Virtual reality during gait training: does it improve gait function in persons with central nervous system movement disorders? A systematic review and meta-analysis

Article type: Review Article

Authors: De Keersmaecker, Emma^{a; b; c; *} | Lefeber, Nina^{a; b; c} | Geys, Marion^a | Jespers, Elise^a | Kerckhofs, Eric^{a; b; c} | Swinnen, Eva^{a; b; c}

Affiliations: [a] Rehabilitation Research – Neurological Rehabilitation, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Brussels, Belgium | [b] Center for Neurosciences (C4N), Vrije Universiteit Brussel, Brussels, Belgium | [c] Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, Brussels, Belgium

Correspondence: [*] Address for correspondence: Emma De Keersmaecker, Rehabilitation Research – Neurological Rehabilitation, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium. Tel.: +32-2-4774529; E-mail: Emma.De.Keersmaecker@vub.be.

Abstract: BACKGROUND:During gait training in persons with central nervous system (CNS) movement disorders, virtual reality (VR) can offer added value by providing task-specific gait training in more interactive and motivating environments. OBJECTIVE:To summarize current evidence for the effectiveness of VR-enhanced gait training in persons with CNS movement disorders. METHODS:PubMed, Web of Science and CENTRAL were systematically searched for studies using VR during walking to improve gait outcomes (spatiotemporal, functional, kinematic and kinetic). Meta-analyses were performed to estimate pooled effects. RESULTS:Eighteen studies with in total 337 patients were included (12 studies with people post-stroke, 4 with multiple sclerosis, 1 with Parkinson’s disease, 1 with traumatic brain injury). Spatiotemporal and functional parameters significantly improved in each population after the VR training. Compared to gait training without VR, differences in favor of VR were found for spatiotemporal and functional parameters only in people post-stroke. CONCLUSION:VR-enhanced gait training is an effective method to improve spatiotemporal and functional parameters in persons with CNS movement disorders. Current evidence supports that, in comparison to training without VR, for people post-stroke VR-enhanced gait training is more effective to improve gait function. Future research regarding other outcome measures and other CNS movement disorders is necessary.

Keywords: Virtual reality, gait, central nervous system movement disorder

DOI: 10.3233/NRE-182551

Journal: NeuroRehabilitation, vol. 44, no. 1, pp. 43-66, 2019