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Utilizing virtual reality training could prove beneficial in the rehabilitation of people afflicted by Parkinson's disease.
A study published in 'The Journal of NeuroEngineering and Rehabilitation' showcased enhancements in activities of daily living (ADL), quality of life (QoL), stride length, and balance in individuals with Parkinson's disease (PD) following virtual reality (VR) training. In this umbrella review of previously published meta-analyses of randomized controlled trials (RCTs), the investigators sought to assess the effectiveness of VR training in enhancing motor skills, ADL, and QoL in PD patients.
In order to find pertinent meta-analyses of RCTs exploring the effects of VR training on motor performance and QoL in volunteers with PD, databases such as Scopus, Web of Science, PsychInfo, and PubMed were explored. Re-evaluation of the effect sizes (Hedges' g) for VR training was conducted utilizing the DerSimonian and Laird random effects models. Furthermore, additional assessments were performed to gauge variations between studies, determine prediction intervals, assess the potential for publication bias, scrutinize the impact of small-scale studies, and ascertain whether the results of positive studies exceeded what would be expected by chance.
As a result of these analyses, the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) criteria was employed to gauge the quality of evidence for each outcome.
Overall, 4 meta-analyses were incorporated, encompassing 8 different outcomes. A recalculation of effect sizes was done, and the pooled results revealed that VR training can significantly enhance the fundamental balance ability to a large extent, moderately improve overall balance capacity, and moderately enhance stride length in people with PD.
In the case of ADL and QoL, the pooled effect sizes recommended that VR training can moderately improve both for individuals with PD. Nevertheless, no clinically meaningful evidence was found regarding improvements in gait function, motor function, and walking speed during VR training. The assessed meta-analyses exhibited methodological quality ranging from low to moderate (AMSTAR2), and the evidence presented within them was generally of moderate to very low quality according to the GRADE criteria. Notably, 2 adverse reactions were noted in the included meta-analyses.
A favorable association was identified between VR and improvements in balance ability, stride length, ADL, and QoL among patients with PD. Notably, VR exhibited a notably strong positive impact on balance, as evidenced by two out of the eight outcomes related to balance ability showing substantial effect sizes. The findings were supported by evidence of moderate to very low quality, underscoring the potential of VR training as a viable rehabilitation approach for individuals with PD.
Journal of NeuroEngineering and Rehabilitation
Efficacy of virtual reality training on motor performance, activity of daily living, and quality of life in patients with Parkinson's disease: an umbrella review comprising meta-analyses of randomized controlled trials
Jingxuan Yu et al.
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