Upper limb rehabilitation interventions using virtual reality for people with multiple sclerosis: A systematic review

Webster, Amy; Poyade, Matthieu; Rooney, Scott; Paul, Lorna

doi:10.1016/j.msard.2020.102610

Cited by 44 publications

(32 citation statements)

References 43 publications

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“…In recent years, some studies have assessed the efficacy of different therapies to reduce the impact of MS and its muscle fatigue symptoms, as well as to increase the QoL of MS patients [60,61]. VR-based intervention is a novel therapy that is being used more in the treatment of neurological diseases [18,62], including MS. To date, a number of published reviews have assessed the effect of VR-based intervention in PwMS regarding balance, gait [29,30], and upper extremity recovery [31]. In addition, a recent review [63], which included a small number of studies, evaluated the effect of VR-based intervention on fatigue and QoL.…”

Section: Discussionmentioning

confidence: 99%

“…PwMS have reported high levels of usability and acceptability regarding the use of VR systems in neurorehabilitation [28]. In relation to the use of VR on combating symptoms of MS, some reviews have assessed its effect on gait and balance [29,30], as well as on motor impairments of the upper extremities [31], with interesting results. Therefore, the aim of this review was to collect all available published evidence that permits us to analyze the effect of VR therapy on fatigue, MS impact, and QoL in PwMS.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Virtual Reality-Based Therapy Improves Fatigue, Impact, and Quality of Life in Patients with Multiple Sclerosis. A Systematic Review with a Meta-Analysis

Cortés‐Pérez

Sánchez-Alcalá

Nieto-Escámez

et al. 2021

Sensors

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Patients with multiple sclerosis (PwMS) have a high level of fatigue and a reduced quality of life (QoL) due to the impact of multiple sclerosis (MS). Virtual reality-based therapy (VRBT) is being used to reduce disability in PwMS. The aim of this study was to assess the effect of VRBT on fatigue, the impact of MS, and QoL in PwMS. Methods: A systematic review with meta-analysis was conducted through a bibliographic search on PubMed, Scopus, Web of Science, and PEDro up to April 2021. We included randomized controlled trials (RCTs) with PwMS that received VRBT in comparison to conventional therapy (CT) including physiotherapy, balance and strength exercises, and stretching or physical activity, among others; or in comparison to simple observation; in order to assess fatigue, MS-impact, and QoL. The effect size was calculated using Cohen’s standardized mean difference with a 95% confidence interval (95% CI). Results: Twelve RCTs that provided data from 606 PwMS (42.83 ± 6.86 years old and 70% women) were included. The methodological quality mean, according to the PEDro Scale, was 5.83 ± 0.83 points. Our global findings showed that VRBT is effective at reducing fatigue (SMD −0.33; 95% CI −0.61, −0.06), lowering the impact of MS (SMD −0.3; 95% CI −0.55, −0.04), and increasing overall QoL (0.5; 95% CI 0.23, 0.76). Subgroup analysis showed the following: (1) VRBT is better than CT at reducing fatigue (SMD −0.4; 95% CI −0.7, −0.11), as well as in improving the mental dimension of QoL (SMD 0.51; 95% CI 0.02, 1); (2) VRBT is better than simple observation at reducing the impact of MS (SMD −0.61; 95% CI −0.97, −0.23) and increasing overall QoL (SMD 0.79; 95% CI 0.3, 1.28); and (3) when combined with CT, VRBT is more effective than CT in improving the global (SMD 0.6, 95% CI 0.13, 1.07), physical (SMD 0.87; 95% CI 0.3, 1.43), and mental dimensions (SMD 0.6; 95% CI 0.08, 1.11) of QoL. Conclusion: VRBT is effective at reducing fatigue and MS impact and improving QoL in PwMS.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Virtual Reality-Based Therapy Improves Fatigue, Impact, and Quality of Life in Patients with Multiple Sclerosis. A Systematic Review with a Meta-Analysis

Cortés‐Pérez

Sánchez-Alcalá

Nieto-Escámez

et al. 2021

Sensors

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“…To date, different studies have analyzed the validity [49], feasibility [50], and usability [32] of LMC for use in neurorehabilitation. Several RCTs have assessed the effect of immersive or non-immersive VR on UE motor function recovery [51][52][53], and consequently, some reviews have been carried out [54][55][56]. However, the use of LMC as a VR tool in UE neurorehabilitation has been less studied [57,58].…”

Section: Introductionmentioning

confidence: 99%

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

Cortés‐Pérez

Zagalaz-Anula

Montoro-Cárdenas

et al. 2021

Sensors

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Leap Motion Controller (LMC) is a virtual reality device that can be used in the rehabilitation of central nervous system disease (CNSD) motor impairments. This review aimed to evaluate the effect of video game-based therapy with LMC on the recovery of upper extremity (UE) motor function in patients with CNSD. A systematic review with meta-analysis was performed in PubMed Medline, Web of Science, Scopus, CINAHL, and PEDro. We included five randomized controlled trials (RCTs) of patients with CNSD in which LMC was used as experimental therapy compared to conventional therapy (CT) to restore UE motor function. Pooled effects were estimated with Cohen’s standardized mean difference (SMD) and its 95% confidence interval (95% CI). At first, in patients with stroke, LMC showed low-quality evidence of a large effect on UE mobility (SMD = 0.96; 95% CI = 0.47, 1.45). In combination with CT, LMC showed very low-quality evidence of a large effect on UE mobility (SMD = 1.34; 95% CI = 0.49, 2.19) and the UE mobility-oriented task (SMD = 1.26; 95% CI = 0.42, 2.10). Second, in patients with non-acute CNSD (cerebral palsy, multiple sclerosis, and Parkinson’s disease), LMC showed low-quality evidence of a medium effect on grip strength (GS) (SMD = 0.47; 95% CI = 0.03, 0.90) and on gross motor dexterity (GMD) (SMD = 0.73; 95% CI = 0.28, 1.17) in the most affected UE. In combination with CT, LMC showed very low-quality evidence of a high effect in the most affected UE on GMD (SMD = 0.80; 95% CI = 0.06, 1.15) and fine motor dexterity (FMD) (SMD = 0.82; 95% CI = 0.07, 1.57). In stroke, LMC improved UE mobility and UE mobility-oriented tasks, and in non-acute CNSD, LMC improved the GS and GMD of the most affected UE and FMD when it was used with CT.

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“…It could also be used as a cost-effective platform for MS rehabilitation programs, both physically and cognitively [ 12 – 14 ]. Novel technologies are being tested for physical activity enhancement [ 14 ], motor rehabilitation [ 15 ], dietary interventions [ 16 ], behavioral changes, and psychotherapy in MS cases [ 17 ]. Some are wearable devices and some are Internet-based programs that track daily parameters [ 18 ].…”

Section: Telemedicine In Msmentioning

confidence: 99%

Telemedicine as a strategic intervention for cognitive rehabilitation in MS patients during COVID-19

2022

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The recent COVID-19 pandemic has taken the lives of nearly 5.2 million up to now. With no definite treatment and considering close contact as the primary mode of transmission, telemedicine has emerged as an essential medical care platform. Virtual medical communications have offered clinicians the opportunity to visit and follow up on patients more efficiently during the lockdown. Not only has telemedicine improved multiple sclerosis (MS) patients’ health and quality of life during the pandemic, but it could also be used as a cost-effective platform for physical and cognitive MS rehabilitation programs. Cognitive impairment is a common problem among MS patients even at the initial phases of the disease. Rehabilitation training programs such as RehaCom, BrainHQ, Speed of Processing Training (PST), and COGNI-TRAcK have made great strides in improving a wide range of cognitive functions that MS patients are challenged with. Regarding the impact of COVID-19 on the cognitive aspects of MS patients, efforts to implement rehabilitation training applications have been increased. Web-based mobile applications, virtual visits, and telephone follow-ups are examples of such efforts. Having said that, limitations such as privacy, socioeconomic disparities, e-health literacy, study settings, and challenges of neurologic examinationss have been raised. Since most MS patients are young, all the beneficiaries are encouraged to embrace the research in the field to pave the road for more feasible and efficient ways of cognitive enhancement in MS patients.

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Upper limb rehabilitation interventions using virtual reality for people with multiple sclerosis: A systematic review

Cited by 44 publications

References 43 publications

Virtual Reality-Based Therapy Improves Fatigue, Impact, and Quality of Life in Patients with Multiple Sclerosis. A Systematic Review with a Meta-Analysis

Virtual Reality-Based Therapy Improves Fatigue, Impact, and Quality of Life in Patients with Multiple Sclerosis. A Systematic Review with a Meta-Analysis

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

Telemedicine as a strategic intervention for cognitive rehabilitation in MS patients during COVID-19

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