Systematic reviewEffectiveness of Virtual Reality- and Gaming-Based Interventions for Upper Extremity Rehabilitation Poststroke: A Meta-analysis
Section snippets
Design
This review was a meta-analysis of studies to examine the effectiveness of VR- and game-based interventions for upper extremity hemiparesis poststroke. It followed PRISMA collaboration recommendations and was registered with the International Prospective Register of Systematic Reviews (PROSPERO).
Identification and selection of studies
The authors consulted with a professional librarian to review PubMed, CINAHL/EBSCO, SCOPUS, Ovid MEDLINE, and EMBASE electronic databases for articles published from January 2005 to May 2019. The
Flow of studies through the review
A total of 58,323 articles were identified from the initial search. After removing duplicates and screening title, year, and abstract, 71 articles were assessed for eligibility using the Downs-Black rating scale,27 which resulted in 11 exclusions. From the remaining 60 articles, another 22 were removed due to insufficient data for meta-analysis (eg, missing mean or SD), leaving 38 articles for analysis (fig 1). There was generally good agreement between the raters in overall score on the
Discussion
The objective of this meta-analysis was to determine the effect of gaming- and VR-based interventions for improving upper extremity function poststroke. The observed percent possible improvement for the VR or gaming groups across all studies was almost 29%, which is consistent with other upper extremity studies.72,73 Studies within both the acute and chronic stroke population showed a positive effect of VR or gaming rehabilitation on motor function, with significantly greater motor recovery
Conclusions
Overall, gaming and VR methods of treatment are effective, closing on average 28.45% of the gap between baseline function and normal motor ability. VR or gaming interventions were more effective than active treatment controls, but the comparative treatment effect was small. Interventions employing a gaming component are more effective overall than those that merely deliver feedback. Future research should involve large-scale randomized controlled studies with high methodologic rigor93 that
Suppliers
- a.
MAd: Meta-Analysis with Mean Differences; A.C. Del Re and William T. Hoyt.
- b.
SPSS, version 20; IBM.
Acknowledgments
Supported in part by the Neuroscience Research Institute at The Ohio State University and from the National Center for Advancing Translational Sciences (award number UL1TR002733). The content is solely the responsibility of the authors and does not necessarily represent the view of the National Center for Advancing Translational Sciences or the National Institutes of Health.
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Clinical Trial Registration No.: PROSPERO 95052.
Disclosures: none.