Application of virtual reality (VR) in the rehabilitation of neurological disorders: a systematic review and meta-analysis of treatment parameters.

Abstract

Purpose: The present study evaluates the impact of virtual reality (VR) technology on balance function in patients with different neurological disorders, and explores the effects of diverse VR parameters on treatment efficacy.

Methods: A comprehensive search of PubMed, Cochrane Library, EMBASE, Web of Science, and Scopus databases was conducted up to December 15, 2024. Data from 44 studies Involving 2,019 patients were independently screened and extracted by two researchers. Risk of bias was assessed using the Cochrane Collaboration's Risk of Bias Tool, and meta-analysis was performed using RevMan 5.4.1 software. The quality of evidence was evaluated using GRADE.

Results: VR significantly improved balance ability in patients with different neurological disorders (SMD = 0.75; 95% CI: 0.62-0.87; Z = 11.96; p < 0.001), with the most pronounced effect in Parkinson's disease (SMD = 0.95; 95% CI: 0.67-1.22; Z = 6.75; p < 0.001). Significant improvements were also noted in static balance (SMD = 0.73; 95% CI: 0.42-1.04; Z = 4.59; p < 0.001), Berg Balance Scale (SMD = 0.76; 95% CI: 0.61-0.90; Z = 10.25; p < 0.001), Timed Up and Go (SMD = - 0.30; 95% CI: - 0.50 to - 0.09; Z = 2.87; p = 0.004), and Tinetti Scale (SMD = 0.53; 95% CI: 0.18-0.88; Z = 2.94; p = 0.003). However, improvements in the Activities-specific Balance Confidence scale (SMD = 0.29; 95% CI: - 0.04-0.61; Z = 1.72; p = 0.09) and Functional Reach Test scores (SMD = 0.17; 95% CI: - 0.30-0.63; Z = 0.70; p = 0.49) were not significant. Combining VR with other therapies yielded better results (SMD = 0.78; 95% CI: 0.63-0.93; Z = 10.29; p < 0.001). Treatments lasting no more than 30 min (SMD = 0.78; 95% CI: 0.63-0.94; Z = 9.73; p < 0.001) and Intervention periods not exceeding 6 weeks (SMD = 0.78; 95% CI: 0.61-0.95; Z = 9.02; p < 0.001) were more effective.

Conclusion: VR technology effectively improves balance In patients with neurological disorders. Optimal results are achieved with sessions under 30 min and intervention periods less than six weeks.