Virtual reality therapy for rehabilitation of balance in the elderly: a systematic review and META-analysis

Abstract

Virtual reality therapy (VRT) has clinical indications in rehabilitation programs for the elderly; however, there is still no consensus on the recovery of body balance. The objective of this review was to summarize the effects of physical therapy interventions with VRT in the rehabilitation of balance in the elderly. The studies were identified via a systematic search in the databases PubMed, SciELO, LILACS and PEDro from 2010 onward. Clinical trials with interventions that involved VRT in the elderly were included in the study and were subjected to methodological quality analysis using the PEDro scale. A random effects meta-analysis of the studies that analyzed balance using the Berg Balance Scale and the Timed Up and Go (TUG) test was performed. Ten articles met the inclusion criteria, which presented variability in relation to the types of interventions used (70%) and the outcomes analyzed (60%). The mean duration of the interventions was 13.90 (± 5.08) weeks, with at least two weekly sessions (± 0.73). There were positive results in relation to improvements in both dynamic and static balance (70% of the studies), mobility (80%), flexibility (30%), gait (20%) and fall prevention (20%). A summary of the meta-analysis showed mean effects on the Berg scale (standardized mean difference [SMD]: -0.848; 95% CI: -1.161; − 0.535) and the TUG test (SMD: 0. 894; 95% CI: 0.341; 1.447). Individually, virtual reality is promising in rehabilitation programs for the elderly. The overall measures were sufficient to show beneficial effects of the therapy on balance in the elderly.

Effects of Exercise-Based Interventions on Fall Risk and Balance in Patients With Chronic Obstructive Pulmonary Disease

“…No study reported the effects of dual-task training, virtual reality training, or perturbation-based training. A review by de Amorim et al 37 concluded that findings of studies using virtual reality training in elderly populations showed promising results. In a review by Ghai et al, 38 beneficial effects of dual-task training in fall-prone elderly populations were demonstrated.…”

Virtual Reality-guided, Dual-task, Body Trunk Balance Training in the Sitting Position Improved Walking Ability without Improving Leg Strength

“…an increasingly useful tool to overcome the lack of human and economic resources associated with rehabilitation medicine, the clinical efficacy of VR rehabilitation compared with traditional training techniques remains to be elucidated. [1][2][3][4][5][6][7][8]…”

“…Balance is essential for walking, and walking ability is a critical basic function associated with the quality of life. [1][2][3][4][5] Walking is a harmonized physical activity requiring (1) lower-extremity muscle strength, (2) postural or trunk balancing ability, and (3) dual-task processing. [5][6][7][8] Whereas lower-extremity muscle strength can be increased by various methods, no effective quantitative approach has been identified to train for balance and dual-task processing skills with the subject in the sitting position.…”

Digital Biomarkers for the Early Detection of Mild Cognitive Impairment: Artificial Intelligence Meets Virtual Reality

“…This, in turn, has supported its deployment for both clinical and non-clinical samples of elderly people and young adults (García-Betances et al, 2015;De Tommaso et al, 2016;Plancher and Piolino, 2017). Within medical and neuropsychological settings, VR has been extensively applied as an assessment and a rehabilitation tool for elderly people suffering from consequences of a traumatic brain injury (Aida et al, 2018;Alashram et al, 2019;Maggio et al, 2019), for poststroke patients (Henderson et al, 2007;Saposnik and Levin, 2011;Laver et al, 2017), and for spatial memory and balance (Allain et al, 2014;Serino et al, 2017;Gerber et al, 2018;Soares et al, 2018), among other applications (see Plancher and Piolino, 2017;Moreno et al, 2019). Crucially, VR allows the therapy to be tailored in a controlled way, according to each disease starting from a continuous assessment of the individual's behaviors.…”