Effects of Virtual Reality Rehabilitation Training on Cognitive Function and Activities of Daily Living of Patients With Poststroke Cognitive Impairment: A Systematic Review and Meta-Analysis

Chen, Xinming; Liu, Fang; Lin, Shaohong; Yu, Liqiang; Lin, Ren

doi:10.1016/j.apmr.2022.03.012

Cited by 55 publications

(30 citation statements)

References 37 publications

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“…Unfortunately, there is no pharmacological treatment approved for PSCI, and prospective pharmaceutical medicines have yet to show significant efficacy in decreasing or preventing cognitive deterioration following a stroke (13, 28). Nonpharmacological interventions such as TMS, tDCS, VR, CA, and Acupuncture (16)(17)(18)(19)(20) have shown promise in several studies. However, there is continued uncertainty on the benefits due to methodological limitations that exist in most metaanalyses above, such as the unclear definition of PSCI, mixing of controlled groups, and combination of interventions in different groups.…”

Section: Discussionmentioning

confidence: 99%

Comparative efficacy of 5 non-pharmacological therapies for adults with post-stroke cognitive impairment: A Bayesian network analysis based on 55 randomized controlled trials

Yang

Qiu

et al. 2022

Front. Neurol.

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BackgroundAs a common sequela after stroke, cognitive impairment negatively impacts patients' activities of daily living and overall rehabilitation. Non-pharmacological therapies have recently drawn widespread attention for their potential in improving cognitive function. However, the optimal choice of non-pharmacological therapies for post-stroke cognitive impairment (PSCI) is still unclear. Hence, in this study, we compared and ranked 5 non-pharmacological therapies for PSCI with a Bayesian Network Meta-analysis (NMA), to offer a foundation for clinical treatment decision-making.MethodsPubMed, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials, Chinese Biomedical Medicine, China National Knowledge Infrastructure, Wangfang Database, and China Science and Technology Journal Database were searched from database inception to December 31, 2021, to collect Randomized Controlled Trials for PSCI. All of the studies were assessed (according to Cochrane Handbook for Systematic Reviews) and then data were extracted by two researchers separately. Pairwise meta-analysis for direct comparisons was performed using Revman. NMA of Bayesian hierarchical model was performed by WinBUGS and ADDIS. STATA was used to construct network evidence plots and funnel plots.ResultsA total of 55 trials (53 Two-arm trials and 2 Three-arm trials) with 3,092 individuals were included in this study. In the pair-wise meta-analysis, Transcranial Magnetic Stimulation (TMS), Virtual Reality Exposure Therapy (VR), Computer-assisted cognitive rehabilitation (CA), Transcranial Direct Current Stimulation (tDCS), and Acupuncture were superior to normal cognition training in terms of MoCA, MMSE, and BI outcomes. Bayesian NMA showed that the MoCA outcome ranked Acupuncture (84.7%) as the best therapy and TMS (79.7%) as the second. The MMSE outcome ranked TMS (76.1%) as the best therapy and Acupuncture as the second (72.1%). For BI outcome, TMS (89.1%) ranked the best.ConclusionsTMS and Acupuncture had a better effect on improving cognitive function in post-stroke patients according to our Bayesian NMA. However, this conclusion still needs to be confirmed with large sample size and high-quality randomized controlled trials.Registrationhttps://inplasy.com (No. INPLASY202260036).

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Section: Discussionmentioning

confidence: 99%

Comparative efficacy of 5 non-pharmacological therapies for adults with post-stroke cognitive impairment: A Bayesian network analysis based on 55 randomized controlled trials

Yang

Qiu

et al. 2022

Front. Neurol.

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“…The current treatments of PSMD include drug therapy, regular rehabilitation therapy, computer-assisted training, virtual reality. [11][12][13] However, these ments are minimally effective and insufficient and are plagued by low adherence. [11,12] With the development and progress of technology, a safe, painless, and noninvasive tool, repetitive transcranial magnetic stimulation (rTMS) has been widely applied in the treatment of stroke.…”

Section: The Authors Have No Conflicts Of Interest To Disclosementioning

confidence: 99%

“…The current treatments of PSMD include drug therapy, regular rehabilitation therapy, computer-assisted training, virtual reality. [11–13] However, these treatments are minimally effective and insufficient and are plagued by low adherence. [11,12]…”

Section: Introductionmentioning

confidence: 99%

Effectiveness and safety of repetitive transcranial magnetic stimulation on memory disorder in stroke: A protocol for systematic review and meta-analysis

et al. 2022

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Background: Approximately 23% to 55% of patients have memory impairments with a greatly negative effect on daily life 3 months after stroke. Repetitive transcranial magnetic stimulation (rTMS) has been widely used in the rehabilitation of stroke as it is safe, painless, and noninvasive. Moreover, few studies have investigated the effect of rTMS on poststroke memory disorder (PSMD). However, the efficacy of rTMS is not consistent and the optional stimulation frequency is unclear. Therefore, this protocol aims to evaluate the clinical effect and safety of rTMS on PSMD by analyzing results from randomized controlled trials.Methods: Search strategies will be performed on seven databases: PubMed, EMBASE, CENTRAL, Chinese Biomedical Literature Database (CBM), Chinese National Knowledge Infrastructure (CNKI), Wan Fang, and Technology Periodical Database (VIP). Only randomized controlled trials registered before August 2021 will be included. Additionally, the language will be limited to English or Chinese. For the outcome, we will focus on the Rivermead Behavioral Memory Test. Additionally, the Montreal Cognitive Assessment, Mini-mental State Examination, Modified Barthel Index, and advent events will be included. Two authors will independently select the study, extract data, and assess quality. Moreover, disagreements will be resolved by the third author. STATA 14 and Review Manager 5.4 will be used to perform the analysis. We will evaluate bias risk in accordance with the Cochrane Handbook for Systematic Reviews of Interventions. To assess the quality of evidence, the Grading of Recommendations Assessment, Development, and Evaluation method will be employed.Results: This study will provide a comprehensive analysis of the current evidence on rTMS for PSMD. Conclusion:A reliable conclusion regarding whether rTMS is an effective and safe intervention for patients with PSMD and the effect of stimulation frequency and sham stimulation will be provided. This study will provide new insights for TMS in treating PSMD, and offer appropriate treatmentoptions to patients and clinicians.

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“…Among other technological innovations in cognitive training programs, it is possible to find the design of augmented reality and virtual reality resources [ 33 – 36 ], the incorporation of robotic devices [ 5 , 32 , 37 ], the design of new devices and interventions that integrate brain-computer interfaces, such as neurofeedback [ 10 , 30 , 38 ], as well as new high-tech interventions such as transcranial direct current stimulation [ 39 , 40 ].…”

Section: Introductionmentioning

confidence: 99%

“…In older adults with a history of stroke, a meta-analysis reviewed the effect of virtual reality rehabilitation from 21 studies, which demonstrated improvements in executive functions and changes in evoked potentials that showed a positive effect of the intervention [ 36 ]. Other reviews recognized transfer effects on working memory [ 4 ], attention and executive functions, and neural changes in both functional and structural connectivity in brain areas related to executive functioning [ 45 ]; however, both reviews noted that the results were very heterogeneous between studies [ 4 , 45 ].…”

Section: Introductionmentioning

confidence: 99%

Artificial Cognitive Systems Applied in Executive Function Stimulation and Rehabilitation Programs: A Systematic Review

2022

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This article presents a systematic review of studies on cognitive training programs based on artificial cognitive systems and digital technologies and their effect on executive functions. The aim has been to identify which populations have been studied, the characteristics of the implemented programs, the types of implemented cognitive systems and digital technologies, the evaluated executive functions, and the key findings of these studies. The review has been carried out following the PRISMA protocol; five databases have been selected from which 1889 records were extracted. The articles were filtered following established criteria, to give a final selection of 264 articles that have been used for the purposes of this study in the analysis phase. The findings showed that the most studied populations were school-age children and the elderly. The most studied executive functions were working memory and attentional processes, followed by inhibitory control and processing speed. Many programs were commercial, customizable, gamified, and based on classic tasks. Some more recent initiatives have begun to incorporate user-machine interfaces, robotics, and virtual reality, although studies on their effects remain scarce. The studies recognize multiple benefits of computerized neuropsychological stimulation and rehabilitation programs for executive functions in different age groups, but there is a lack of studies in specific population sectors and with more rigorous research designs. Supplementary Information The online version contains supplementary material available at 10.1007/s13369-022-07292-5.

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Effects of Virtual Reality Rehabilitation Training on Cognitive Function and Activities of Daily Living of Patients With Poststroke Cognitive Impairment: A Systematic Review and Meta-Analysis

Cited by 55 publications

References 37 publications

Comparative efficacy of 5 non-pharmacological therapies for adults with post-stroke cognitive impairment: A Bayesian network analysis based on 55 randomized controlled trials

Comparative efficacy of 5 non-pharmacological therapies for adults with post-stroke cognitive impairment: A Bayesian network analysis based on 55 randomized controlled trials

Effectiveness and safety of repetitive transcranial magnetic stimulation on memory disorder in stroke: A protocol for systematic review and meta-analysis

Artificial Cognitive Systems Applied in Executive Function Stimulation and Rehabilitation Programs: A Systematic Review

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