Thursday, April 10, 2014 New Review Says Virtual Reality, Gaming for Individuals Poststroke Provide 'Moderate Advantage' Over Conventional Therapy In a study they describe as the first to incorporate analyses of International Classification of Functioning, Disability, and Heath (ICF) data, researchers make a cautious assertion that for individuals poststroke, the use of virtual reality—including commercially available video game systems—produces "a significant moderate advantage" in ICF outcomes compared with conventional therapies. The findings were the result of an analysis of 26 randomized controlled trials that focused on the use of virtual reality (VR) to augment or replace conventional therapy in populations largely or solely comprising individuals poststroke. Of the studies analyzed, 4 focused on the use of commercially available gaming platforms such as the Nintendo Wii, while the rest used more specialized virtual environment (VE) equipment designed for rehabilitation. The study was published in the March 28, 2014, edition of PLoS ONE. Although other systematic reviews have been conducted around the effectiveness of VR in rehabilitation, authors of the study in PLoS ONE included more recent trials (14 in all since the last such review) and incorporated ICF data into the meta-analysis. While the authors didn't find any trials that examined ICF outcomes related to body function and structures or environmental factors, and found only 3 that analyzed participation restrictions, they did note "a moderate but reliable advantage of VR therapy over [conventional therapy] in the components of body function and activity." The authors concede the findings are tempered with limitations. While authors found "strong evidence" for the effectiveness of therapies that incorporated VE, they described the evidence around commercial videogame platforms as "promising" but "too small to draw conclusions." Researchers also cited a "high degree of variability" in the trials, and an insufficient number of studies to allow authors to control for stroke severity or the effects of time poststroke on the outcomes of conventional therapy. In fact, they write, future studies should attempt to clearly define “conventional therapy” to make results more useful. Research-related stories featured in News Now are intended to highlight a topic of interest only and do not constitute an endorsement by APTA. For synthesized research and evidence-based practice information, visit the association's PTNow website. Read APTA's full website disclaimer.