Table 1 Characteristics of the included systematic reviews
Author (year) | Country | Trials (sample size) | Intervention | Outcomes | Quality assessment tool | Main conclusions | |
|---|---|---|---|---|---|---|---|
Experiment | Control | ||||||
Sarasso E (2021) [16] | Italy | 22 (901) | VR | AT | Gait speed Stride/step length Walking stability (DGI/FGA) Walking distance (6MWT) Balance (BBS) Balance (TUG) Balance confidence (ABC/FES/FES-I) Motor function (UPDRS-III) Quality of life (PDQ-39/PDQ-8) | Cochrane Collaboration’s tool | Balance training in a VR setting is more effective than balance training to improve balance in PD subjects immediately after training. |
Li R (2021) [17] | China | 22 (836) | VR | Both (mix AT with PT) | Balance (BBS) Quality of life (PDQ-39) Activities of daily living (MBI/UPDRS-II) Neuropsychiatric symptoms (HAMD/HADS/GDS-15/BDI) | PEDro scale | Rehabilitation training based on VR significantly improved balance, quality of life, activities of daily living, and depressive symptoms compared to the control group. |
Elena P (2021) [18] | Cyprus | 14 (548) | VR | AT | Walking stability (DGI) Balance (BBS) Balance (TUG) Balance confidence (ABC) Quality of life (PDQ-39) Activities of daily living (UPDRS-II) | PEDro scale | VR therapy related with improved quality of life, balance, and gait. |
Triegaardt J (2020) [19] | UK | 10 (343) | VR | AT; PT | Gait speed Stride/step length Balance (BBS) Motor function (UPDRS-III) Cognitive function (MoCA) Activities of daily living (UPDRS-II) Quality of life (PDQ39/PDQ8) | Cochrane Collaboration’s tool | Compared with AT, VR therapy led to greater improvement of stride length. Compared with PT, VR therapy had greater effects on gait speed, stride length, balance, and activities of daily living. |
Marotta N (2020) [20] | Italy | 7 (236) | VR | Both (mix AT with PT) | Functional locomotion | Cochrane Collaboration’s tool | VR therapy show immediate positive effects on functional locomotion in people with PD. |
Lina C (2020) [21] | China | 12 (360) | VR | AT | Gait speed Balance (BBS) Motor function (TUG) Activities of daily living (MBI) | Cochrane Collaboration’s tool | VR therapy may be valuable in improving the balance, gait speed, and ability to perform activities of daily living in patients with PD. |
Chen Y (2020) [22] | China | 14 (574) | VR | AT | Walking stability (DGI/FGA) Balance (BBS) Balance (TUG) Balance confidence (ABC) | PEDro scale | Compared with AT, VR therapy improved the balance (BBS). There was no significant difference on balance (TUG), balance confidence, and walking stability between the VR therapy groups and the AT groups. |
Wang B (2019) [23] | China | 12 (419) | VR | AT | Gait speed Stride/step length Walking distance (6MWT) Balance (BBS) Balance (TUG) | PEDro scale | This review demonstrated significant improvements in balance and stride length in PD patients who received VR compared with controls. There was no significant difference in gait speed and walking distance. |
Santos P (2019) [24] | Brasil | 5 (152) | VR | AT | Balance (BBS) Quality of life (PDQ-39) | PEDro scale | Combination VR and conventional physiotherapy was more effective on balance rehabilitation and quality of life of patients with PD. |
Lei C (2019) [25] | China | 16 (555) | VR | AT | Gait speed Stride/step length Walking stability (DGI) Balance (BBS) Balance (TUG) Balance confidence (ABC/FES) Motor function (UPDRS-III) Activities of daily living (UPDRS-II) Quality of life (PDQ-39/WHOQOL-OLD) Neuropsychiatric symptoms (BAI/BDI/HAMD) Cognitive function (DSF/MoCA) | Cochrane Collaboration’s tool | VR performed better than AT in step/stride length, balance, balance confidence, quality of life, and neuropsychiatric symptoms. There was no effect on the gait speed, DGI, motor function, cognitive function, and activities of daily living. |
Dockx K (2016) [26] | Belgium | 8 (263) | VR | AT; PT | Gait speed Stride/step length Balance (BBS) Balance (BBS/TUG/SLS) Quality of life (PDQ-39) | Cochrane Collaboration’s tool | In comparison to AT, VR may lead to a moderate improvement in step and stride length. VR and physiotherapy may have similar effects on gait, balance, and quality of life. In comparison to PT, VR therapy elicited greater improvements in gait, balance, and quality of life. |
Harris DM (2015) [27] | Japan | 2 (74) | VR | AT; PT. | Balance (BBS) Postural control (SOT) | PEDro scale | With the current available studies, the efficacy of VR therapy cannot be sufficiently determined for people with PD. |