The Clinical Utility of Virtual Reality in Neurorehabilitation: A Systematic Review

Abstract

Background:Virtual reality (VR) experiences (through games and virtual environments) are increasingly being used in physical, cognitive, and psychological interventions. However, the impact of VR as an approach to rehabilitation is not fully understood, and its advantages over traditional rehabilitation techniques are yet to be established.Method:We present a systematic review which was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). During February and March of 2018, we conducted searches on PubMed (Medline), Virtual Health Library Search Portal databases (BVS), Web of Science (WOS), and Embase for all VR-related publications in the past 4 years (2015, 2016, 2017, and 2018). The keywords used in the search were “neurorehabilitation” AND “Virtual Reality” AND “devices.”Results:We summarize the literature which highlights that a range of effective VR approaches are available. Studies identified were conducted with poststroke patients, patients with cerebral palsy, spinal cord injuries, and other pathologies. Healthy populations have been used in the development and testing of VR approaches meant to be used in the future by people with neurological disorders. A range of benefits were associated with VR interventions, including improvement in motor functions, greater community participation, and improved psychological and cognitive function.Conclusions:The results from this review provide support for the use of VR as part of a neurorehabilitation program in maximizing recovery.

Virtual Reality-guided, Dual-task, Body Trunk Balance Training in the Sitting Position Improved Walking Ability without Improving Leg Strength

“…Virtual reality (VR) technology has been recently introduced in a variety of clinical settings, e.g., physical, occupational, cognitive, and psychological rehabilitation or training. 1,2) In particular, VR-guided body balance training to address neurological disorders such as stroke has garnered a lot of attention from physicians and therapists. Balance is essential for walking, and walking ability is a critical basic function associated with the quality of life.…”

Randomized controlled trial combining constraint-induced movement therapy and action-observation training in unilateral cerebral palsy: clinical effects and influencing factors of treatment response

“…Hence, we advocate for trainings that are engaging and motivating for the children. For example, a virtual reality environment [70,71] where the child sees himself as an avatar, could serve as a more motivating, engaging, and potentially more effective AOT approach.…”

Efeitos do videogame interativo Nintendo® Wii Sports na função motora de membros superiores de indivíduos com síndrome pós poliomielite: ensaio clínico aleatorizado de aplicabilidade, segurança, aceitabilidade

“…Como ferramenta complementar na reabilitação das doenças neurológicas, a realidade virtual (RV) é um recurso em ascensão e diversos estudos com estas populações apresentam resultados positivos (de Bruin et al, 2010;Massetti et al, 2018, Tieri et al, 2018. A RV surgiu como um método de interação e simulação em tempo real por meio de múltiplos canais sensorias, onde os usuários são imersos em ambientes virtuais gerados pelo computador (de Bruin et al, 2010; Lange e Pompeu, 2018), além de ser uma estratégias de intervenção motora e cognitiva aplicada à avaliação e a reabilitação (Massetti et al, 2018). Para criar um ambiente de RV existe uma ampla variedade de dispositivos de interação, sistemas de exibição sensorial e conteúdo apresentado no ambiente virtual (Rizzo, 2017), dentre eles videogames interativos (TierI et al, 2018).…”

“…Um programa de reabilitação pode se tornar cansativo e o paciente perder o interesse se novas técnicas ou recursos não forem incluídos na rotina do tratamento de um paciente crônico . Dessa forma, aliar um programa com intervenções convencionais e novas tecnologias, pode produzir efeitos positivos na adesão ao tratamento e proporcionar ganhos funcionais e cognitivos (Burdea, 2003;Monteiro et al, 2011, Massetti et al, 2018. Entre as novas intervenções, estudos vêm mostrando efeitos positivos dos videogames interativos nos desfechos clínicos de pacientes pós AVC (Laver et al, 2017), PC (Chen et al, 2018); doença de Parkinson (Dockx et al, 2016), idosos frágeis (Gomes et al, 2018) entre outros.…”

“…Entre as novas intervenções, estudos vêm mostrando efeitos positivos dos videogames interativos nos desfechos clínicos de pacientes pós AVC (Laver et al, 2017), PC (Chen et al, 2018); doença de Parkinson (Dockx et al, 2016), idosos frágeis (Gomes et al, 2018) entre outros. Em sua maioria os estudos são com AVC, seguidos por PC e Lesão Medular Encefálica (LME) respectivamente, dentre outras patologias, resultado da incidência destas patologias e maior dificuldade no recrutamento de populações, dada a heterogeneidade do comprometimento de funções que esses grupos apresentam (Massetti et al, 2018).…”