Background: Many people who experience a stroke have upper-limb motor function impairments. Virtual reality (VR) training is a potential strategy for enhancing upper limb function. VR is a computer based, interactive, multisensory simulation environment where users can be engaged in activities; however, it is unclear if VR is effective. Objectives: To investigate the effectiveness of VR in upper limb rehabilitation after stroke. Search strategy: A computerized literature search of the following databases was conducted: MEDLINE, EMBASE, CINAHL, PEDro, OT seeker, PsycINFO, Cochrane, Cochrane Central Register of Controlled Trials, Evidence-Based Review of Stroke Rehabilitation-Upper Limb Interventions, and ISI Web of Science. The keywords used were: cerebrovascular accident, stroke, virtual reality, virtual environment, rehabilitation, treatment, and brain damage. In addition, a reference check was conducted for all retrieved articles. Selection criteria: The authors included studies the met the following criteria: 1) experimental designs published in English, and 2) studies focused on the use of immersive or non-immersive VR for upper limb rehabilitation (training arm movement) after ischemic or hemorrhagic stroke. Data collection and analysis: Studies were allocated into two groups, either immersive or non-immersive VR and reviewed. The authors assessed the methodological quality of each randomized controlled trial (RCT) using the PEDro scale. Other experimental studies were reviewed using the Newcastle-Ottawa Scale (NOS). Results: Six articles met the inclusion criteria for the review: 2 RCTs, 1 single-subject design study, and 3 pre-post design studies. Two RCTs and the single-subject study examined the effects of immersive VR compared to a no therapy control group. The two RCT studies showed significant differences between treatment and control groups on motor impairment and functional measures. None of the studies investigated the effects of immersive VR training compared to conventional therapy. Conclusion: Few studies were identified that demonstrate the effectiveness of VR in upper limb rehabilitation. Additional high quality experimental studies are needed for further investigation of the use of VR. |
