Abstract
IntroductionParkinson’s disease (PD) is managed primarily by dopamine agonists and physiotherapy while virtual reality (VR) has emerged recently as a complementary method. The present study reviewed the effectiveness of VR in rehabilitation of patients with PD.MethodsLiterature search up to June 2019 identified ten studies (n = 343 participants) suitable for meta-analysis and 27 studies (n = 688 participants) for systematic review. Standard mean difference (SMD) and 95% confidence intervals (CI) were calculated using a random effects model.ResultsIn meta-analysis, compared with active rehabilitation intervention, VR training led to greater improvement of stride length, SMD = 0.70 (95%CI = 0.32–1.08, p = 0.0003), and was as effective for gait speed, balance and co-ordination, cognitive function and mental health, quality of life and activities of daily living. Compared with passive rehabilitation intervention, VR had greater effects on balance: SMD = 1.02 (95%CI = 0.38–1.65, p = 0.002). Results from single randomised controlled trials showed that VR training was better than passive rehabilitation intervention for improving gait speed SMD = 1.43 (95%CI = 0.51–2.34, p = 0.002), stride length SMD = 1.27 (95%CI = 0.38–2.16, p = 0.005) and activities of daily living SMD = 0.96 (95%CI = 0.02–1.89). Systematic review showed that VR training significantly (p < 0.05) improved motor function, balance and co-ordination, cognitive function and mental health, and quality of life and activities of daily living.ConclusionVR used in rehabilitation for patients with PD improves a number of outcomes and may be considered for routine use in rehabilitation.
Highlights
Parkinson’s disease (PD) is managed primarily by dopamine agonists and physiotherapy while virtual reality (VR) has emerged recently as a complementary method
VR training led to greater improvement of stride length: Standard mean difference (SMD) = 0.70 (95%confidence intervals (CI) = 0.32 to 1.08, p = 0.0003)
We found only a single study comparing VR and active intervention on activities of daily living and cognitive function comprising 32 subjects [20]
Summary
Parkinson’s disease (PD) is managed primarily by dopamine agonists and physiotherapy while virtual reality (VR) has emerged recently as a complementary method. The present study reviewed the effectiveness of VR in rehabilitation of patients with PD. Physical rehabilitation is an essential complementary component to drug therapy of PD while virtual reality (VR) has increasingly been applied to rehabilitation of patients with neurological conditions [5]. This technology is a computer-generated environment in which the user can perceive, feel and interact in a manner that is similar to a physical place, achieved by combining stimulation over multiple sensory channels such as sight, sound and touch [6].
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