Rehabilitation that incorporates virtual reality is more effective than standard rehabilitation for improving walking speed, balance and mobility after stroke: a systematic review

Abstract

Substituting some or all of a standard rehabilitation regimen with VRBR elicits greater benefits in walking speed, balance and mobility in people with stroke. Although the benefits are small, the extra cost of applying virtual reality to standard rehabilitation is also small, especially when spread over many patients in a clinic. Adding extra VRBR time to standard rehabilitation also has some benefits; further research is needed to determine if these benefits are clinically worthwhile.

Recommendations for the Implementation of Telehealth in Cardiovascular and Stroke Care: A Policy Statement From the American Heart Association

“…[108][109][110] These therapies can improve upper limb function, walking speed, balance, and mobility in people with stroke by enhancing traditional poststroke treatment through simulated practice of therapy-related tasks at a higher dose, for longer periods, consistently and precisely without fatigue. [110][111][112][113] However, because of the lack of high-quality evidence, both clinical and costeffectiveness, the benefits and risks of robotic, virtual reality, and gaming-based rehabilitation compared with conventional therapies remain unclear. [112][113][114][115] Large, welldesigned, multicenter studies evaluating the benefits and risks of robotic, virtual reality, and gaming therapy are clearly needed.…”

“…[110][111][112][113] However, because of the lack of high-quality evidence, both clinical and costeffectiveness, the benefits and risks of robotic, virtual reality, and gaming-based rehabilitation compared with conventional therapies remain unclear. [112][113][114][115] Large, welldesigned, multicenter studies evaluating the benefits and risks of robotic, virtual reality, and gaming therapy are clearly needed. Research that provides information on optimal dose, appropriate time to initiate such therapies, and criteria for identifying patients who will benefit most from such therapies is especially needed.…”

The use of virtual reality for balance among individuals with chronic stroke: a systematic review and meta-analysis

“…The authors reported significant improvements among those using VR compared to controls on the Berg Balance Scale (BBS) and the Timed Up and Go Test (TUG). Li et al, 7 among others, 8,9 positively assert the use of VR in the stroke population as a whole.…”

Video and computer-based interactive exercises are safe and improve task-specific balance in geriatric and neurological rehabilitation: a randomised trial

“…A more recently published systematic review and meta-analysis investigating the use of virtual reality in a stroke population found that substitution of some or all of standard rehabilitation with virtual reality training resulted in improved mobility. 18 [ 2 4 _ T D $ D I F F ] However, when data were pooled from trials that used exergames as an addition to standard therapy, there was insufficient evidence of effect due to[ 2 5 _ T D $ D I F F ] a lack of trials that evaluated walking speed, and the heterogeneity of the participants. 18 The feasibility of exergame use in rehabilitation settings remains unclear, with one study suggesting that patients prefer traditional therapy.…”

“…18 [ 2 4 _ T D $ D I F F ] However, when data were pooled from trials that used exergames as an addition to standard therapy, there was insufficient evidence of effect due to[ 2 5 _ T D $ D I F F ] a lack of trials that evaluated walking speed, and the heterogeneity of the participants. 18 The feasibility of exergame use in rehabilitation settings remains unclear, with one study suggesting that patients prefer traditional therapy. 19 More research is therefore required to evaluate the feasibility and impact of a range of different interactive video and computer systems to address mobility limitations in rehabilitation ward settings.…”