Effects of virtual reality in the early-stage stroke rehabilitation: A systematic review and meta-analysis of randomized controlled trials

Hao, Jie; Yao, Zixuan; Harp, Kimberly; Gwon, Yeongjin; Siu, Ka-Chun

doi:10.1080/09593985.2022.2094302

Cited by 11 publications

(3 citation statements)

References 74 publications

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“…15 with PROSPERO (41,48,55,59,63,64,66,70,71,75,77,78,79,81,33) and one with the Cochrane database (20). The search strategy was judged to be comprehensive in over 60% of the reviews while the rest were partially comprehensive.…”

Section: Figurementioning

confidence: 99%

Virtual Reality in Stroke Recovery: A meta-review of Systematic Reviews

Khan,

Imam,

Muneer

et al. 2024

Preprint

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Background Virtual Reality (VR) is an emerging technology in post stroke recovery. However, its precise role in stroke rehabilitation is not well defined. The aim of this paper is to conduct an overview of systematic reviews on the role of VR in stroke rehabilitation. Methods A meta-review with results from a search of 7 databases from inception till 5th December 2022 with subsequent quality appraisal was conducted. The primary outcome was to produce a narrative review on the efficacy of VR versus usual or other care in stroke recovery. Data was synthesized in a descriptive fashion and high-quality systematic reviews were emphasized. The AMSTAR-2 tool was used for quality assessment of the included studies. Results Evidence from high-quality systematic reviews suggests that there is benefit from VR in upper limb, lower limb, gait, and balance recovery particularly when additive to conventional therapy. There is also limited evidence to suggest that VR has a positive effect in those with impaired cognition. Conclusion VR is safe and effective as an adjunct to conventional therapy for adults after stroke and should be used routinely for upper and lower limb motor recovery. Further high-quality studies that evaluate its efficacy and explore ways to increase its positive impact in areas such as cognition are required. There is also a scope for the development of stroke-specific virtual environments. (PROSPERO registration # CRD42022372926).

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Section: Figurementioning

confidence: 99%

Virtual Reality in Stroke Recovery: A meta-review of Systematic Reviews

Khan,

Imam,

Muneer

et al. 2024

Preprint

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“…Due to the increasing number of elderly people, stroke is a leading cause of death in recent years, which has brought a burden to society and economy [1]. Currently, a non-drug treatment has been used for the brain injury, primarily through interaction with the environment known as environmental enrichment (EE) [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Environmental enrichment enhanced neurogenesis and behavioral recovery after stroke in aged rats

Yan,

Liu,

Zheng

et al. 2023

Aging

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Background and Purpose: Age is identified as a significant prognostic factor for poorer outcome after stroke. However, environmental enrichment (EE) has been reported to promote functional recovery after ischemic stroke. The purpose of this study was to investigate whether environmental enrichment was beneficial to ischemic stroke in aged rats. Methods: Aged rats were randomly assigned as control rats, rats subjected to cerebral ischemia, and rats with cerebral ischemia treated with EE for 30 days. Focal cortical ischemia was induced by intracranial injection of endothelin-1 (ET-1). EE housing began one day after focal ischemia and was maintained for the whole experimental period. We used immunofluorescence staining to analyze the neurogenesis in the subventricular zone (SVZ) and TdT-mediated dUTP-biotin nick-end labeling (TUNEL) assay to evaluate apoptosis. The expression of neuronal nuclei, glial fibrillary acidic protein (GFAP) and Iba-1 around the infarcted area were also measured by double immunohistochemistry. Results: EE enhanced the proliferation of newborn neurons in the SVZ, as well as increased the long-term survival of newborn neurons. EE also exerted effects on inflammation after stroke. Furthermore, EE suppressed apoptosis and improved the motor functions after stroke in the aged rats. Conclusions: EE improved post-stroke recovery on the basis of enhancing neurogenesis in aged rats.

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“…A 2017 Cochrane Review suggested that addition of VR to conventional care produced a significant difference between intervention and control groups in upper limb function [15]. A recent meta-analysis of 17 studies confirmed the feasibility of VR in early stroke rehabilitation and also suggested that VR intervention showed similar outcomes in upper extremity and ADL function to dose-matched conventional therapy [16].…”

Section: Introductionmentioning

confidence: 99%

A Smart Glove Digital System Promotes Restoration of Upper Limb Motor Function and Enhances Cortical Hemodynamic Changes in Subacute Stroke Patients with Mild to Moderate Weakness: A Randomized Controlled Trial

Shin

Lee

Chang

et al. 2022

JCM

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This study was a randomized controlled trial to examine the effects of the RAPAEL® Smart Glove digital training system on upper extremity function and cortical hemodynamic changes in subacute stroke patients. Of 48 patients, 20 experimental and 16 controls completed the study. In addition to conventional occupational therapy (OT), the experimental group received game-based digital hand motor training with the RAPAEL® Smart Glove digital system, while the control group received extra OT for 30 min. The Fugl-Meyer assessment (UFMA) and Jebsen-Tayler hand function test (JTT) were assessed before (T0), immediately after (T1), and four weeks after intervention (T2). Cortical hemodynamics (oxyhemoglobin [OxyHb] concentration) were measured by functional near-infrared spectroscopy. The experimental group had significantly better improvements in UFMA (T1-T0 mean [SD]; Experimental 13.50 [7.49]; Control 8.00 [4.44]; p = 0.014) and JTT (Experimental 21.10 [20.84]; Control 5.63 [5.06]; p = 0.012). The OxyHb concentration change over the ipsilesional primary sensorimotor cortex during the affected wrist movement was greater in the experimental group (T1, Experimental 0.7943 × 10−4 μmol/L; Control −0.3269 × 10−4 μmol/L; p = 0.025). This study demonstrated a beneficial effect of game-based virtual reality training with the RAPAEL® Smart Glove digital system with conventional OT on upper extremity motor function in subacute stroke patients.

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Effects of virtual reality in the early-stage stroke rehabilitation: A systematic review and meta-analysis of randomized controlled trials

Cited by 11 publications

References 74 publications

Virtual Reality in Stroke Recovery: A meta-review of Systematic Reviews

Virtual Reality in Stroke Recovery: A meta-review of Systematic Reviews

Environmental enrichment enhanced neurogenesis and behavioral recovery after stroke in aged rats

A Smart Glove Digital System Promotes Restoration of Upper Limb Motor Function and Enhances Cortical Hemodynamic Changes in Subacute Stroke Patients with Mild to Moderate Weakness: A Randomized Controlled Trial

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