Virtual reality therapy for upper limb rehabilitation in patients with stroke: a meta-analysis of randomized clinical trials

Mekbib, Destaw B; Han, Jian; Zhang, Li; Fang, Shan; Jiang, Hongjie; Zhu, Junming; Roe, Anna Wang; Xu, Dongrong

doi:10.1080/02699052.2020.1725126

Cited by 111 publications

(93 citation statements)

References 56 publications

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“…selected systematic reviews and meta-analyses for review. Six meta-analyses were included for our evidence summary [ 63 , 64 , 65 , 66 , 67 , 68 ].…”

Section: Clinical Evidence and Considerations For Vr In Motor Rehamentioning

confidence: 99%

“…The general characteristics of the included meta-analyses are presented in Table 3 . Two studies included randomized controlled trials (RCTs) and quasi-randomized controlled trials [ 64 , 68 ] and three other studies only included RCTs [ 63 , 65 , 67 ]. Karamians et al included RCTs and prospective studies [ 66 ].…”

Section: Clinical Evidence and Considerations For Vr In Motor Rehamentioning

confidence: 99%

“…Outcomes were usually the composite outcomes of upper limb function or activities and Karamians et al only included studies using one of the following outcome measures: Fugl-Meyer Assessment (FMA), Wolf Motor Function Test (WMFT), and Action Research Arm Test (ARAT) [ 66 ]. Mekbib et al only included studies using one of the three following outcomes: FMA, Box and Block Test (BBT), and Motor Activity Log (MAL) [ 65 ]. Methodological quality of the included meta-analyses was assessed using the Assessment of Multiple Systematic Reviews (AMSTAR 2) instrument by two authors (S.C. and W.S.K.)…”

Section: Clinical Evidence and Considerations For Vr In Motor Rehamentioning

confidence: 99%

“…Two metanalyses by Aminov et al [ 63 ] and Lee et al [ 67 ] also showed similar moderate effect sizes for upper limb function in VR rehabilitation ( Table 4 ). Mekbib et al [ 65 ] only included RCTs using dose-matched conventional therapy and calculated the mean differences of FMA, BBT, and MAL, which all represent upper limb function. Although VR showed better improvements in all outcomes when compared to conventional therapy, they were less than the minimal clinically important difference [ 70 , 71 ].…”

Section: Clinical Evidence and Considerations For Vr In Motor Rehamentioning

confidence: 99%

See 3 more Smart Citations

Clinical Application of Virtual Reality for Upper Limb Motor Rehabilitation in Stroke: Review of Technologies and Clinical Evidence

Kim

Cho²,

et al. 2020

JCM

145

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Neurorehabilitation for stroke is important for upper limb motor recovery. Conventional rehabilitation such as occupational therapy has been used, but novel technologies are expected to open new opportunities for better recovery. Virtual reality (VR) is a technology with a set of informatics that provides interactive environments to patients. VR can enhance neuroplasticity and recovery after a stroke by providing more intensive, repetitive, and engaging training due to several advantages, including: (1) tasks with various difficulty levels for rehabilitation, (2) augmented real-time feedback, (3) more immersive and engaging experiences, (4) more standardized rehabilitation, and (5) safe simulation of real-world activities of daily living. In this comprehensive narrative review of the application of VR in motor rehabilitation after stroke, mainly for the upper limbs, we cover: (1) the technologies used in VR rehabilitation, including sensors; (2) the clinical application of and evidence for VR in stroke rehabilitation; and (3) considerations for VR application in stroke rehabilitation. Meta-analyses for upper limb VR rehabilitation after stroke were identified by an online search of Ovid-MEDLINE, Ovid-EMBASE, the Cochrane Library, and KoreaMed. We expect that this review will provide insights into successful clinical applications or trials of VR for motor rehabilitation after stroke.

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“…selected systematic reviews and meta-analyses for review. Six meta-analyses were included for our evidence summary [ 63 , 64 , 65 , 66 , 67 , 68 ].…”

Section: Clinical Evidence and Considerations For Vr In Motor Rehamentioning

confidence: 99%

Section: Clinical Evidence and Considerations For Vr In Motor Rehamentioning

confidence: 99%

Section: Clinical Evidence and Considerations For Vr In Motor Rehamentioning

confidence: 99%

Section: Clinical Evidence and Considerations For Vr In Motor Rehamentioning

confidence: 99%

See 2 more Smart Citations

Clinical Application of Virtual Reality for Upper Limb Motor Rehabilitation in Stroke: Review of Technologies and Clinical Evidence

Kim

Cho²,

et al. 2020

JCM

145

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“…Indeed, VR is now recognized as a clinically valid approach for delivering post-stroke therapy. There is significant clinical evidence supporting the use of VR as an adjunct therapy for UE rehabilitation post-stroke [30][31][32][33], leading to its inclusion in stroke rehabilitation practice guidelines, including the Canadian Stroke Best Practice Recommendations [34]. VR is recommended for post-stroke therapy as it provides additional opportunities for engagement, feedback, repetition, intensity, and task-oriented training.…”

Section: Related Workmentioning

confidence: 99%

At-Home Self-Administration of an Immersive Virtual Reality Therapeutic Game for Post-Stroke Upper Limb Rehabilitation

Salisbury

Aronson

Simon

2020

Extended Abstracts of the 2020 Annual Symposium on Computer-Human Interaction in Play

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After a stroke, it is common to experience weakness or paralysis on one side of the body, including difficulty incorporating an affected upper extremity in activities of daily living. Virtual reality and video games that encourage task-oriented movement have been recognized as a valid clinical approach for providing stroke survivors with additional therapy. However, there have been few, if any, reports that examine the use of immersive virtual reality in the home for this purpose. Here, we describe a case study of a stroke survivor utilizing a therapeutic gaming system in the home over the course of several months. The digital therapeutic, CogniviveVR, utilizes head-mounted display-based virtual reality to provide patients with an immersive world where therapeutic tasks can be generated and dynamically self-adapted within a patient's peripersonal space. The therapy was found to be feasible, well-tolerated, and engaging, with the study participant selfadministering therapy approximately half an hour per day, 5-6 times a week over the course of eight weeks. Analysis of 3D motion data collected during sessions showed significant improvements in movement smoothness during performance of game tasks. After this pilot study, the system was successfully adapted to run on a stand-alone virtual reality headset. This has substantially reduced system setup requirements and will enable additional home-based studies to be conducted without the need for a study staff member to visit patients' homes to verify installation.

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XR and Neurorehabilitation

Arlati¹,

Borghetti²

2022

Roadmapping Extended Reality

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Virtual reality therapy for upper limb rehabilitation in patients with stroke: a meta-analysis of randomized clinical trials

Cited by 111 publications

References 56 publications

Clinical Application of Virtual Reality for Upper Limb Motor Rehabilitation in Stroke: Review of Technologies and Clinical Evidence

Clinical Application of Virtual Reality for Upper Limb Motor Rehabilitation in Stroke: Review of Technologies and Clinical Evidence

At-Home Self-Administration of an Immersive Virtual Reality Therapeutic Game for Post-Stroke Upper Limb Rehabilitation

XR and Neurorehabilitation

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