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

Abstract

Stroke is the main cause of disability in adulthood. Recent advances in virtual reality (VR) technologies have led to its increased use in the rehabilitation of stroke patients. A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to determine the effectiveness of game-based reality on upper limb (UL) motor function and quality of life after stroke. In March 2018, a search of the following databases was performed: PubMed, PEDro, Web of Science, Scopus, The Cochrane Library, and Medline at EBSCO. The selection criteria were all RCTs published in English or Spanish during the past 10 years. The PEDro scale was used to evaluate the methodological quality of the studies. A total of 20 clinical trials were included in the systemic review, of which 15 contributed information to the meta-analysis. Favorable results were found for VR interventions on UL motor function (Fugl-Meyer Assessment for upper extremity, standardized mean difference [SMD] = 1.53, 95% CI [0.51-2.54]) and quality of life (functional independence measure, SMD = 0.77, 95% CI [0.05-1.49]). The results demonstrate the potential benefits of VR interventions on the recovery of UL motor function and on quality of life after stroke.

Effectiveness of Virtual Reality on Functional Performance after Spinal Cord Injury: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…Although VR-based systems could provide many advantages in neurorehabilitation, such as offering precise measurement, increasing motivation, providing direct feedback and safe environments [ 12 , 40 ], the results obtained in our study revealed that VR interventions might not be more effective than CPT in improving functional performance in patients with SCI. Moreover, the statistical analysis showed favorable results of CPT on the functional independence measured by the FIM scale.…”

Leap Motion Controller Video Game-Based Therapy for Upper Extremity Motor Recovery in Patients with Central Nervous System Diseases. A Systematic Review with Meta-Analysis

“…To date, different studies have analyzed the validity [49], feasibility [50], and usability [32] of LMC for use in neurorehabilitation. Several RCTs have assessed the effect of immersive or non-immersive VR on UE motor function recovery [51][52][53], and consequently, some reviews have been carried out [54][55][56]. However, the use of LMC as a VR tool in UE neurorehabilitation has been less studied [57,58].…”

Is Virtual Reality Effective for Balance Recovery in Patients with Spinal Cord Injury? A Systematic Review and Meta-Analysis

“…Concerning the VR devices used, despite all the studies performing VR interventions through semi-immersive or non-immersive systems, where a computer or videogame console displays the virtual environments through screens [ 49 ], all of them got positive effects on balance recovery. Regarding the participant’s characteristics, there is heterogeneity in terms of the injury severity (measured by ASIA scale) and the levels of injury.…”

“…It should be emphasized that the positive results obtained in the present review could have an impact in clinical neurorehabilitation, since patients with SCI usually present severe limitations on their participation and performance of the activities of daily living [ 1 , 20 ]. Furthermore, the inclusion of VR interventions in clinical practice could generate more patient motivation and treatment adherence [ 24 ], performance of different activities in virtual safe environments [ 49 ], and provision of feedback and task-oriented training [ 6 ].…”