Virtual Reality for Limb Motor Function, Balance, Gait, Cognition and Daily Function of Stroke Patients: A Systematic Review and Meta-Analysis

Journal of Advanced Nursing

Zhang, B., Li, D., et al. (2021).

Journal of Advanced Nursing, 77(8), 3255-3273.

This systematic review investigates the use of of virtual reality (VR) rehabilitation therapy in adult stroke patients. While this systematic review includes a variety of outcomes (e.g., limb motor function, gait, daily function), this summary highlights conclusions on the effects of VR on cognition within the scope of speech-language pathology.

Science Research Project of Chinese Nursing Association

Database inception to December 31, 2019

Randomized controlled trials

87

For adult stroke patients, seven studies investigating the effects of virtual reality (VR) rehabilitation on cognitive outcomes as measured by the Mini-Mental State Examination (MMSE) found no significant difference (MD=0.81, 95% CI=-0.41-2.03, p=0.19) and moderate heterogeneity (p=0.007, I²=66%) as compared to control groups. Subgroup analysis of an intervention period of four weeks or less demonstrated significant differences on the MMSE between VR rehabilitation and control intervention groups. No significant difference between groups was identified at five weeks or more. Two studies investigating outcomes as measured by the Auditory Continuous Performance Test (ACPT) reported no significant differences (MD=0.03, 95% CI=-0.12-0.17, p=0.74) and high heterogeneity (p=0.006, I²=87%) between VR rehabilitation and control groups. Two studies investigating cognitive outcomes as measured by the Visual Continuous Performance Test (VCPT) found no significant difference (MD=-0.03, 95% CI=-0.09-0.02, p=0.20) and low heterogeneity (p=0.20, I²=40%) between VR rehabilitation and control groups. The authors conclude the "results showed no significant benefits of VR rehabilitation on cognition, compared with conventional rehabilitation therapy" (p. 3270); however, they note that there is a "lack of VR programs tailored for cognitive function training" (p. 3270) and that "better assessment tools are needed to study the effect of VR on cognitive function in stroke patients" (p. 3270). Additional studies are warranted.