Exergames for balance dysfunction in neurological disability: a meta-analysis with meta-regression

Prosperini, Luca; Tomassini, Valentina; Castelli, Letizia; Tacchino, Andrea; Brichetto, Giampaolo; Cattaneo, Davide; Solaro, Claudio

doi:10.1007/s00415-020-09918-w

Cited by 38 publications

(43 citation statements)

References 65 publications

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“…Furthermore, a recent meta-analysis performed by Nascimento et al (58) suggested that VR could induce benefits that can be similar or greater than conventional exercises in patients with MS. However, taken together, all these studies were unable to draw strong conclusion about the real impact of VR on balance improvement in patients with MS, even though the effects of this approach are promising, considering the evidence obtained in other chronic neurological disorders (59,60).…”

Section: Discussionmentioning

confidence: 99%

“…Concerning exergames, Mura et al (45), found that in mixed neurological pathologies, including MS, they might significantly improve executive functions and visuospatial perception compared with no intervention or standard rehabilitative treatment. Concerning balance, successive studies in mixed neurological diseases confirmed that exergames might be at least equivalent to conventional therapy (59) and are able to improve balance dysfunction (60).…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of Virtual Reality and Exergaming in Improving Balance in Patients With Multiple Sclerosis: A Systematic Review and Meta-Analysis

et al. 2021

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Multiple sclerosis (MS) is one of the most common causes of neurological progressive disease and can lead to loss of mobility, walk impairment, and balance disturbance. Among several rehabilitative approaches proposed, exergaming and virtual reality (VR) have been studied in the recent years. Active video game therapy could reduce the boredom of the rehabilitation process, increasing patient motivation, providing direct feedback, and enabling dual-task training. Aim of this systematic review was to assess the efficacy of exergaming and VR for balance recovery in patients with MS. PubMed, Scopus, and Web of Science were systematically searched from the inception until May 14, 2021 to identify randomized controlled trials (RCTs) presenting: patients with MS as participants, exergaming and VR as intervention, conventional rehabilitation as comparator, and balance assessment [Berg Balance Scale (BBS)] as outcome measure. We also performed a meta-analysis of the mean difference in the BBS via the random-effects method. Out of 93 records, this systematic review included and analyzed 7 RCTs, involving a total of 209 patients affected by MS, of which 97 patients performed exergaming or VR and 112 patients underwent conventional rehabilitation. The meta-analysis reported a significant overall ES of 4.25 (p < 0.0001), showing in the subgroup analysis a non-significant ES of 1.85 (p = 0.39) for the VR and a significant ES of 4.49 (p < 0.0001) for the exergames in terms of the BBS improvement. Taken together, these findings suggested that balance rehabilitation using exergames appears to be more effective than conventional rehabilitation in patients affected by MS.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Efficacy of Virtual Reality and Exergaming in Improving Balance in Patients With Multiple Sclerosis: A Systematic Review and Meta-Analysis

et al. 2021

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“…One possible explanation is that performing motor and cognitive tasks at different times (sequential motor-cognitive training) may not be as stimulating for improving complex movement tasks as performing these tasks simultaneously. In addition, Prosperini et al ( 2021 ) conducted a meta-analysis in which they found that exergaming interventions can have a positive impact on the balance of people with neurological disorders. This study (Prosperini et al, 2021 ) was performed on a group of diseased older adults, and we cannot directly confirm our findings with the above-mentioned study, but related results may help us draw meaningful conclusions on this topic.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, Prosperini et al ( 2021 ) conducted a meta-analysis in which they found that exergaming interventions can have a positive impact on the balance of people with neurological disorders. This study (Prosperini et al, 2021 ) was performed on a group of diseased older adults, and we cannot directly confirm our findings with the above-mentioned study, but related results may help us draw meaningful conclusions on this topic. That is, a motor-cognitive intervention with incorporated cognitive task or exergaming has already been shown to have a positive effect on the selected population.…”

Section: Discussionmentioning

confidence: 99%

Impact of Motor-Cognitive Interventions on Selected Gait and Balance Outcomes in Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Teraž

Šlosar²,

Paravlić³

et al. 2022

Front. Psychol.

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BackgroundEfficient performance of most daily activities requires intact and simultaneous execution of motor and cognitive tasks. To mitigate age-related functional decline, various combinations of motor and cognitive training have shown promising results. The aim of this systematic review and meta-analysis of randomized controlled trials (RCTs) was to evaluate the efficacy of different types of motor-cognitive training interventions (e.g., sequential and simultaneous) on selected functional outcomes in healthy older adults.MethodsSix online academic databases were used to retrieve eligible RCTs up to April 2021, following PRISMA guidelines and PICO criteria. A random-effects model was used for all meta-analyses conducted on selected functional outcomes: single- and dual-task gait speed, the Timed Up and Go Test (TUG), and Berg Balance Scale (BBS) score. Effect size (ES) was calculated as Hedges' g and interpreted as: trivial: <0.20, small: 0.20–0.60, moderate: 0.61–1.20, large: 1.21–2.00, very large: 2.01–4.00 or extremely large >4.00.ResultsFrom 2,546 retrieved records, 91 RCTs were included for meta-analysis (n = 3,745 participants; 64.7–86.9 years). The motor-cognitive interventions included differed according to the type of training (e.g., sequential, simultaneous with additional cognitive task or exergame training. The results showed that motor-cognitive interventions can improve gait speed under single-task conditions (small ES = 0.34, P = 0.003). The effect of the intervention was moderated by the type of control group (Q = 6.203, P = 0.013): passive (moderate ES = 0.941, P = 0.001) vs. active controls (trivial ES = 0.153, P = 0.180). No significant effect was found for dual-task walking outcomes (P = 0.063). Motor-cognitive intervention had a positive effect on TUG (small ES = 0.42, P < 0.001), where the effect of intervention was moderated by control group [passive (moderate ES = 0.73, P = 0.001) vs. active (small ES = 0.20, P = 0.020)], but not by the type of training (P = 0.064). Finally, BBS scores were positively affected by motor-cognitive interventions (small ES = 0.59, P < 0.001) with however no significant differences between type of control group (P = 0.529) or intervention modality (P = 0.585).ConclusionsThis study provides evidence for the effectiveness of various types of motor-cognitive interventions on performance-based measures of functional mobility in healthy older adults. With respect to significant effects, gait speed under single-task condition was improved by motor-cognitive interventions, but the evidence shows that this type of intervention is not necessarily more beneficial than motor training alone. On the other hand, motor-cognitive interventions are better at improving multicomponent tasks of dynamic balance and mobility function, as measured by the TUG. Because of substantial heterogeneity and the current limited availability of different types of interventions, the conclusions should be interpreted with caution.

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“…As dificuldades de equilíbrio e quedas consistem em uma queixa recorrente das pessoas com desordens neurológicas na fisioterapia, o que pode afetar no desempenho funcional e qualidade de vida 5 . Isso se explica pelo fato de que, para manter o equilíbrio postural o sistema nervoso faz a integração de componentes centrais e periféricos que resultam em comportamentos complexos baseados na interação de processos sensório-motores dinâmicos (ex.…”

Section: Introductionunclassified

O uso da telereabilitação para melhora do equilíbrio nas disfunções neurológicas

et al. 2021

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Introdução. Distúrbios neurológicos são capazes de causar comprometimento no desempenho funcional, como a dificuldade da manutenção do equilíbrio, exigindo um tratamento a longo prazo, e a telereabilitação favorece a continuidade do tratamento à distância. Objetivo. Verificar se a telereabilitação é efetiva no treino de equilíbrio de pacientes com disfunção neurológica. Método. Trata-se de uma revisão de literatura, em que foi realizado busca nas bases de dados PubMed, Cochrane Library, Biblioteca Virtual de Saúde, Scielo e PEDro, no mês de setembro de 2020, sendo a busca atualizada em março de 2021. Resultados. Foram incluídos 7 ensaios clínicos controlados realizados entre 2004 e 2020. Para os desfechos de equilíbrio estático e dinâmico, dois estudos mostraram que o grupo de telereabilitação apresentou melhora superior do que o grupo controle, enquanto, os demais obtiveram efeitos semelhantes. Quando avaliado o nível de confiança de equilíbrio, apenas um de dois estudos apresentou melhoras significativas. Para a adesão e satisfação avaliada em três estudos, um obteve boa satisfação e dois não tiveram diferenças quanto ao grupo controle. Conclusões. Telereabilitação é uma forma eficaz para o treinamento de equilíbrio de pacientes com disfunção neurológica, sendo uma opção viável, capaz de gerar benefícios similares ao da fisioterapia convencional.

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Exergames for balance dysfunction in neurological disability: a meta-analysis with meta-regression

Cited by 38 publications

References 65 publications

Efficacy of Virtual Reality and Exergaming in Improving Balance in Patients With Multiple Sclerosis: A Systematic Review and Meta-Analysis

Efficacy of Virtual Reality and Exergaming in Improving Balance in Patients With Multiple Sclerosis: A Systematic Review and Meta-Analysis

Impact of Motor-Cognitive Interventions on Selected Gait and Balance Outcomes in Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

O uso da telereabilitação para melhora do equilíbrio nas disfunções neurológicas

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