The Rehabilitative Effects of Virtual Reality Games on Balance Performance among Children with Cerebral Palsy: A Meta-Analysis of Randomized Controlled Trials

Abstract

This research aims to evaluate the effect of virtual reality (VR) games on balance recovery of children with cerebral palsy (CP) by quantitatively synthesizing the existing literature, and to further determine the impact of VR game intervention (the duration of each intervention, intervention frequency, intervention cycle, and total intervention time) on the balance recovery of children with CP. To this end, relevant literature up until 3 August 2019 was retrieved from Chinese databases (CNKI and Wanfang Data) and the databases in other languages (Web of Science, Pubmed, EBSCOhost, Informit, Scopus, Science Direct, and ProQuest), and bias analysis was conducted with the PEDro scale in this research. Randomized controlled trials (RCTs) were selected and underwent meta-analysis, and combined effect size was calculated with a random effects model. The results showed that VR games may improve the balance of children with CP (Hedge’s g = 0.29; 95% CI 0.10–0.48), and no significant influence of the intervention on balance of children with CP was shown in the subgroup analysis. In conclusion, VR games played a positive role in the improvement of balance of children with CP, but these results should be viewed with caution owing to current methodological defects (difference in measurement, heterogeneity of control groups, intervention combined with other treatments, etc.).

Virtual Reality in Neurorehabilitation: An Umbrella Review of Meta-Analyses

“…Thirty-two reviews included patients with stroke, six had samples of children with CP [ 34 , 36 , 45 , 48 , 55 , 59 , 65 , 67 , 68 ] and three had patients with ABI, including stroke and TBI [ 33 , 57 , 61 ].…”

“…Nineteen reviews investigated the effectiveness of VR interventions at immediate follow-up for balance and postural control compared with conventional therapy or no intervention. Three meta-analyses included children with CP [ 36 , 65 , 68 ] and three included people with Acquired Brain Injury (ABI) (e.g., stroke, TBI) [ 33 , 57 , 61 ]. Thirteen reviews focused on the effect of VR on people with stroke [ 13 , 35 , 37 , 38 , 40 , 42 , 44 , 46 , 47 , 52 , 56 , 62 , 64 ].…”

Leap Motion Controller Video Game-Based Therapy for Upper Extremity Motor Recovery in Patients with Central Nervous System Diseases. A Systematic Review with Meta-Analysis

“…Different studies have assessed the effect of the clinical application of non-immersive VR in patients who have suffered a CNSD [ 26 ]. Although stroke is the leading CNSD in which non-immersive VR has been used [ 27 ], in other CNSDs that cause motor impairments such as cerebral palsy [ 28 ], multiple sclerosis [ 29 ], Parkinson’s disease [ 30 ] or spinal cord injury [ 31 ], non-immersive VR has been extensively studied with promising results. However, to train the disabled manual skills more specifically (e.g., GS, GMD and FMD), it is necessary to use VR haptic devices, such as the Leap Motion Controller (LMC) [ 32 ].…”

Virtual Reality-Assisted Cognitive Behavioral Therapy for Anxiety Disorders: A Systematic Review and Meta-Analysis

“…As a newly developing intervention method, VR has gradually become an adjacent therapy to various disease treatments, such as for cerebral palsy, depression, and Parkinson's disease. VR technology is a human-computer interaction technology based on multisensory perception and has the advantage of creating a sense of immersion while providing timely feedback based on personal performance (11)(12)(13)(14). VR was initially widely used in specific phobias, such as arachnophobia (fear of spiders) and aerophobia (fear of flying), and has expanded to more complex anxiety disorders, such as in the treatment of obsessive-compulsive disorder and acrophobia (fear of heights) (10,15).…”