Effect of specific over nonspecific VR-based rehabilitation on poststroke motor recovery: a systematic meta-analysis

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• dc.contributor.author Maier, Martina
• dc.contributor.author Rubio Ballester, Belén
• dc.contributor.author Duff, Armin
• dc.contributor.author Duarte Oller, Esther
• dc.contributor.author Verschure, Paul F. M. J.
• dc.date.accessioned 2019-06-20T06:19:00Z
• dc.date.available 2019-06-20T06:19:00Z
• dc.date.issued 2019
• dc.description.abstract BACKGROUND: Despite the rise of virtual reality (VR)-based interventions in stroke rehabilitation over the past decade, no consensus has been reached on its efficacy. This ostensibly puzzling outcome might not be that surprising given that VR is intrinsically neutral to its use-that is, an intervention is effective because of its ability to mobilize recovery mechanisms, not its technology. As VR systems specifically built for rehabilitation might capitalize better on the advantages of technology to implement neuroscientifically grounded protocols, they might be more effective than those designed for recreational gaming. OBJECTIVE: We evaluate the efficacy of specific VR (SVR) and nonspecific VR (NSVR) systems for rehabilitating upper-limb function and activity after stroke. METHODS: We conducted a systematic search for randomized controlled trials with adult stroke patients to analyze the effect of SVR or NSVR systems versus conventional therapy (CT). RESULTS: We identified 30 studies including 1473 patients. SVR showed a significant impact on body function (standardized mean difference [SMD] = 0.23; 95% CI = 0.10 to 0.36; P = .0007) versus CT, whereas NSVR did not (SMD = 0.16; 95% CI = -0.14 to 0.47; P = .30). This result was replicated in activity measures. CONCLUSIONS: Our results suggest that SVR systems are more beneficial than CT for upper-limb recovery, whereas NSVR systems are not. Additionally, we identified 6 principles of neurorehabilitation that are shared across SVR systems and are possibly responsible for their positive effect. These findings may disambiguate the contradictory results found in the current literature.
• dc.description.sponsorship The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was supported by SANAR (MINECO, TIN2013- 44200), cDAC (ERC 2013 ADG 341196), and socSMCs (Grant Number EC, H2020-641321).
• dc.format.mimetype application/pdf
• dc.identifier.citation Maier M, Rubio Ballester B, Duff A, Duarte Oller E, Verschure PFMJ. Effect of specific over nonspecific VR-based rehabilitation on poststroke motor recovery: a systematic meta-analysis. Neurorehabil Neural Repair. 2019 Feb;33(2):112-129. DOI: 10.1177/1545968318820169
• dc.identifier.doi http://dx.doi.org/10.1177/1545968318820169
• dc.identifier.issn 1545-9683
• dc.identifier.uri http://hdl.handle.net/10230/41845
• dc.language.iso eng
• dc.publisher SAGE Publications
• dc.relation.ispartof Neurorehabilitation and Neural Repair. 2019 Feb;33(2):112-29
• dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/641321
• dc.rights Maier M, Rubio Ballester B, Duff A, Duarte Oller E, Verschure PFMJ. Effect of specific over nonspecific VR-based rehabilitation on poststroke motor recovery: a systematic meta-analysis. Neurorehabil Neural Repair. 2019 Feb;33(2):112-129. Copyright © 2019 . DOI: 10.1177/1545968318820169
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.subject.keyword Occupational therapy
• dc.subject.keyword Paresis
• dc.subject.keyword Rehabilitation
• dc.subject.keyword Review
• dc.subject.keyword Stroke
• dc.subject.keyword Virtual reality
• dc.title Effect of specific over nonspecific VR-based rehabilitation on poststroke motor recovery: a systematic meta-analysis
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/acceptedVersion