Virtual reality (VR) and video game applications are novel and potentially useful technologies that can be combined with conventional rehabilitation for upper arm improvement after stroke, say authors of a meta-analysis published in the April issue of Stroke.
The authors searched Medline, EMBASE, and Cochrane literature from 1966 to July 2010 with the terms "stroke," "virtual reality," and "upper arm/extremity," and evaluated the effect of VR on motor function improvement after stroke. Of the 35 studies identified, 12 met the inclusion/exclusion criteria, totaling 195 participants. Among the studies, 5 were randomized clinical trials and 7 were observational studies with a pre-/postintervention design. Interventions were delivered within 4 to 6 weeks in 9 of the studies and within 2 to 3 weeks in the remaining 3. Eleven of the 12 studies showed a significant benefit of VR for the selected outcomes. In the pooled analysis of all 5 randomized controlled trials, the effect of VR on motor impairment (Fugl-Meyer) was OR=4.89. No significant difference was observed for Box and Block Test or motor function. Among observational studies, there was a 14.7% improvement in motor impairment and a 20.1% improvement in motor function after VR.