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

Abstract

Virtual reality (VR) is an emerging tool used in the neurological rehabilitation of patients with spinal cord injury (SCI), focused on recovering balance, mobility, and motor function, among other functional outcomes. The main objective of this study was to analyze the effectiveness of VR systems to recover balance in patients with SCI. The literature search was performed between October and December 2019 in the following databases: Embase, Web of Science, CINAHL, Scopus, Medline, Physiotherapy Evidence Database (PEDro), PubMed, and the Cochrane Central Register of Controlled Trials. The methodological quality of each study was assessed using the Spinal Cord Injury Rehabilitation Evidence (SCIRE) system and the PEDro scale, while the risk of bias was analyzed by the Cochrane Collaboration’s tool. A total of 12 studies, involving 188 participants, were included in the systematic review, of which two were included in the meta-analysis. Statistical analysis showed favorable results for balance measured by the modified Functional Reach Test (standardized mean difference (SMD) = 3.42; 95% confidence interval: 2.54 to 4.29) and by the t-shirt test (SMD= −2.29; 95% confidence interval: −3.00 to −1.59). The results showed that VR interventions provided potential benefits, in addition to conventional physical therapy, to recover balance in patients with SCI.

Do Individuals with Spinal Cord Injury Benefit from Semi-Immersive Virtual Reality Cognitive Training? Preliminary Results from an Exploratory Study on an Underestimated Problem

“…However, recent technological advances in neurorehabilitation, such as robotic devices and virtual reality (VR) systems, have been adopted to allow more intensive, repetitive, and task-oriented training, in order to achieve better outcomes [ 7 ]. Specifically, VR systems create virtual environments simulating everyday life scenarios in which patients are able to interact with different degrees of virtual immersion (i.e., non-immersive, semi-immersive, and immersive) [ 8 ]. According to a recent systematic review [ 9 ], the use of VR in the context of motor training in SCI patients can be considered a promising approach to improve sensorimotor functions, motivation, and engagement, but its effects on cognition are still unclear.…”

Improving Outcomes in People with Spinal Cord Injury: Encouraging Results from a Multidisciplinary Advanced Rehabilitation Pathway

“…Recent advances in neurorehabilitation, encompassing robotic devices and virtual reality (VR) systems, have been integrated to facilitate more intensive, repetitive, and task-oriented training for enhanced outcomes [8]. According to a systematic review [9], the application of VR in motor training for SCI patients holds promise in improving sensorimotor functions, motivation, and engagement. Specifically, VR is an advanced technology that immerses users in a simulated environment, allowing them to interact with virtual elements in an immersive and engaging way.…”

Performance of Post-Stroke Patient's Balance on a Game Platform "Game Balance" and its Correlation with Functional Tests: A Cross-Sectional Study

“…Among commercial games, the most commonly used is the Nintendo Wii (ALARCÓN-ALDANA et al, 2020; MASSETTI et al, 2018;CLARK et al, 2018;GUMAA et al, 2021). This console features a non-immersive system that uses a screen to display the environment (MIGUEL- RUBIO et al, 2020). In terms of clinical applicability, non-immersive interventions become more attractive and easy to use.…”