Comparison of immersive and non-immersive virtual reality for upper extremity functional recovery in patients with stroke: a systematic review and network meta-analysis

Hao, Jie; He, Zhengting; Yu, Xin; Remis, Andréas

doi:10.1007/s10072-023-06742-8

Cited by 26 publications

(14 citation statements)

References 48 publications

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“…The possibility of performing task-oriented gestures in a naturalistic manner during VR treatments may increase the motor transferability needed for inducing neuromotor improvements in patients after stroke [63,64] and could explain the encouraging results seen in the field [65]. On these bases, some authors have reviewed the literature on IVR training [34][35][36], and HMDs specifically [37], for UE recovery in stroke patients, showing valuable but partial information due to strict [37] or non-specific [34][35][36] search strategies, or derived by a non-structured, validated, methodological conduction [37].…”

Section: Discussionmentioning

confidence: 99%

“…Recently, Hao et al proved a greater clinical efficacy of IVR tools in UE treatment in post-stroke patients when compared to NIVR systems [36], probably due to the increased immersion provided that can amplify the user's sensory experience, thus facilitating the interaction with the virtual world and increasing the relevance of the tasks, resulting in a greater motor transferability to the activities of daily life.…”

Section: Introductionmentioning

confidence: 99%

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Head-Mounted Displays for Upper Limb Stroke Rehabilitation: A Scoping Review

Fregna,

Paoluzzi,

Baroni

et al. 2023

JCM

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Upper extremity (UE) paresis is one of the most frequent and disabling clinical consequences after stroke. Head-Mounted Displays (HMDs) are wearable virtual reality devices that seem effective in promoting the recovery of functional abilities by increasing adherence levels in this population. This scoping review is aimed at collecting available evidence on the use of HMD-based immersive virtual reality systems for UE rehabilitation treatment in stroke survivors. Four electronic bibliographic databases were consulted from inception until 18 January 2023. A total of 19 clinical trials in which HMDs were used as a clinical tool for increasing UE functioning, as a single intervention or in adjunct to other rehab treatments, were included; no restrictions were applied for UE paresis severity or stroke onset. The large majority of the clinical trials involved chronic stroke patients (15 out of 19), with a wide range of UE impairments. Overall, HMD use seemed to be well-tolerated and promising for increasing UE motor function in adult chronic stroke survivors, with benefits in subjects’ arm use and independence. The possibility of executing highly realistic and task-oriented movements appears to be promising in enhancing gesture relevance, thus promoting new motor strategies in a “virtual ecological way”. Across studies, we found a high heterogeneity in protocol design and a lack of reporting that prevents us drawing conclusions regarding potential subgroups of patients that could benefit more from HMD-based interventions or suggested treatment modalities.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Head-Mounted Displays for Upper Limb Stroke Rehabilitation: A Scoping Review

Fregna,

Paoluzzi,

Baroni

et al. 2023

JCM

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“…The study by Hao et al (2023) contributes valuable insights into the effectiveness of immersive VR in post-stroke rehabilitation, particularly focusing on upper-extremity function [ 40 ]. Their results, based on a network meta-analysis of twenty randomized controlled trials with 813 participants, indicate that immersive VR systems were the most effective in improving upper-extremity function, surpassing non-immersive VR systems and non-immersive gaming consoles.…”

Section: Discussionmentioning

confidence: 99%

Effects of Immersive Virtual Reality on Upper-Extremity Stroke Rehabilitation: A Systematic Review with Meta-Analysis

Kiper,

Godart,

Cavalier

et al. 2023

JCM

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Virtual reality (VR) is an innovative rehabilitation tool increasingly used in stroke rehabilitation. Fully immersive VR is a type of VR that closely simulates real-life scenarios, providing a high level of immersion, and has shown promising results in improving rehabilitation functions. This study aimed to assess the effect of immersive VR-based therapy for stroke patients on the upper extremities, activities of daily living (ADLs), and pain reduction and its acceptability and side effects. For this review, we gathered all suitable randomized controlled trials from PubMed, EMBASE, Cochrane Library, Scopus, and Web of Science. Out of 1532, 10 articles were included, with 324 participants. The results show that immersive VR offers greater benefits in comparison with conventional rehabilitation, with significant improvements observed in ADLs (SMD 0.58, 95% CI 0.25 to 0.91, I2 = 0%, p = 0.0005), overall function as measured by the Fugl-Meyer Assessment (MD 6.33, 95% CI 4.15 to 8.50, I2 = 25%, p = 0.00001), and subscales for the shoulder (MD 4.96, 95% CI—1.90–8.03, I2 = 25%, p = 0.002), wrist (MD 2.41, 95% CI—0.56–4.26, I2 = 0%, p = 0.01), and hand (MD 2.60, 95% CI—0.70–4.5°, I2 = 0%, p = 0.007). These findings highlight the potential of immersive VR as a valuable therapeutic option for stroke survivors, enhancing their ADL performance and upper-limb function. The immersive nature of VR provides an engaging and immersive environment for rehabilitation.

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“…Other studies support the efficacy of fully immersive VR over non-immersive VR for improving 3D perception and evaluation of cognitive functions [ 8 , 9 ], but also for enhancing the sense of presence and emotional response [ 10 ]. A recent meta-analysis on stroke patients reported beneficial effects of both immersive and non-immersive VR-based rehabilitation protocols, with immersive using head-mounted displays (HMDs) inducing the largest improvements in upper extremity function, as assessed by the Fugl-Meyer test [ 6 ]. Using EEG, it was found that learning in immersive VR leads to better knowledge transfer compared to conventional learning [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

“…Prior to the advent of technological advancements enabling 3D systems, VR settings predominantly consisted of 2D environments, usually via computer/laptop screens or projectors, known as non-immersive VR. Since the emergence of the 3D technology, many studies have sought to examine disparities between them (for a review, see [ 6 ]). However, others reported that in 3D systems, users become more engaged in the environment, being active participants, rather than just being passive observers, which brings the possibility of explorative interaction with the environment [ 7 ], but also better memory performance [ 8 ] and perception [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

A Comparison of Immersive vs. Non-Immersive Virtual Reality Exercises for the Upper Limb: A Functional Near-Infrared Spectroscopy Pilot Study with Healthy Participants

Dordevic,

Maile,

Das

et al. 2023

JCM

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Functional near-infrared spectroscopy (fNIRS) allows for a reliable assessment of oxygenated blood flow in relevant brain regions. Recent advancements in immersive virtual reality (VR)-based technology have generated many new possibilities for its application, such as in stroke rehabilitation. In this study, we asked whether there is a difference in oxygenated hemoglobin (HbO2) within brain motor areas during hand/arm movements between immersive and non-immersive VR settings. Ten healthy young participants (24.3 ± 3.7, three females) were tested using a specially developed VR paradigm, called “bus riding”, whereby participants used their hand to steer a moving bus. Both immersive and non-immersive conditions stimulated brain regions controlling hand movements, namely motor cortex, but no significant differences in HbO2 could be found between the two conditions in any of the relevant brain regions. These results are to be interpreted with caution, as only ten participants were included in the study.

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Comparison of immersive and non-immersive virtual reality for upper extremity functional recovery in patients with stroke: a systematic review and network meta-analysis

Cited by 26 publications

References 48 publications

Head-Mounted Displays for Upper Limb Stroke Rehabilitation: A Scoping Review

Head-Mounted Displays for Upper Limb Stroke Rehabilitation: A Scoping Review

Effects of Immersive Virtual Reality on Upper-Extremity Stroke Rehabilitation: A Systematic Review with Meta-Analysis

A Comparison of Immersive vs. Non-Immersive Virtual Reality Exercises for the Upper Limb: A Functional Near-Infrared Spectroscopy Pilot Study with Healthy Participants

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