Virtual Reality Intervention to Help Improve Motor Function in Patients Undergoing Rehabilitation for Cerebral Palsy, Parkinson’s Disease, or Stroke: A Systematic Review of Randomized Controlled Trials

Abstract

There are many successful interventions in medicine, especially in neurology and rehabilitation. The neurosciences represent an area of medicine with tremendous recent research innovations, one of which is virtual reality. This paper aims to discover the powerful relationship between virtual reality and rehabilitation. We assessed the effectiveness of virtual reality-based rehabilitation compared to conventional rehabilitation on motor function recovery of three patient groups: patients with a diagnosis of cerebral palsy, Parkinson's disease, or stroke. We conducted a systematic review using PubMed and included only articles that were randomized controlled trials that were published in the last five years. We used a general search in combination with a more focused Medical Subject Headings (MeSH) search. After thorough assessment and risk of bias evaluation using the Cochrane risk of bias tool, we included thirteen studies in this review. The majority of the clinical trials showed a statistically significant effect for improved motor function. More specifically, improvements in upper extremity motor function, gait, and balance in patients diagnosed with stroke were seen. Similarly, when evaluating patients with Parkinson's disease, improved gait and posture were also seen. When it came to cerebral palsy, however, there were no significant differences between the experimental group and the control. The level of improvement in motor function with a virtual reality intervention was striking, particularly since a few studies demonstrated sustained motor improvement a few months post-trial as well. Virtual reality-based rehabilitation has promising results for adult patients diagnosed with stroke or Parkinson's disease. For pediatric patients, on the other hand, a larger number of clinical trials would still need to be conducted to validate if virtual reality interventions have the capability of providing improved motor function recovery.

Effects of virtual reality in improving upper extremity function after stroke: A systematic review and meta-analysis of randomized controlled trials

“…8,9 Several previous reviews did not examine the role of virtual reality in participation. [10][11][12][13][64][65][66] We did not observe significant enhancement on either the amount of use or the quality of movement in virtual reality group comparing with the control group. Programs used in the included studies mainly focused on inducing goal-oriented task-specific motions.…”

Non-Immersive Virtual Reality to Improve Balance and Reduce Risk of Falls in People Diagnosed with Parkinson’s Disease: A Systematic Review

“…This reduces the fear of falling, and transfers this confidence into the real world through motor learning [ 51 ]. Amirthalingam et al [ 52 ] recently suggested that task repetition using VR increases neural plasticity in both post-stroke patients and patients diagnosed with Parkinson’s disease…”

Virtual Reality in Clinical Practice and Research: Viewpoint on Novel Applications for Nursing

“…The application of VR is not limited to these education or training purposes but is increasingly being used for therapeutic purposes as well. Several major therapeutic purposes of VR use include distraction from pain or uncomfortable medical procedures [ 2 , 11 ], relaxation and mindfulness for stress and symptom improvement [ 12 - 15 ], cognitive coping as psychotherapy [ 16 , 17 ], and rehabilitation of neuromotor functions [ 18 ]. VR has shown promising levels of effectiveness in various clinical scenarios.…”

“…In recent years, VR has shown its potential as an assistive technology to aid the rehabilitation of patients with impaired neuromotor functions. Although VR cannot replace conventional physical or occupational therapies, it can promote the effectiveness of rehabilitation by providing task-oriented and multisensory training within an individualized safe virtual environment [ 18 ]. Mekbib et al [ 24 ] developed a VR-based rehabilitation system and validated its therapeutic potential in 23 recent patients who had stroke.…”

“…The system provided upper extremity training in an immersive virtual environment and was effective in recovering upper extremity motor function when combined with conventional occupational therapy [ 24 ]. Regularity and repetition are essential in rehabilitation training for individuals with neurological disorders; however, motivation and adherence often decrease over time [ 18 ]. VR combined with traditional rehabilitation training may improve motivation and training outcomes.…”