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http://dx.doi.org/10.22683/tsnr.2021.10.3.007

A Study on the Effect of Virtual Reality Intervention on Cognitive Function in Individuals With Stroke Through Meta-analysis  

Kwon, Jae Sung (Dept. of Occupational Therapy, College of Health Science, Cheongju University)
Publication Information
Therapeutic Science for Rehabilitation / v.10, no.3, 2021 , pp. 7-22 More about this Journal
Abstract
Objective : The purpose of this study was to verify the effect of virtual reality interventions (VRIs) on cognitive function in individuals with stroke through a systematic literature review and meta-analysis. Methods : We reviewed randomized controlled trials (RCTs) the last 10 years using academic databases. PubMed, MEDLINE, and CINAHL were used for international studies, and DBpia, KISS, Kyoboscholar, and e-article were used for Korean studies. For the quantitative meta-analysis, subgroups of outcomes were classified into general cognitive function (G-CF), attention and memory (A&M), and executive function (EF). Results : Nine RCTs were analyzed. The total number of participants was 271 (140 in the experimental group). The effect size (Cohen's d) was estimated using a random effects model. The effect sizes of the outcome subgroups of were as follows: small to medium for G-CF (d=0.422; 95% CI: 0.101~0.742; p=0.010), small for A&M (d=0.249; 95% CI: -0.107~0.605; p=0.170), and medium for EF (d=0.666; 95% CI: 0.136~1.195; p=0.014). Conclusion : Considering the various stimuli provided by the virtual environment and the results from available research, virtual reality should be applied to interventions for integrated cognitive functions. In addition, it would be appropriate to be used as an additional intervention to traditional cognitive rehabilitation for stroke.
Keywords
Cognitive function; Meta-analysis; Stroke; Virtual reality;
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1 Kim, Y. M., Chun, M. H., Yun, G. J., Song, Y. J., & Young, H. E. (2011). The effect of virtual reality training on unilateral spatial neglect in stroke patients. Annals of Rehabilitation Medicine, 35(3), 309-315. doi:10.5535/arm.2011.35.3.309   DOI
2 Langhorne, P., Bernhardt, J., & Kwakkel, G. (2011). Stroke rehabilitation. The Lancet, 377(9778), 1693-1702. doi:10.1016/S0140-6736(11)60325-5   DOI
3 Larsen, C. R., Soerensen, J. L., Grantcharov, T. P., Dalsgaard, T., Schouenborg, L., Ottosen, C., ... Ottesen, B. S. (2009). Effect of virtual reality training on laparoscopic surgery: Randomised controlled trial. British Medical Journal, 338, 1-6. doi:10.1136/bmj.b1802   DOI
4 Kwon, J. S. (2015). Effects of computer based virtual reality program on clinical rehabilitation in Korea: A meta-analysis. Journal of Digital Convergence, 13(7), 293-304. doi:10.14400/JDC.2015.13.7.293   DOI
5 Aminov, A., Rogers, J. M., Middleton, S., Caeyenberghs, K., & Wilson, P. H. (2018). What do randomized controlled trials say about virtual rehabilitation in stroke? A systematic literature review and meta-analysis of upper-limb and cognitive outcomes. Journal of NeuroEngineering and Rehabilitation, 15(1), 1-24. doi:10.1186/s12984-018-0370-2   DOI
6 Arienti, C., Lazzarini, S. G., Pollock, A., & Negrini, S. (2019). Rehabilitation interventions for improving balance following stroke: An overview of systematic reviews. PLoS One, 14(7), 1-23. doi:10.1002/14651858.CD008349.pub310.1371/journal.pone. 0219781   DOI
7 Borenstein, M., Hedges, L. V., Higgins, J. P., & Rothstein, H. R. (2009). Introduction to meta-analysis. Chichester, UK: Wiley.
8 Castiello, U., Lusher, D., Burton, C., Glover, S., & Disler, P. (2004). Improving left hemispatial neglect using virtual reality. Neurology, 62(11), 1958-1962. doi:10.1212/01.WNL.0000128183.63917.02   DOI
9 Choi, J. H., Han, E. Y., Kim, B. R., Kim, S. M., Im, S. H., Lee, S. Y., & Hyun, C. W. (2014). Effectiveness of commercial gaming-based virtual reality movement therapy on functional recovery of upper extremity in subacute stroke patients. Annals of Rehabilitation Medicine, 38(4), 485-493. doi:10.5535/arm.2014.38.4.485   DOI
10 Goncalves, R., Pedrozo, A. L., Coutinho, E. S. F., Figueira, I., & Ventura, P. (2012). Efficacy of virtual reality exposure therapy in the treatment of PTSD: A systematic review. PLoS One, 7(12), 1-7. doi:10.1371/journal.pone.0048469   DOI
11 Kim, B. R., Chun, M. H., Kim, L. S., & Park, J. Y. (2011). Effect of virtual reality on cognition in stroke patients. Annals of Rehabilitation Medicine, 35(4), 450-459. doi:10.5535/arm.2011.35.4.450   DOI
12 Kwon, J. S., Park, M. J., Yoon, I. J., & Park, S. H. (2012). Effects of virtual reality on upper extremity function and activities of daily living performance in acute stroke: A double-blind randomized clinical trial. NeuroRehabilitation, 31(4), 379-385. doi:10.3233/NRE-2012-00807   DOI
13 Park, S. A., & Kim, H. Y. (2019). Effects of virtual reality program on recovery of functional in individuals stroke: A systematic review and meta analysis. Journal of Digital Convergence, 17(5), 235-247. doi:10.14400/JDC.2019.17.5.235   DOI
14 Cho, K., Yu, J., & Jung, J. (2012). Effects of virtual reality-based rehabilitation on upper extremity function and visual perception in stroke patients: A randomized control trial. Journal of Physical Therapy Science, 24(11), 1205-1208. doi:10.1589/jpts.24.1205   DOI
15 Choi, B. G., & Kwon, J. S. (2020). A preliminary study of the effects of monitor-based virtual reality games on the cognition & activities of daily living for acute stroke: A double-blind randomized controled trial. The Journal of the Korea Contents Association, 20(9), 531-540. doi:10.5392/JKCA.2020.20.09.531   DOI
16 Chung, J. C. (2004). Activity participation and well-being of people with dementia in long term care settings. OTJR: Occupation, Participation and Health, 24(1), 22-31. doi:10.1177/153944920402400104   DOI
17 Cicerone, K. D., Langenbahn, D. M., Braden, C., Malec, J. F., Kalmar, K., Fraas, M., ... Bergquist, T. (2011). Evidence-based cognitive rehabilitation: Updated review of the literature from 2003 through 2008. Archives of Physical Medicine and Rehabilitation, 92(4), 519-530. doi:10.1016/j.apmr.2010.11.015   DOI
18 Cohen, J. (1988). Statistical power analysis for the behabioral sciences. Hillsdale, NJ: Laurence Erlbaum Associates.
19 Cooper, H. M. (1982). Scientific guidelines for conducting integrative research reviews. Review of Educational Research, 52(2), 291-302. doi:10.2307/1170314   DOI
20 Dehn, L. B., Piefke, M., Toepper, M., Kohsik, A., Rogalewski, A., Dyck, E., ... Schabitz, W. R. (2020). Cognitive training in an everyday-like virtual reality enhances visual-spatial memory capacities in stroke survivors with visual field defects. Topics in Stroke Rehabilitation, 27(6), 442-452. doi:10.1080/10749357.2020.1716531   DOI
21 Wald, J., & Taylor, S. (2003). Preliminary research on the efficacy of virtual reality exposure therapy to treat driving phobia. CyberPsychology & Behavior, 6(5), 459-465. doi:10.1089/109493103769710488   DOI
22 Oh, Y. B., Kim, G. W., Han, K. S., Won, Y. H., Park, S. H., Seo, J. H., & Ko, M. H. (2019). Efficacy of virtual reality combined with real instrument training for patients with stroke: A randomized controlled trial. Archives of Physical Medicine and Rehabilitation, 100(8), 1400-1408. doi:10.1016/j.apmr.2019.03.013   DOI
23 De Luca, R., Russo, M., Naro, A., Tomasello, P., Leonardi, S., Santamaria, F., ... Calabro, R. S. (2018). Effects of virtual reality-based training with BTs-Nirvana on functional recovery in stroke patients: Preliminary considerations. International Journal of Neuroscience, 128(9), 791-796. doi:10.1080/00207454.2017.1403915   DOI
24 Faria, A. L., Andrade, A., Soares, L., & Badia, S. B. (2016). Benefits of virtual reality based cognitive rehabilitation through simulated activities of daily living: A randomized controlled trial with stroke patients. Journal of NeuroEngineering and Rehabilitation, 13(1), 1-12. doi:10.1186/s12984-016-0204-z   DOI
25 Lee, H. W., & Jeon, H. S. (2012). Effects of mirror therapy on motor recovery following a stroke: A meta-analysis. Physical Therapy Korea, 19(2), 48-58. doi:10.12674/ptk.2012.19.2.048   DOI
26 Maier, M., Ballester, B. R., Leiva Banuelos, N., Duarte Oller, E., & Verschure, P. F. M. J. (2020). Adaptive conjunctive cognitive training (ACCT) in virtual reality for chronic stroke patients: A randomized controlled pilot trial. Journal of NeuroEngineering and Rehabilitation, 17(1), 1-20. doi:10.1186/s12984-020-0652-3   DOI
27 Moseley, A. M., Herbert, R. D., Sherrington, C., & Maher, C. G. (2002). Evidence for physiotherapy practice: A survey of the physiotherapy evidence database (PEDro). Australian Journal of Physiotherapy, 48(1), 43-49. doi:10.1016/S0004-9514(14)60281-6   DOI
28 Rogers, J. M., Duckworth, J., Middleton, S., Steenbergen, B., & Wilson, P, H. (2019). Elements virtual rehabilitation improves motor, cognitive, and functional outcomes in adult stroke: Evidence from a randomized controlled pilot study. Journal of NeuroEngineering and Rehabilitation, 16(1), 1-13. doi:10.1186/s12984-019-0531-y   DOI
29 Laver, K. E., Lange, B., George, S., Deutsch, J. E., Saposnik, G., & Crotty, M. (2017). Virtual reality for stroke rehabilitation. Cochrane Database of Systematic Reviews, 11(11), 1-161. doi:10.1002/14651858.CD008349.pub4   DOI
30 Sacco, R. L., Kasner, S. E., Broderick, J. P., Caplan, L. R., Connors, J., Culebras, A., ... Higashida, R. T. (2013). An updated definition of stroke for the 21st century: A statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 44(7), 2064-2089. doi:10.1161/STR.0b013e318296aeca   DOI
31 Adomaviciene, A., Daunoraviciene, K., Kubilius, R., Varzaityte, L., & Raistenskis, J. (2019). Influence of new technologies on post-stroke rehabilitation: A comparison of armeo spring to the kinect system. Medicina, 55(4), 1-12. doi:10.3390/medicina55040098   DOI
32 Josman, N., Kizony, R., Hof, E., Goldenberg, K., Weiss, P. L., & Klinger, E. (2014). Using the virtual action planning-supermarket for evaluating executive functions in people with stroke. Journal of Stroke and Cerebrovascular Diseases, 23(5), 879-887. doi:10.1016/j.jstrokecerebrovasdis.2013.07.013   DOI
33 Yang, N. Y., Park, H. S., Yoon, T. H., & Moon, J. H. (2018). Effectiveness of motion-based virtual reality training (Joystim) on cognitive function and activities of daily living in patients with stroke. Journal of Rehabilitation Welfare Engineering & Assistive Technology, 12(1), 10-19. doi:10.21288/resko.2018.12.1.10   DOI
34 Weiss, P. L., Kizony, R., Feintuch, U., & Katz, N. (2006). Virtual reality in neurorehabilitation. Textbook of Neural Repair and Rehabilitation, 51(8), 182-197.
35 Lesniak, M., Bak, T., Czepiel, W., Seniow, J., & Czlonkowska, A. (2008). Frequency and prognostic value of cognitive disorders in stroke patients. Dementia and Geriatric Cognitive Cisorders, 26(4), 356-363. doi:10.1159/000162262   DOI
36 Lewis, G. N., & Rosie, J. A. (2012). Virtual reality games for movement rehabilitation in neurological conditions: How do we meet the needs and expectations of the users? Disability and Rehabilitation, 34(22), 1880-1886. doi:10.3109/09638288.2012.670036   DOI
37 Lintern, G., Roscoe, S. N., & Sivier, J. E. (1990). Display principles, control dynamics, and environmental factors in pilot training and transfer. Human Factors, 32(3), 299-317. doi:10.1177/001872089003200304   DOI
38 Lohse, K. R., Hilderman, C. G., Cheung, K. L., Tatla, S., & Van der Loos, H. M. (2014). Virtual reality therapy for adults post-stroke: A systematic review and meta-analysis exploring virtual environments and commercial games in therapy. PLoS One, 9(3), 1-13. doi:10.1371/journal.pone.0093318   DOI
39 Heo, S., Lee, H., Ham, A., Kim, Y., Jeong, S., & Kim, K. (2016). The effects of virtual reality therapy on executive function and balance for stroke patients: A randomized controlled clinical trial. The Journal of Korean Society of Occupational Therapy, 24(4), 1-14. doi:10.14519/jksot.2016.24.4.01   DOI
40 Katz, N., Ring, H., Naveh, Y., Kizony, R., Feintuch, U., & Weiss, P. (2005). Interactive virtual environment training for safe street crossing of right hemisphere stroke patients with unilateral spatial neglect. Disability and Rehabilitation, 27(20), 1235-1244. doi:10.1080/09638280500076079   DOI
41 Kim, Y. G. (2015). The effect of the virtual reality rehabilitation system on activities of daily living, cognitive function, self-esteem in stroke. Journal of the Korea Academia-Industrial Cooperation Society, 16(8), 5476-5484. doi:10.5762/KAIS.2015.16.8.5476   DOI