Evidence map›Paper›PMID 29587853›Full record

SynthesisJournal of neuroengineering and rehabilitation2018

What do randomized controlled trials say about virtual rehabilitation in stroke? A systematic literature review and meta-analysis of upper-limb and cognitive outcomes.

Anna Aminov, Jeffrey M Rogers, Sandy Middleton, Karen Caeyenberghs, Peter H Wilson

2 registry-linked trialsAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of neuroengineering and rehabilitation, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 81 papers, 14 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
81citing papers in PubMed, 14 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04429945 nacompletednot on this mapstarted 2021, after this paper: background citation

Immersive Virtual Reality to Improve Outcomes in Patients With Stroke: A Pilot Study

TypeinterventionalSponsorVA Office of Research and DevelopmentRan2021 to 2022Enrolled10ConditionsStrokeArmsVirtual Reality
NCT06691880 nacompletednot on this mapstarted 2020, after this paper: background citation

Translating SMARTS 2: the Integration of Video Gaming Technology Into Traditional Rehabilitation

TypeinterventionalSponsorJohns Hopkins UniversityRan2020 to 2025Enrolled58ConditionsSubacute Stroke, Acute StrokeArmsMindPod Dolphin VGT, Bimanual Arm Trainer VGT
3 · Its place in the literature

Who cites it

81 citing papers in PubMed, 14 syntheses or guidelines pooled it.

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  9. Serious games for upper limb rehabilitation after stroke: a meta-analysis.Journal of neuroengineering and rehabilitation · 2021
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  17. Examining the effects of non-immersive virtual reality game-based training on knee hyperextension control and balance in chronic stroke patients: a single-blind randomized controlled study.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025
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  19. "Brain-IT": Exergame training with biofeedback breathing in neurocognitive disorders.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2024
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21 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Anna AminovSchool of Psychology, Faculty of Health Sciences, Australian Catholic University, Sydney, NSW, Australia.ORCID 0000-0003-4805-5476
Jeffrey M RogersSouth Eastern Sydney Local Health District, Sydney, NSW, Australia.
Sandy MiddletonSchool of Psychology, Faculty of Health Sciences, Australian Catholic University, Sydney, NSW, Australia.
Karen CaeyenberghsSchool of Psychology, Australian Catholic University, Melbourne, VIC, Australia.
Peter H WilsonSchool of Psychology, Faculty of Health Sciences, Australian Catholic University, Sydney, NSW, Australia. peterh.wilson@acu.edu.au.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundVirtual-reality based rehabilitation (VR) shows potential as an engaging and effective way to improve upper-limb function and cognitive abilities following a stroke. However, an updated synthesis of the literature is needed to capture growth in recent research and address gaps in our understanding of factors that may optimize training parameters and treatment effects.

methodsPublished randomized controlled trials comparing VR to conventional therapy were retrieved from seven electronic databases. Treatment effects (Hedge's g) were estimated using a random effects model, with motor and functional outcomes between different protocols compared at the Body Structure/Function, Activity, and Participation levels of the International Classification of Functioning.

resultsThirty-three studies were identified, including 971 participants (492 VR participants). VR produced small to medium overall effects (g = 0.46; 95% CI: 0.33-0.59, p < 0.01), above and beyond conventional therapies. Small to medium effects were observed on Body Structure/Function (g = 0.41; 95% CI: 0.28-0.55; p < 0.01) and Activity outcomes (g = 0.47; 95% CI: 0.34-0.60, p < 0.01), while Participation outcomes failed to reach significance (g = 0.38; 95% CI: -0.29-1.04, p = 0.27). Superior benefits for Body Structure/Function (g = 0.56) and Activity outcomes (g = 0.62) were observed when examining outcomes only from purpose-designed VR systems. Preliminary results (k = 4) suggested small to medium effects for cognitive outcomes (g = 0.41; 95% CI: 0.28-0.55; p < 0.01). Moderator analysis found no advantage for higher doses of VR, massed practice training schedules, or greater time since injury.

conclusionVR can effect significant gains on Body Structure/Function and Activity level outcomes, including improvements in cognitive function, for individuals who have sustained a stroke. The evidence supports the use of VR as an adjunct for stroke rehabilitation, with effectiveness evident for a variety of platforms, training parameters, and stages of recovery.

Indexed as

Randomized Controlled Trials as TopicVirtual RealityCognitionHumansStrokeStroke RehabilitationUpper ExtremityCognitionMeta-analysisMotor performanceRehabilitationStrokeVirtual reality

Identifiers

PMID29587853
PMCPMC5870176

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.