Abstract
BackgroundStroke remains one of the major chronic illnesses worldwide that health care organizations will need to address for the next several decades. Individuals poststroke are subject to levels of cognitive impairment and mental health problems. Virtual reality (VR)-based therapies are new technologies used for cognitive rehabilitation and the management of psychological outcomes.ObjectiveThis study performed a meta-analysis to evaluate the effects of VR-based therapies on cognitive function and mental health in patients with stroke.MethodsA comprehensive database search was performed using PubMed, MEDLINE (Ovid), Embase, Cochrane Library, and APA PsycINFO databases for randomized controlled trials (RCTs) that studied the effects of VR on patients with stroke. We included trials published up to April 15, 2021, that fulfilled our inclusion and exclusion criteria. The literature was screened, data were extracted, and the methodological quality of the included trials was assessed. Meta-analysis was performed using RevMan 5.3 software.ResultsA total of 894 patients from 23 RCTs were included in our meta-analysis. Compared to traditional rehabilitation therapies, the executive function (standard mean difference [SMD]=0.88, 95% confidence interval [CI]=0.06-1.70, P=.03), memory (SMD=1.44, 95% CI=0.21-2.68, P=.02), and visuospatial function (SMD=0.78, 95% CI=0.23-1.33, P=.006) significantly improved among patients after VR intervention. However, there were no significant differences observed in global cognitive function, attention, verbal fluency, depression, and the quality of life (QoL).ConclusionsThe findings of our meta-analysis showed that VR-based therapies are efficacious in improving executive function, memory, and visuospatial function in patients with stroke. For global cognitive function, attention, verbal fluency, depression, and the QoL, further research is required.Trial RegistrationPROSPERO International Prospective Register of Systematic Reviews CRD42021252788; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=252788
Highlights
Stroke is the second-highest cause of death worldwide and a leading cause of disability, contributing to approximately 3 million cases every year in China [1]
The findings of our meta-analysis showed that Virtual reality (VR)-based therapies are efficacious in improving executive function, memory, and visuospatial function in patients with stroke
Based on a random-effects model, our results showed a beneficial effect of VR-based therapies on enhancing memory in patients with stroke (SMD=1.44, 95% confidence interval (CI)=0.21-2.68, P=.02), with high heterogeneity (I2=91%, P
Summary
Stroke is the second-highest cause of death worldwide and a leading cause of disability, contributing to approximately 3 million cases every year in China [1]. Multiple studies have shown that due to unsatisfactory sequelae and irreversible prognosis, patients with stroke always experience higher levels of emotional distress and ineffective coping than the general population, which poses adverse effects on the rehabilitation process and indirectly affects the patients’ quality of life (QoL) [13,14]. Objective: This study performed a meta-analysis to evaluate the effects of VR-based therapies on cognitive function and mental health in patients with stroke. There were no significant differences observed in global cognitive function, attention, verbal fluency, depression, and the quality of life (QoL). Conclusions: The findings of our meta-analysis showed that VR-based therapies are efficacious in improving executive function, memory, and visuospatial function in patients with stroke. Trial Registration: PROSPERO International Prospective Register of Systematic Reviews CRD42021252788; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=252788
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