Virtual Reality Training for balance rehabilitation in neurological disorders: A Systematic Review and Meta-Analysis (Preprint)

Abstract

Neurological disorders such as Parkinson's disease, multiple sclerosis, cerebellar ataxia, and Alzheimer's disease often impact the body's balance functions. The primary cause of balance deficits in these conditions is the effect on the sensory-motor system and the pathways controlling neuromuscular functions. This disruption increases the likelihood of falls while walking. Evidence-based research has demonstrated the efficacy of VR in addressing balance issues associated with neurological conditions.

To investigate the efficacy and safety of virtual reality training for treating balance dysfunction in various neurological disorders.

Data Sources: PubMed, Cochrane Library, EMBASE, and Web of Science were searched from their inception until June 20th, 2024. The PROSPERO registration number for this study is CRD42024484012. Study Selection: Randomised controlled trial of the single or combined use of virtual reality technology as an intervention for the treatment of balance disorders caused by various neurological disorders. Data Extraction: The data was extracted independently by two authors .The quality of the included studies was assessed according to the Cochrane Risk of Bias Tool. The results of continuous variables after treatment were represented by the standardized mean difference (SMD) and its 95% confidence interval (CI). Overall heterogeneity was controlled by excluding a study through sensitivity analysis. Reporting bias was assessed using the Begg’s test and presented in a funnel plot.

A total of 36 studies with 1311 subjects were included in the quantitative evaluation. The neurological disorders were classified into eight distinct groups: stroke, multiple sclerosis, Parkinson's disease, Alzheimer's disease, Ataxia, traumatic brain injury, tropical spastic paraparesis and unilateral peripheral vestibular loss. Stroke patients experienced enhanced balance due to VR (SMD = 0.65; 95% CI = 0.40 to 0.90; Z = 5.10; p < 0.001), multiple sclerosis sufferers (SMD = 0.57; 95% CI = 0.29 to 0.86; Z = 3.90; p < 0.001),Parkinson's patients (SMD = 0.49; 95% CI = 0.12 to 0.86; Z = 2.62; p < 0.05) and unilateral peripheral vestibular loss (SMD = 0.61; 95% CI = 0.23 to 0.99; Z = 3.17; p < 0.05) .

Virtual reality (VR) holds potential as an effective therapy for balance training in adults suffering from neurological conditions.

The PROSPERO registration number for this study is CRD42024484012.