 to 0.02; simulated feeding, SMD –0.64, 95% CI –1.61 to 0.32; stacking checkers, SMD 0.99, 95% CI –0.02 to 2.00; picking up large light objects, SMD –0.42, 95% CI –1.37 to 0.54; and picking up large heavy objects, SMD 0.52, 95% CI –0.44 to 1.49), range of motion of shoulder abduction/adduction (SMD –0.23, 95% CI –1.48 to 1.03), shoulder flexion/extension (SMD 0.56, 95% CI –1.24 to 2.36), elbow flexion (SMD –0.36, 95% CI –1.14 to 0.42), elbow extension (SMD –0.21, 95% CI –0.99 to 0.57), wrist extension (SMD 1.44, 95% CI –2.19 to 5.06), and elbow supination (SMD –0.18, 95% CI –1.80 to 1.44). Favorable results were found for the JTHFT subtest picking up small common objects (SMD –1.33, 95% CI –2.42 to –0.24). CONCLUSIONS The current evidence for VR interventions to improve ULMF in patients with SCI is limited. Future studies employing immersive systems to identify the key aspects that increase the clinical impact of VR interventions are needed, as well as research to prove the benefits of the use of VR in the rehabilitation of patients with SCI in the clinical setting.

scholarly journals Game-Based Virtual Reality Interventions to Improve Upper Limb Motor Function and Quality of Life After Stroke: Systematic Review and Meta-analysis

2020 ◽  
Vol 9 (1) ◽  
pp. 1-10 ◽  
Author(s):  
Pablo Domínguez-Téllez ◽  
Jose A. Moral-Muñoz ◽  
Alejandro Salazar ◽  
Esteban Casado-Fernández ◽  
David Lucena-Antón
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Virtual Reality ◽  
Motor Function ◽  
Upper Limb ◽  
Meta Analysis

scholarly journals Virtual Reality Systems for Upper Limb Motor Function Recovery in Patients With Spinal Cord Injury: Systematic Review and Meta-Analysis

10.2196/22537 ◽  
2020 ◽  
Vol 8 (12) ◽  
pp. e22537
Author(s):  
Amaranta De Miguel-Rubio ◽  
M Dolores Rubio ◽  
Alvaro Alba-Rueda ◽  
Alejandro Salazar ◽  
Jose A Moral-Munoz ◽  
...  
Keyword(s):  
Systematic Review ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Virtual Reality ◽  
Physical Therapy ◽  
Motor Function ◽  
Upper Limb ◽  
Meta Analysis ◽  
Current Evidence ◽  
Cord Injury

Background Patients with spinal cord injury (SCI) usually present with different motor impairments, including a deterioration of upper limb motor function (ULMF), that limit their performance of activities of daily living and reduce their quality of life. Virtual reality (VR) is being used in neurological rehabilitation for the assessment and treatment of the physical impairments of this condition. Objective A systematic review and meta-analysis was conducted to evaluate the effectiveness of VR on ULMF in patients with SCI compared with conventional physical therapy. Methods The search was performed from October to December 2019 in Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, Medline, Physiotherapy Evidence Database (PEDro), PubMed, and Cochrane Central Register of Controlled Trials. The inclusion criteria of selected studies were as follows: (1) comprised adults with SCI, (2) included an intervention with VR, (3) compared VR intervention with conventional physical therapy, (4) reported outcomes related to ULMF, and (5) was a controlled clinical trial. The Cochrane Collaboration’s tool was used to evaluate the risk of bias. The RevMan 5.3 statistical software was used to obtain the meta-analysis according to the standardized mean difference (SMD) and 95% CIs. Results Six articles were included in this systematic review. Four of them contributed information to the meta-analysis. A total of 105 subjects were analyzed. All of the studies used semi-immersive or nonimmersive VR systems. The statistical analysis showed nonsignificant results for the Nine-Hole Peg Test (SMD –0.93, 95% CI –1.95 to 0.09), muscle balance test (SMD –0.27, 95% CI –0.82 to 0.27), Motricity Index (SMD 0.16, 95% CI −0.37 to 0.68), Jebsen-Taylor Hand Function Test (JTHFT) subtests (writing, SMD –0.10, 95% CI –4.01 to 3.82; simulated page turning, SMD –0.99, 95% CI –2.01 to 0.02; simulated feeding, SMD –0.64, 95% CI –1.61 to 0.32; stacking checkers, SMD 0.99, 95% CI –0.02 to 2.00; picking up large light objects, SMD –0.42, 95% CI –1.37 to 0.54; and picking up large heavy objects, SMD 0.52, 95% CI –0.44 to 1.49), range of motion of shoulder abduction/adduction (SMD –0.23, 95% CI –1.48 to 1.03), shoulder flexion/extension (SMD 0.56, 95% CI –1.24 to 2.36), elbow flexion (SMD –0.36, 95% CI –1.14 to 0.42), elbow extension (SMD –0.21, 95% CI –0.99 to 0.57), wrist extension (SMD 1.44, 95% CI –2.19 to 5.06), and elbow supination (SMD –0.18, 95% CI –1.80 to 1.44). Favorable results were found for the JTHFT subtest picking up small common objects (SMD –1.33, 95% CI –2.42 to –0.24). Conclusions The current evidence for VR interventions to improve ULMF in patients with SCI is limited. Future studies employing immersive systems to identify the key aspects that increase the clinical impact of VR interventions are needed, as well as research to prove the benefits of the use of VR in the rehabilitation of patients with SCI in the clinical setting.

scholarly journals Effectiveness of Virtual Reality in Children With Cerebral Palsy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2017 ◽  
Vol 98 (1) ◽  
pp. 63-77 ◽  
Author(s):  
Yuping Chen ◽  
HsinChen D Fanchiang ◽  
Ayanna Howard
Keyword(s):  
Systematic Review ◽  
Virtual Reality ◽  
Cerebral Palsy ◽  
Motor Function ◽  
Effect Size ◽  
Literature Search ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Children With Cerebral Palsy

Abstract Background Researchers recently investigated the effectiveness of virtual reality (VR) in helping children with cerebral palsy (CP) to improve motor function. A systematic review of randomized controlled trials (RCTs) using a meta-analytic method to examine the effectiveness of VR in children with CP was thus needed. Purpose The purpose of this study was to update the current evidence about VR by systematically examining the research literature. Data Sources A systematic literature search of PubMed, CINAHL, Cochrane Central Register of Controlled Trials, ERIC, PsycINFO, and Web of Science up to December 2016 was conducted. Study Selection Studies with an RCT design, children with CP, comparisons of VR with other interventions, and movement-related outcomes were included. Data Extraction A template was created to systematically code the demographic, methodological, and miscellaneous variables of each RCT. The Physiotherapy Evidence Database (PEDro) scale was used to evaluate the study quality. Effect size was computed and combined using meta-analysis software. Moderator analyses were also used to explain the heterogeneity of the effect sizes in all RCTs. Data Synthesis . The literature search yielded 19 RCT studies with fair to good methodological quality. Overall, VR provided a large effect size (d = 0.861) when compared with other interventions. A large effect of VR on arm function (d = 0.835) and postural control (d = 1.003) and a medium effect on ambulation (d = 0.755) were also found. Only the VR type affected the overall VR effect: an engineer-built system was more effective than a commercial system. Limitations The RCTs included in this study were of fair to good quality, had a high level of heterogeneity and small sample sizes, and used various intervention protocols. Conclusions Then compared with other interventions, VR seems to be an effective intervention for improving motor function in children with CP.

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