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Cited by 239Stroke Rehabilitation and RecoveryVirtual Reality Applications and ImpactsTranscranial Magnetic Stimulation Studies

Effect of Specific Over Nonspecific VR-Based Rehabilitation on Poststroke Motor Recovery: A Systematic Meta-analysis

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Maier, Martina, Rubio Ballester, Belén, Duff, Armin, Duarte Oller, Esther, Verschure, Paul F. M. J.·2019·Neurorehabilitation and Neural Repair
DOI 10.1177/1545968318820169PMC PMC6376608
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Abstract

Background. Despite the rise of virtual reality (VR)-based interventions in stroke rehabilitation over the past decade, no consensus has been reached on its efficacy. This ostensibly puzzling outcome might not be that surprising given that VR is intrinsically neutral to its use—that is, an intervention is effective because of its ability to mobilize recovery mechanisms, not its technology. As VR systems specifically built for rehabilitation might capitalize better on the advantages of technology to implement neuroscientifically grounded protocols, they might be more effective than those designed for recreational gaming. Objective. We evaluate the efficacy of specific VR (SVR) and nonspecific VR (NSVR) systems for rehabilitating upper-limb function and activity after stroke. Methods. We conducted a systematic search for randomized controlled trials with adult stroke patients to analyze the effect of SVR or NSVR systems versus conventional therapy (CT). Results. We identified 30 studies including 1473 patients. SVR showed a significant impact on body function (standardized mean difference [SMD] = 0.23; 95% CI = 0.10 to 0.36; P = .0007) versus CT, whereas NSVR did not (SMD = 0.16; 95% CI = −0.14 to 0.47; P = .30). This result was replicated in activity measures. Conclusions. Our results suggest that SVR systems are more beneficial than CT for upper-limb recovery, whereas NSVR systems are not. Additionally, we identified 6 principles of neurorehabilitation that are shared across SVR systems and are possibly responsible for their positive effect. These findings may disambiguate the contradictory results found in the current literature.

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  • Several systematic reviews have evaluated the effect of new home-technologies on patient clinical outcomes, but positive results were not always guaranteed.

    “Although several systematic reviews have evaluated the effect of new home-technologies on patient clinical outcomes, positive results were not always guaranteed [6,7,8].”

    From High-Tech Home-Based Rehabilitation after Stroke: A Systematic Review and Meta-Analysis (2023) · cites this paper as [7]

    The Introduction reports that several meta-analyses evaluated VR technologies for stroke rehabilitation and that some found no benefit over conventional therapy. It describes home rehabilitation as a potential use of these technologies, but does not establish that this meta-analysis evaluated technologies used at home. The home-technologies qualifier is therefore not supported. (LLM, conf=0.84)

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Authors
Maier, M., Rubio Ballester, B., Duff, A., Duarte Oller, E., & Verschure, P. F. M. J.
Affiliations
  • Barcelona Institute of Science and Technology (ES)
  • Laboratory of Synthetic, Perceptive, Emotive and Cognitive Systems (SPECS), Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Science and Technology, Barcelona, Spain
  • Rehabilitation Research Group, Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), Physical Medicine and Rehabilitation Department Parc de Salut Mar (Hospital del Mar, Hospital de l’Esperança), Barcelona, Spain
  • Institució Catalana de Recerca i Estudis Avançats (ES)
Corresponding author
Verschure, Paul F. M. J.
ORCID
Venue
Neurorehabilitation and Neural Repair
Publisher
SAGE Publications
Published
2019-01-30
Volume
33
Issue
2
Pages
112-129
ISSN
  • 0888-4390 (ISSN-L)
  • 1545-9683
  • 1552-6844
DOI
10.1177/1545968318820169
PMC
PMC6376608
OpenAlex
W2914871332
Cited by
239
References
7
Citations by year
2026: 28 · 2025: 24 · 2024: 40 · 2023: 29 · 2022: 34 · 2021: 54 · 2020: 23 · 2019: 7
FWCI
20.60
Type
journal article
Language
en
Open access
Licence
Locations
  • Neurorehabilitation and neural repair (publishedVersion, cc-by-nc)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Dipòsit Digital de la Universitat de Barcelona (Universitat de Barcelona) (publishedVersion, cc-by-nc)
  • RECERCAT (Consorci de Serveis Universitaris de Catalunya) (submittedVersion, cc-by-nc)
  • Repositori digital de la UPF (Universitat Pompeu Fabra) (submittedVersion)
Funders
  • SANAR (MINECO, TIN2013- 44200)
  • cDAC (ERC 2013 ADG 341196)
  • socSMCs (EC, H2020-641321)
Topics
  • Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
  • Physical Sciences › Computer Science › Human-Computer Interaction › Virtual Reality Applications and Impacts
  • Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
Keywords
virtual reality, stroke rehabilitation, upper limb function, conventional therapy, physiological function
MeSH terms
Telerehabilitation, Stroke Rehabilitation, Humans, Motor Activity, Randomized Controlled Trials as Topic, Recovery of Function, Upper Extremity, Observational Studies as Topic

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