Gait disorders and postural instability are the leading causes of falls and
disability in Parkinson's disease (PD). Cognition plays an important role in
postural control and may interfere with gait and posture assessment and
treatment. It is important to recognize gait, posture and balance dysfunctions
by choosing proper assessment tools for PD. Patients at higher risk of falling
must be referred for rehabilitation as early as possible, because
antiparkinsonian drugs and surgery do not improve gait and posture in PD.
This systematic review examined the evidence about the effects of virtual reality (VR) on dual-task gait training in Parkinson's disease (PD). Methods: this study (PROSPERO registration CRD42019114736) aimed to answer the question: “Is VR beneficial for dual-task gait training in patients with PD?” We searched for studies from 2008 to 2018 on Medline/PubMed and Web of Science/Web of knowledge databases. The keywords were Parkinson AND gait training AND virtual reality OR Parkinson AND gait training AND game. A total of 55 articles were retrieved, of which 11 systematic reviews, 11 opinions, letters to the editor, posters or conferences abstracts and 17 studies not evaluating the effects of VR gait training were excluded. Three further studies addressing VR dual-task gait training in PD (found in references of studies selected) were also included. Therefore, 19 studies were included and analysed. Results: all studies reported gait improvement after VR training. Many clinical scales were used, hampering comparison of the effects of each protocol. Conclusion: VR dual-task gait training should be part of rehabilitation protocols for PD. The studies showed that VR training was effective, although specific guidelines have not yet been established.
Science/Web of knowledge databases. The keywords were Parkinson AND gait training AND virtual reality OR Parkinson AND gait training AND game. We found 55 articles and eliminated 11 systematic reviews, 11 opinions, letters to the editor, posters or conferences abstracts and 17 studies that did not evaluate the effects of VR gait training. Three more studies (found in the references of the selected studies) were included because they also approached VR dual-task gait training in PD. Therefore, nineteen studies were included and analysed. RESULTS: All studies reported gait improvement after VR training. Many clinical scales were used, and it was difficult to compare the effects of each protocol. CONCLUSION: VR dual-task gait training should be part of rehabilitation protocols for PD. The studies showed that VR training is effective, although specific guidelines have not been established yet.
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