Impact of Virtual Reality-Based Therapies on Cognition and Mental Health of Stroke Patients: Systematic Review and Meta-analysis

Zhang, Qi; Fu, Yu; Lu, Yanhui; Zhang, Yating; Huang, Qifang; Yang, Yajie; Zhang, Ke; Li, Mingzi

doi:10.2196/31007

Cited by 74 publications

(41 citation statements)

References 69 publications

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“…However, studies comparing active comparators, such as exercise, nonserious games, and watching videos, showed a reduction in depression, but this was not statistically significant. These findings are consistent with those of a meta-analysis that included active comparators [ 81 ]. The absolute and relative effects of the intervention can be interpreted according to the type of control group [ 82 ].…”

Section: Discussionsupporting

confidence: 91%

Effects of Serious Games on Depression in Older Adults: Systematic Review and Meta-analysis of Randomized Controlled Trials

Kim¹,

Hong²,

Choi³

2022

J Med Internet Res

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Background Depression is a severe psychological concern that negatively affects health in older adults. Serious games applied in various fields are considered appropriate interventions, especially in mental health care. However, there is a lack of evidence regarding the effects of serious games on depression in older adults. Objective This study aimed to investigate the characteristics and effectiveness of serious games for depression in older adults. Methods A systematic review and meta-analysis of randomized controlled trials were conducted. In total, 5 electronic databases (PubMed, CINAHL, Embase, PsycINFO, and Cochrane Library) were searched to identify relevant studies published until July 6, 2021. A total of 2 reviewers independently conducted study selection, data extraction, and quality appraisals. The risk of bias in the included studies was assessed using the JBI Critical Appraisal Checklist. For the meta-analysis, the effect size was calculated as the standardized mean difference (SMD) by using a random effects model. Results A total of 17 studies with 1280 older adults were included in the systematic review, and 15 studies were included in the meta-analysis. Serious game interventions were classified into 3 types: physical activity (PA), cognitive function, and both PA and cognitive function. The meta-analysis demonstrated that serious games reduced depression in older adults (SMD −0.54, 95% CI −0.79 to −0.29; P<.001). Serious games had a more significant effect size in community or home settings (SMD −0.61, 95% CI −0.95 to −0.26; P<.001) than in hospital settings (SMD −0.46, 95% CI −0.85 to −0.08; P=.02); however, the difference between groups was not significant. Among the types of games, games for PA (SMD −0.60, 95% CI −0.95 to −0.25; P<.001) and games for both (SMD −0.73, 95% CI −1.29 to −0.17; P=.01) had a significant effect on reducing depression in older adults. However, no significant correlations were observed between the duration or number of serious games and depression. Conclusions Serious games were beneficial in reducing depression in older adults. Regardless of the study setting, serious games appeared to reduce depression. Particularly, serious games including PA had a significant impact on reducing depression. Furthermore, high-quality randomized controlled trials are needed to establish substantial evidence for the effectiveness of serious games on depression in older adults. Trial Registration PROSPERO CRD42021242573; https://tinyurl.com/26xf7ym5

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Section: Discussionsupporting

confidence: 91%

Effects of Serious Games on Depression in Older Adults: Systematic Review and Meta-analysis of Randomized Controlled Trials

Kim¹,

Hong²,

Choi³

2022

J Med Internet Res

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“…This creates a more realistic, intuitive, and interactive feedback environment ( 38 – 40 ). Which is regarded as a conducive way of improving the neuroplasticity of the brain ( 41 ). However, the effectiveness of VR in improving global cognitive function in PSCI patients remains uncertain, just as demonstrated by several meta-analyses ( 41 , 42 ).…”

Section: Discussionmentioning

confidence: 99%

“…Which is regarded as a conducive way of improving the neuroplasticity of the brain ( 41 ). However, the effectiveness of VR in improving global cognitive function in PSCI patients remains uncertain, just as demonstrated by several meta-analyses ( 41 , 42 ). This may be related to the fact that current VR rehabilitation content is more focused on various immersive games that require more physical mobilization to cooperate.…”

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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“…Therefore, it would be safe to say that virtual reality technologies and cognitive rehabilitation are two new treatment approaches that promote the functions of patients in specific areas such as attention, memory, component function, and perceptual abilities. They do this by sensory involvement and increased visual and auditory feedback [17]. This technology has the potential to create scenarios in the field of cognitive rehabilitation that facilitate brain reconstruction [16].…”

Section: Introductionmentioning

confidence: 99%

Cognitive rehabilitation in people with autism spectrum disorder: a systematic review of emerging virtual reality-based approaches

Shahmoradi

Rezayi

2022

J NeuroEngineering Rehabil

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Introduction Emerging virtual technologies and cognitive rehabilitation methods are two new treatment approaches that can be used to strengthen cognitive functions in Autism Spectrum Disorder (ASD). The main aim of this study was to examine the effect of using virtual reality-based approaches on cognitive disorders of children and adults with ASD. Methods This systematic review was conducted on scientific papers to determine the effects of virtual reality-based technologies on the cognitive functions of children and adults with ASD. We identified 688 studies related to this topic and filtered them down to 17 articles, and then extracted the effects of interventions on cognitive outcomes. Results A total of 17 studies met the inclusion criteria, in which 226 persons with ASD had taken place. The sample size in the selected studies ranged from 1 to 56 participants (Median: 8, Q1: 3.5, Q3: 15.5). Four of the studies were case–control studies, ten were pre-test/post-test studies, and three were Randomized Control Trials (RCTs). Results of 16 studies showed significant progress in various cognitive indexes, such as task learning, attention, executive functioning, and daily skills in people with ASD. In most studies, virtual technologies had beneficial effects on reducing cognitive problems, but existing limitations could reduce their effectiveness. These limitations included the cost of virtual reality devices, inappropriate size of software, the weight of devices, potential addiction, intolerance of wearing glasses or headsets by people with autism (especially in children), and the possibility of eye injury. Conclusion Applying appropriate virtual-based approaches could improve cognitive indexes in people with ASD. However, further studies are needed to investigate the real effects of these technologies in the long run.

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Impact of Virtual Reality-Based Therapies on Cognition and Mental Health of Stroke Patients: Systematic Review and Meta-analysis

Cited by 74 publications

References 69 publications

Effects of Serious Games on Depression in Older Adults: Systematic Review and Meta-analysis of Randomized Controlled Trials

Effects of Serious Games on Depression in Older Adults: Systematic Review and Meta-analysis of 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

Cognitive rehabilitation in people with autism spectrum disorder: a systematic review of emerging virtual reality-based approaches

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