Benefits of virtual reality balance training for patients with Parkinson’s disease: A systematic review, meta-analysis, and meta-regression of a randomized controlled trial (Preprint)

Abstract

Background: Virtual reality (VR) balance training are increasingly being pursued in biomedical research and specifically with respect to investigating the balance ability with VR .However, Existing systematic reviews have found inconsistent conclusions about the efficacy of VR in improving balance in parkinson’s disease patients (PD).

Objective: To evaluate the impact of VR balance training on the balance ability of patients with PD.

Methods: All major databases, including Web of Science, PubMed, Scopus, China National Knowledge Infrastructure (CNKI) and Wanfang, were searched to identify all relevant studies published in English or Chinese since September 15th, 2010. Two researchers independently conducted document retrieval, study selection, data extraction, and methodological quality evaluation.

Results: 16 randomized controlled trials were analyzed (N = 583 patients with PD), with the methodological quality evaluation score ranging from 5 to 8 points. A random effects model was selected to combine effect sizes. Meta-analysis showed that the balance ability of PD was significantly improved after VR training compared with the control group.(standardized mean difference(SMD) = 2.127, 95% confidence interval [CI] = 1.202 - 3.052, P < .001, I2 = 95.1, df = 15). It is worth noting that intervention platform may be the main reason for heterogeneity. Meta regression analysis showed that no training program could predict the impact of VR training (P = 0.567-0.938) on PD balance ability. Subgroub result showed that when a single training time 0-20 minutes (SMD = 6.446), 4 to 6 times a week (SMD = 4.067), training for 3 to 5 weeks (SMD = 62.478), training course reached more than 30 times (SMD = 4.405), 201-300 minutes per week (SMD = 4.059) maybe have more benefit .

Conclusions: the systematic review and meta analysis confirmed that VR balance train is a highly effective means to improve balance performance with large effects iin Parkinson’s disease. In addition, we preliminary extracted dose–effect relationships for training volume informing clinicians and practitioners to design effective VR balance training for balance ability. Still, further research is needed to reveal optimal dose–response rela tionships following VR balbance training.