Virtual reality as a complementary therapy in the rehabilitation of balance and gait disorders in patients with mild cognitive impairment and Alzheimer's disease: Systematic review.

Abstract

ObjectiveTo analyse the benefits of virtual reality in the management of balance and gait disorders in people with Alzheimer's disease and cognitive impairment.Data sourcesPubMed, PEDro, Cochrane Library, Science Direct, Google Scholar and Epistemonikos.Review methodThis study is a systematic review (PROSPERO Registration number: CRD42023486083). The inclusion criteria were: randomised, cross-sectional, quasi-experimental controlled clinical trials involving patients diagnosed with mild cognitive impairment, dementia and Alzheimer's disease with a score of ≤23 on the MMSE test and age ≥60 years, and interventions conducted with virtual reality and conventional physiotherapy for the treatment of balance and gait disorders. The methodological quality and risk of bias assessment was performed with the PEDro scale.Results12 studies were included in the review (n = 476). Three studies applied virtual reality to both experimental and control groups, six applied virtual reality to the experimental group and conventional physiotherapy to the control, and three investigations applied virtual reality to the experimental group and no treatment to the control group. Virtual reality based rehabilitation significantly improved balance and gait, as well as cognitive level, functionality, postural control and mood of the patients compared to those participants who received conventional physiotherapy or no treatment.ConclusionStudies suggest that interventions based on virtual environments in older adults with early Alzheimer's disease can improve balance and gait impairments, postural control and executive function, delaying the deterioration caused by the disease. Furthermore, this therapy has a positive impact on cognitive and motivational performance in these patients.