Dropout Rate of Participants in Randomized Clinical Trials That Use Virtual Reality to Train Balance and Gait in Parkinson’s Disease. A Systematic Review With Meta-analysis and Meta-regression

Parra, Artimes García; González-Medina, Gloria; Pérez-Cabezas, Verónica; Casuso-Holgado, María Jesús; Vinolo-Gil, María Jesús; García-Muñoz, Cristina

doi:10.1007/s10916-023-01930-7

Cited by 2 publications

(2 citation statements)

References 28 publications

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“…Therefore, the future research agenda should analyze the efficacy of telerehabilitation in more severely affected patients and increase the panel typology of treatments delivered remotely for complete physical and cognitive telerehabilitation in patients with chronic neurological diseases. Furthermore, the observed dropout rate (slightly more than 10%) was higher than the estimated a priori dropout rate (about 5%), approximately expected in these two neurological populations after virtual reality clinical trials as reported from recent metanalyses [86,87]. In these metanalyses, the typical reasons for dropout were difficulties in reaching the research center, refusal to participate, personal or familial issues, loss of data due to administrative problems, exacerbation of symptoms or other medical complications [86].…”

Section: Discussionmentioning

confidence: 68%

Non-Immersive Virtual Reality Telerehabilitation System Improves Postural Balance in People with Chronic Neurological Diseases

Goffredo

Pagliari

Turolla

et al. 2023

JCM

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Background: People with chronic neurological diseases, such as Parkinson’s Disease (PD) and Multiple Sclerosis (MS), often present postural disorders and a high risk of falling. When difficulties in achieving outpatient rehabilitation services occur, a solution to guarantee the continuity of care may be telerehabilitation. This study intends to expand the scope of our previously published research on the impact of telerehabilitation on quality of life in an MS sample, testing the impact of this type of intervention in a larger sample of neurological patients also including PD individuals on postural balance. Methods: We included 60 participants with MS and 72 with PD. All enrolled subjects were randomized into two groups: 65 in the intervention group and 67 in the control group. Both treatments lasted 30–40 sessions (5 days/week, 6–8 weeks). Motor, cognitive, and participation outcomes were registered before and after the treatments. Results: All participants improved the outcomes at the end of the treatments. The study’s primary outcome (Mini-BESTest) registered a greater significant improvement in the telerehabilitation group than in the control group. Conclusions: Our results demonstrated that non-immersive virtual reality telerehabilitation is well tolerated and positively affects static and dynamic balance and gait in people with PD and MS.

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Section: Discussionmentioning

confidence: 68%

Non-Immersive Virtual Reality Telerehabilitation System Improves Postural Balance in People with Chronic Neurological Diseases

Goffredo

Pagliari

Turolla

et al. 2023

JCM

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“…However, its efficacy for motor function, participation in life, and quality of life was controversial. Chan et al [59] reported that VR training was more effective than traditional rehabilitation training in improving balance function (standardized mean difference [SMD] 0.22, 95% CI 0.01-0.42; P=.04) and mobility (mean difference −1.95, 95% CI −2.81 to -1.08; P<.01), while a study by Parra et al [79] showed that no statistical differences were found in balance and gait between patients with Parkinson disease in the VR group and those in the control group (odds ratio 0.83, 95% CI 0.62-1.12). The differences between meta-analyses were probably the result of the different heterogeneous populations or the interventions being used at different points in the disease course.…”

Section: Vr In Neuronursingmentioning

confidence: 99%

Virtual Reality in Clinical Nursing Practice Over the Past 10 Years: Umbrella Review of Meta-Analyses

Hu,

Yuan,

et al. 2023

JMIR Serious Games

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Background Virtual reality (VR) has shown promising levels of effectiveness in nursing education, pain management, and rehabilitation. However, meta-analyses have discussed the effects of VR usage in nursing unilaterally and inconsistently, and the evidence base is diffuse and varied. Objective We aimed to synthesize the combined evidence from meta-analyses that assessed the effects of nurses using VR technology on nursing education or patient health outcomes. Methods We conducted an umbrella review by searching for meta-analyses about VR intervention in clinical nursing practice on Web of Science, Embase, Cochrane, and PubMed, and in reference lists. Eligible studies were published in English between December 1, 2012, and September 20, 2023. Meta-analyses of ≤2 intervention studies and meta-analyses without 95% CI or heterogeneity data were excluded. Characteristic indicators, population information, VR intervention information, and 95% CIs were extracted. A descriptive analysis of research results was conducted to discern relationships between VR interventions and outcomes. I2 and P values were used to evaluate publication bias. AMSTAR (A Measurement Tool to Assess Systematic Reviews) 2 and the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) checklist were used to appraise literature quality. Results In total, 768 records were identified; 74 meta-analyses were included for review. The most reported VR study conditions were neuronursing (25/74, 34%), pediatric nursing (13/74, 18%), surgical and wound care (11/74, 15%), oncological nursing (11/74, 15%), and older adult nursing (10/74, 14%). Further, 30% (22/74) of meta-analyses reported publication bias, and 15% (11/74) and 8% (6/74) were rated as “high” based on AMSTAR 2 and the GRADE checklist, respectively. The main outcome indicators among all included meta-analyses were pain (37/214, 17.3%), anxiety (36/214, 16.8%), cognitive function (17/214, 7.9%), balance (16/214, 7.5%), depression (16/214, 7.5%), motor function (12/214, 5.6%), and participation in life (12/214, 5.6%). VR treatment for cognition, pain, anxiety, and depression was effective (all P values were <.05), while the utility of VR for improving motor function, balance, memory, and attention was controversial. Adverse effects included nausea, vomiting, and dizziness (incidence: range 4.76%-50%). The most common VR platforms were Pico VR glasses, head-mounted displays, the Nintendo Wii, and the Xbox Kinect. VR intervention duration ranged from 2 weeks to 12 months (typically ≥4 wk). VR session length and frequency ranged from 5 to 100 minutes and from 1 to 10 times per week, respectively. Conclusions VR in nursing has positive effects—relieving patients’ pain, anxiety, and depression and improving cognitive function—despite the included studies’ limited quality. However, applying VR in nursing to improve patients’ motor function, balance, memory, and attention remains controversial. Nursing researchers need to further explore the effects and standard operation protocols of VR in clinical practice, and more high-quality research on VR in nursing is needed.

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Dropout Rate of Participants in Randomized Clinical Trials That Use Virtual Reality to Train Balance and Gait in Parkinson’s Disease. A Systematic Review With Meta-analysis and Meta-regression

Cited by 2 publications

References 28 publications

Non-Immersive Virtual Reality Telerehabilitation System Improves Postural Balance in People with Chronic Neurological Diseases

Non-Immersive Virtual Reality Telerehabilitation System Improves Postural Balance in People with Chronic Neurological Diseases

Virtual Reality in Clinical Nursing Practice Over the Past 10 Years: Umbrella Review of Meta-Analyses

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