ARTICLE REVIEW - NATASHA - WEEK 4

Virtual Reality for Stroke Rehabilitation

Kate Laver, Stacey George, Susie Thomas, Judith E. Deutsch, Maria Crotty

https://doi.org/10.1161/STROKEAHA.111.642439

Stroke. 2012;43:e20-e21

Originally published January 23, 2012

AIMS OF THE STUDY:

With Virtual reality and interactive video gaming becoming an emerging medium for treatment approaches in the medical field, these researchers wanted to see how far a non-clinical environment can be pushed to rehabilitate patients who had suffered from strokes.

The primary objective of this review was to evaluate the effects of virtual reality and interactive video gaming compared with an alternative intervention or no intervention on upper limb, lower limb, and global motor function after stroke. Secondary outcomes included activity limitation and adverse events. We also explored feasibility of the approach by examining recruitment rates.

METHODOLOGY:

-       Randomised controlled trials that compared virtual reality with an “alternate intervention” or “no intervention” in people diagnosed with stroke (movement exercise).

-       VR defined as “an advanced form of human-computer interface that allows the user to ‘interact’ with and become ‘immersed’ in a computer-generated environment in a naturalistic fashion.

-       Included 19 trials that involved 565 participants.

-       Two studies used commercially available gaming consoles with the remaining studies using programs designed for rehabilitation

MAIN FINDINGS:

-       Results from 7 studies with 205 participants showed a statistically significant effect on arm function.

-       After pooling 3 studies which assessed the effect on gait speed, the researchers were unable to find a definitive result.

-       Results from the outcome of activity limitation showed statistically significant results based on 3 studies with 101 participants.

Overall, this research seemed very redundant, even reading the PDF had a sense of the researchers knowing that there was no definitive result. The whole reading was only a few pages long and used very ambiguous explanations for exactly HOW they utilised VR to exercise the person. I feel that some clarification about the effect of stroke and how they wanted to combat/research VR in relation to this would have been incredibly useful and may even give some credit to the result even though they were not definitive.

The did note that their sample sizes were small (10-83) and interventions and outcome measures varied, limiting ability to compare studies. And there were low recruitment rates as an average of 34% of participants who were screened, were recruited.

-        Two studies used commercially available gaming consoles with the remaining studies using programs designed for rehabilitation. The most common intervention approach was upper limb training (used in 8 studies) in contrast to lower limb and gait training (3 studies), global motor function (3 studies), activity retraining (4 studies), and visual–perceptual retraining (1 study).

They concluded with : “There were an insufficient number of comparable studies to assess the effect on global motor function... In summary, we found limited evidence that the use of virtual reality and interactive video gaming may be beneficial in improving arm function and activities of daily living function when compared with the same dose of conventional therapy. There was insufficient evidence to reach conclusions about the effect on gait speed.”

This could be good for them if they were pioneering and had a strong relevance in their material as it could be used as a foundation for future comparision, but none of this was discussed or seemed to be contemplated. Personally, if I was publishing my work, even if inconclusive, I would like to offer some sort of use for it or positive outcomes. The tone of their piece lacked inspiration and made the study seem completely useless which I do not think it is.