Head-Mounted Display-Based Therapies for Adults Post-Stroke: A Systematic Review and Meta-Analysis

Guillermo Palacios-Navarro,Neville Hogan

doi:10.3390/s21041111

Abstract

Immersive virtual reality techniques have been applied to the rehabilitation of patients after stroke, but evidence of its clinical effectiveness is scarce. The present review aims to find studies that evaluate the effects of immersive virtual reality (VR) therapies intended for motor function rehabilitation compared to conventional rehabilitation in people after stroke and make recommendations for future studies. Data from different databases were searched from inception until October 2020. Studies that investigated the effects of immersive VR interventions on post-stroke adult subjects via a head-mounted display (HMD) were included. These studies included a control group that received conventional therapy or another non-immersive VR intervention. The studies reported statistical data for the groups involved in at least the posttest as well as relevant outcomes measuring functional or motor recovery of either lower or upper limbs. Most of the studies found significant improvements in some outcomes after the intervention in favor of the virtual rehabilitation group. Although evidence is limited, immersive VR therapies constitute an interesting tool to improve motor learning when used in conjunction with traditional rehabilitation therapies, providing a non-pharmacological therapeutic pathway for people after stroke.

Highlights

In the past decades, there has been an sharp increase in the application of virtual reality (VR) treatments to the rehabilitation of a range of disorders resulting from lesions of the nervous system [1,2]
Sensors 2021, 21, 1111 of post-stroke adult subjects via a fully immersive device (HMD); (b) the study had to include a control group; pretest–posttest one-group designs and N = 1 designs were excluded; (c) the study had to include significant outcomes measuring functional or motor recovery of either lower or upper limbs; (d) the study had to report statistical data for the groups involved in at least the posttest; (e) the sample size of each group should not be less than 5 subjects in the posttest; (f) the study had to be published in a peer-reviewed journal and written in English
There were significantly higher improvements in timed up and go (TUG) and activities-specific balance confidence (ABC) in the VR treadmill-training group compared to the control group

Summary

Introduction

There has been an sharp increase in the application of virtual reality (VR) treatments to the rehabilitation of a range of disorders resulting from lesions of the nervous system [1,2]. The area of rehabilitation of patients with stroke is the most productive in terms of technology-based interventions in both upper and lower extremities [3]. Virtual reality can provide an engaging and motivational experience, allowing the user to practice motor movements while manipulating an interface device [5]. Different studies have reported improvements in motor abilities, as well as a great level of participant motivation after including virtual reality in stroke rehabilitation [9,10,11,12,13,14,15]. In stroke rehabilitation, providing an intervention that is motivating and engaging is crucial to patient involvement and participation. Semi-immersive and non-immersive VR systems have been widely used for stroke patient rehabilitation

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Results

Discussion

Conclusion