Systematic review of the application of virtual reality to improve balance, gait and motor function in patients with Parkinson’s disease

Abstract

Background: Virtual reality (VR) is an advanced technique used in physical rehabilitation of neurological disorders, however the effects of VR on balance, gait, and motor function in people with Parkinson's (PD) are still debated. Therefore, the systematic review aimed to determine the role of VR on motor function, balance and gait in PD patients.Methods: A comprehensive search to identify similar randomised controlled trials was conducted targeting 5 databases including Web of Science, PubMed, CINHAL, Cochrane Library, and Physiotherapy Evidence Database. A total of 25 studies were found eligible for this systematic review, and the methodological assessment of the quality rating of the studies was accomplished using the physiotherapy evidence database scale by 2 authors.Results: Out of the 25 included studies, 14 studies reported on balance as the primary outcome, 9 studies were conducted to assess motor function, and 12 assessed gait as the primary outcome. Most studies used the Unified Parkinson disease rating scale UPDRS (part-III) for evaluating motor function and the Berg Balance Scale as primary outcome measure for assessing balance. A total of 24 trials were conducted in clinical settings, and only 1 study was home-based VR trainings. Out of 9 studies on motor function, 6 reported equal improvement of motor function as compared to other groups. In addition, VR groups also revealed superior results in improving static balance among patient with PD.Conclusion: This systemic review found that the use of VR resulted in substantial improvements in balance, gait, and motor skills in patients with PD when compared to traditional physical therapy exercises or in combination with treatments other than physical therapy. Moreover, VR can be used as a supportive method for physical rehabilitation in patients of PD. However, the majority of published studies were of fair and good quality, suggesting a demand for high quality research in this area.

Machine Learning and Eye Movements Give Insights into Neurodegenerative Disease Mechanisms

“…Moreover, Mandera [ 72 ] shared the opinion that virtual reality can be a supportive therapy for patients with MCI and various forms of dementia to improve adherence to cognitive training of older adults with cognitive impairment. This opinion is coherent with the outcome of the meta-analysis prepared by Kashif et al [ 73 ]. Out of nine studies on motor function, six reported equal improvements in motor function compared to other groups.…”

Machine Learning and Eye Movements Give Insights into Neurodegenerative Disease Mechanisms

“…Moreover, Mandera [72] shared the opinion that Virtual Reality can be a supportive therapy for patients with MCI and various forms of dementia to improve adherence to cognitive training of older adults with cognitive impairment. This opinion is coherent with the outcome of the meta-analysis prepared by Kashif et al [86]. Out of 9 studies on motor function, 6 reported equal improvement of motor function as compared to other groups.…”

Assisted technology in Parkinson's disease gait: what's up?

“…42 Some studies used VR to interact three-dimensional virtual environment. 4,25,[43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58] We also found studies using Robotic-assisted gait training for PD. 24,29,[59][60][61][62] We analyzed several types of AP and categorized them into commercial and non-commercial devices available for research, rehabilitation, or home-based care.…”

“…52 Finally, VR rehabilitation should be offered to PD patients as a supplementary approach to existing proven and safe interventions until further and more robust evidence is available. 50,51,53,57 Hence, large trials with good methodologic designs are necessary with a focus on comparing the efficacy of VRbased rehabilitation with conventional treatments and or new emerging technologies.…”