Effects of Virtual Reality Training on Upper Limb Function and Balance in Stroke Patients: Systematic Review and Meta-Meta-Analysis (Preprint)

Abstract

BACKGROUND Virtual reality (VR) training is a promising intervention strategy, which has been utilized in healthcare fields like stroke rehabilitation and psychotherapy. The current study suggests that, VR training is effective in improving the locomotor ability of individuals with stroke patients. OBJECTIVE This is the first meta-meta-analysis of the effects of virtual reality on motor function in stroke patients. This study aimed to systematically summarize and quantify the present meta-analyses results of VR training, and produce high-quality meta-meta-analysis results to obtain a more accurate prediction. METHODS We searched four online databases (Web of Science, Scopus, PubMed, and Chinese National Knowledge Infrastructure) for the meta-analysis studies. After accounting for the overlap, ten studies (almost 550 stroke patients) were obtained. Based on the meta-meta-analysis of these patients, this study quantified the impact of VR training on stroke patients’ motor performance, mainly including upper limb function, balance, and walking ability. We combined the effects under the random effect model and pooled the estimates as standardized mean differences (SMD). RESULTS The results of the meta-meta analysis showed that VR intervention effectively improved the upper limb function (SMD= 4.606, 95% confidence interval (Cl): 2.733-6.479, P< 0.05) and balance (SMD=2.101, 95%Cl：0.202-4.000, P< 0.05) of stroke patients. However, the results showed considerable heterogeneity, and thus, may need to be treated with caution. Due to the limited research, the meta-meta-analysis of walking ability was not performed. CONCLUSIONS These findings represent a comprehensive body of high-quality evidence that, VR interventions were more effective at improving the upper limb function and balance of stroke patients.