Virtual Reality for Pediatric Traumatic Brain Injury Rehabilitation: A Systematic Review

Abstract

Objective. Pediatric traumatic brain injury (TBI) is associated with physical and psychobehavioral impairment in children. Effective rehabilitation programs postinjury are critical for children with TBI. Virtual reality (VR) has been increasingly adopted for brain injury rehabilitation. However, scientific synthesis is lacking in evaluating its effectiveness in pediatric TBI rehabilitation. This article aimed to conduct a systematic review on the effectiveness of VR-based pediatric TBI rehabilitation. Methods. A systematic literature search was conducted in PubMed, PsycInfo, SCOPUS, CENTRAL, BioMed Central, CiNAHL, and Web of Science through November 2015. Personal libraries and relevant references supplemented the search. Two authors independently reviewed the abstracts and/or full text of 5824 articles. Data extraction and qualitative synthesis was conducted along with quantitative assessment of research quality by 2 authors. Results. A positive impact was found for VR-based interventions on children’s physical rehabilitation post-TBI. The quality of research evidence was moderate, which largely suffered from small samples, lack of immersive VR experience, and lack of focus on socioemotional outcomes post-TBI. Conclusions. The present review identified positive effects of VR interventions for pediatric TBI rehabilitation especially in physical outcomes. Future research should include larger samples and broader post-TBI outcomes in children using VR-based interventions.

Virtual Reality–Based Executive Function Rehabilitation System for Children With Traumatic Brain Injury: Design and Usability Study

“…Leveraging VR for the rehabilitation of cognitive and motor functions for children after a traumatic brain injury (TBI) is an active field of research and development [ 4 - 6 ]. TBI often disrupts the normal function of the brain of a child and is the leading cause of death and acquired disability in children, with an estimated 700,000 pediatric TBI cases annually in the United States [ 7 , 8 ].…”

“…Most traditional rehabilitation exercises involve repetitive, task-oriented training, which patients with TBI have reported to be boring, leading to poor adherence [ 9 , 10 ]. VR may provide a more engaging and cost-effective alternative or supplement to the traditional rehabilitation program [ 4 - 6 ].…”

“…Current therapeutic VR applications for pediatric TBI mostly focus on physical rehabilitation and include games that assist patients in regaining balance, increasing extremity strength, and practicing real-life tasks in low-risk environments [ 5 , 11 - 13 ]. Our systematic review of the use of VR in pediatric TBI rehabilitation found only 3 studies meeting the review criteria, and all of them focused on the positive effects of VR on physical rehabilitation [ 6 ]. However, it is promising to learn that VR’s efficacy in cognitive rehabilitation in adults with TBI has turned out positive.…”

Available Virtual Reality-Based Tools for Executive Functions: A Systematic Review

“…Shen et al developed VR-based cognitive training for EFs rehabilitation among children with TBI (Shen et al, 2020a , b ). The VR system included three VR games for training three main EFs: inhibitory control (game 1), working memory (game 2), and cognitive flexibility (game 3).…”

“…This innovative mechanical support system allowed for using this training in sitting and reclining positions; therefore, users could experience VR in a chair or hospital bed. Interestingly, the authors chose a PC-tethered system that allowed using a separate interface for the therapist, in which they could enter user information, chose the training module, customised training by setting the number of trials and monitored VR training progress (Shen et al, 2020a , b ).…”