Use of virtual reality-based training in different fields of rehabilitation: A systematic review and meta-analysis
Sebastan Rutkowski, Pawel Kiper, Luisa Cacciante, Błażej Cieślik, Justyna Mazurek, Andrea Turolla, Joanna Szczepańska-Gieracha
Department of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland.
Objectives: To analyse the effectiveness of virtual reality-based interventions within several fields of rehabilitation, and to investigate whether the outcomes of virtual reality-based interventions, in terms of upper or lower limb function, gait and balance, differ with respect to the virtual reality system used. Methods: A search of PubMed database resulted in an initial total of 481 records. Of these, 27 articles were included in the study. A final total of 20 articles, with neurological, orthoapedic, geriatric or paediatric patients, published between 2012 and 2019, were included in the study. Two independent reviewers selected potentially relevant articles based on the inclusion criteria for full-text reading. They extracted data, and evaluated the methodological quality of each study. Results: Seventeen studies were included in the meta¬ -analysis. Eight studies analysed upper limb function, with no significant evidence that specialized VR is superior to conventional treatment. Regarding FuglMeyer scale results, the effect of specialized virtual reality therapy was found to be significantly better than conventional treatment. No significant differences between specialized VR and conventional treatment were observed in effects on hand dexterity and gait. There was a significant difference in effects on balance in favour of specialized virtual reality as compared to conventional treatment. Gaming virtual reality was significantly better than conventional treatment for upper limb function, but not for hand dexterity, gait and balance. Conclusion: Use of specialized virtual reality and gaming virtual reality can be advantageous for treatment of the upper extremity, but not for hand dexterity and gait in all pathologies considered. Specialized virtual reality can improve balance in neurological patients.
Virtual reality is an innovative technology consisting of interaction between a user and a computer that involves real-time simulation. The objectives of this review were to analyse the effectiveness of virtual reality interventions within several fields of rehabilitation, and to investigate whether the outcomes differ with respect to the type of virtual reality system used. From an initial search of the literature, 481 records were retrieved. Of these, 20 articles were selected for qualitative analysis. Two independent reviewers selected relevant studies based on the inclusion criteria. Furthermore, 17 studies were included for meta-analysis (i.e. quantitative analysis). The results showed that upper limb function can improve with the use of both specialized and gaming virtual reality. Balance disorders improved with specialized virtual reality, but not with gaming virtual reality. However, no improvements were evident in hand dexterity or gait for either specialized or gaming virtual reality. In conclusion, interventions using specialized and gaming virtual reality can be advantageous for upper extremity, but not for hand dexterity and gait. Specialized virtual reality can improve balance.
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