Effectiveness of virtual reality-based rehabilitation versus conventional therapy on upper limb motor function of chronic stroke patients: a systematic review and meta-analysis of randomized controlled trials

There are numerous trials, showing positive results for using the music therapy for stroke patient rehabilitation. Therefore, summarizing the data from these trials is an actual topic. The objective, of this research, was to summarize the data from trials about the use of music therapy methods and techniques, especially the rhythmic auditory stimulation, for improving of the motor functions for stroke patients, by creating a systematic review of randomized controlled trials, with meta-analysis. The trials where searched in MEDLINE, Cochrane Trial Register and EBSO databases. The trial quality was evaluated by the PEDro scale. 20 randomized controlled trials were included in the systematic review. The meta-analysis for 5 gait outcomes, including gait speed, steps per minute, step length, gait symmetry, Time up and go test, and 7 arm function outcomes, including Fugl-Meyer test, ARAT test, Box and blocks test, Wolf motor function test, Nine hole peg test, shoulder flexion, elbow extension, was conducted. According to the results of the meta-analysis, gait exercises, combined with rhythmic auditory stimulation, provide statistically significant improvement, compared with gait exercises alone. Concerning the use of rhythmic auditory stimulation and other music therapy interventions for arm function rehabilitation, a statistically significant improvement was not detected.

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Effects of Virtual Reality-Based Intervention on Cognition, Motor Function, Mood, and Activities of Daily Living in Patients With Chronic Stroke: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Frontiers in Aging Neuroscience ◽

10.3389/fnagi.2021.766525 ◽

2021 ◽

Vol 13 ◽

Author(s):

Yong Gao ◽

Lu Ma ◽

Changsheng Lin ◽

Shizhe Zhu ◽

Lingling Yao ◽

...

Keyword(s):

Systematic Review ◽

Virtual Reality ◽

Activities Of Daily Living ◽

Motor Function ◽

Daily Living ◽

Meta Analysis ◽

Chronic Stroke ◽

Controlled Trials ◽

Randomized Controlled ◽

Global Cognition

Background: The efficacy of virtual reality (VR)-based intervention for improving cognition in patients with the chronic stage of stroke is controversial. The aims of this meta-analysis were to evaluate the effect of VR-based training combined with traditional rehabilitation on cognition, motor function, mood, and activities of daily living (ADL) after chronic stroke.Methods: The search was performed in the Cochrane Library (CENTRAL), EBSCO, EMBASE, Medline (OVID), Web of Science databases, PubMed, CINAHL Ovid, and Scopus from inception to May 31, 2021. All included studies were randomized controlled trials (RCTs) examining VR-based intervention combined with traditional rehabilitation for chronic stroke. The main outcomes of this study were cognition, including overall cognition (combined with all cognitive measurement results), global cognition (measured by the Montreal Cognitive Assessment, MoCA, and/or Mini-Mental State Examination, MMSE), and attention/execution. The additional outcomes were motor function, mood, and ADL. Subgroup analyses were conducted to verify the potential factors for heterogeneity.Results: Six RCTs including 209 participants were included for systematic review, and five studies of 177 participants were included in meta-analyses. Main outcome analyses showed large and significant effect size (ES) of VR-based training on overall cognition (g = 0.642; 95% CI = 0.134–1.149; and P = 0.013) and attention/execution (g = 0.695; 95% CI = 0.052–1.339; and P = 0.034). Non-significant result was found for VR-based intervention on global cognition (g = 0.553; 95% CI = −0.273–1.379; and P = 0.189). Additional outcome analyses showed no superiority of VR-based intervention over traditional rehabilitation on motor function and ADL. The ES of VR-based intervention on mood (g = 1.421; 95% CI = 0.448–2.393; and P = 0.004) was large and significant. In the subgroup analysis, large effects for higher daily intensity, higher weekly frequency, or greater dose of VR intervention were found.Conclusion: Our findings indicate that VR-based intervention combined with traditional rehabilitation showed better outcomes for overall cognition, attention/execution, and depressive mood in individuals with chronic stroke. However, VR-based training combined with traditional rehabilitation showed a non-significant effect for global cognition, motor function, and ADL in individuals with chronic stroke.

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The effectiveness and safety of cupping therapy for stroke survivors: A systematic review and meta-analysis of randomized controlled trials

Journal of Korean Medicine ◽

10.13048/jkm.21039 ◽

2021 ◽

Vol 42 (4) ◽

pp. 75-112

Author(s):

Mikyung Kim ◽

Chang-ho Han

Keyword(s):

Randomized Controlled Trials ◽

Motor Function ◽

Upper Limb ◽

Meta Analysis ◽

Mean Difference ◽

Cochrane Library ◽

Controlled Trials ◽

Stroke Survivors ◽

Randomized Controlled ◽

Standard Mean Difference

Objectives: ncluding stroke. The aim of this study was to systematically review the clinical evidence of CT for stroke.Methods: To identify randomized controlled trials (RCTs) reporting the effectiveness and/or safety of CT, seven databases including PubMed, EMBASE, and Cochrane Library were searched for articles published from January 2000 to February 2021 without language restrictions. Meta-analysis was performed using Review Manager 5.4 software and the results were presented as mean difference (MD) or standard mean difference (SMD) for continuous variables and odds ratio (OR) for diverse variables with 95% confidence intervals (CIs). Assessment of the methodological quality of the eligible trials was conducted using the Cochrane Collaboration tool for risk of bias in RCTs.Results: Twenty-two RCTs with 1653 participants were included in the final analysis. CT provided additional benefit in improving upper limb motor function (Fugl-Meyer assessment for upper limb motor function, MD 6.91, 95% CI 4.64 to 1.67, P<0.00001) and spasticity (response rate, OR 3.28, 95% CI 1.31 to 8.22, P=0.08) in stroke survivors receiving conventional medical treatment. These findings were supported with a moderate level of evidence. CT did not significantly increase the occurrence of adverse events.Conclusions: This study demonstrated the potential of CT to be beneficial in managing a variety of complications in stroke survivors. However, to compensate for the shortcomings of the existing evidence, rigorously designed large-scale RCTs are warranted in the future.

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Optimal Method of Electrical Stimulation for the Treatment of Upper Limb Dysfunction After Stroke: A Systematic Review and Bayesian Network Meta-Analysis of Randomized Controlled Trials

Neuropsychiatric Disease and Treatment ◽

10.2147/ndt.s332967 ◽

2021 ◽

Vol Volume 17 ◽

pp. 2937-2954

Author(s):

Yuqi Tang ◽

Linjia Wang ◽

Jinxi He ◽

Yipeng Xu ◽

Shijie Huang ◽

...

Keyword(s):

Systematic Review ◽

Electrical Stimulation ◽

Bayesian Network ◽

Randomized Controlled Trials ◽

Upper Limb ◽

Meta Analysis ◽

Controlled Trials ◽

Optimal Method ◽

Randomized Controlled ◽

Upper Limb Dysfunction

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The Impact of Immersive and Non-Immersive Virtual Reality Trends in Sensorimotor Recovery of Post-Stroke Patients-A Meta-Analysis

Journal of Intellectual Disability - Diagnosis and Treatment ◽

10.6000/2292-2598.2021.09.05.14 ◽

2021 ◽

Vol 9 (5) ◽

pp. 555-564

Author(s):

Jaza Rizvi ◽

◽

Abid Khan ◽

Sumaira Imran Farooqui ◽

Bashir Ahmed Soomro ◽

...

Keyword(s):

Virtual Reality ◽

Randomized Controlled Trials ◽

Meta Analysis ◽

Cochrane Library ◽

Controlled Trials ◽

Stroke Patients ◽

Post Stroke ◽

Randomized Controlled ◽

Sensorimotor Recovery ◽

The Impact

Virtual Reality (VR) is an approach in stroke rehabilitation with ever-improving technological advancement for targeted motor rehabilitation by providing a user interface in a simulated environment with proprioceptive and visual feedback. This meta-analysis intended to evaluate the impact of immersive and non-immersive VR-based interventions compared to conventional rehabilitation in sensorimotor recovery following stroke. Randomized Controlled Trials based on the impact of VR, either immersive or non-immersive type in comparison to conventional rehabilitation on post-stroke patients (>18 years) sensorimotor recovery were searched on six databases including Google Scholar, PEDro, MEDLINE, Cochrane Library, EMBASE, and Web of Science from August to November 2020. A total of 17 randomized controlled trials on VR based intervention showed significant improvement in sensorimotor recovery following a stroke in overall FMA outcomes in comparison to the control group with pool effects in terms of SMD in a random effect model showed an impact of 0.498 at 95% CI (p<0.001) depicts a moderate effect size. An immersive and non-immersive emerging VR trend appears to be a promising therapeutic tool in sensorimotor recovery following stroke.

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