Abstract
Objective
This study aimed to evaluate the comparative effectiveness and ranking of robot-assisted training, virtual reality, and robot-assisted rehabilitation combined with virtual reality in improving balance, gait, and daily function in patients with stroke.
Data sources
PubMed, EMBASE, the Cochrane Library, Physiotherapy Evidence Database, CINAHL, Web of Science, and ProQuest Dissertations and Theses A&I databases were comprehensively searched to include randomized controlled trials published through August 31, 2022.
Study selection
Randomized controlled trials (RCTs) comparing between robot-assisted training, virtual reality, robot-assisted rehabilitation combined with virtual reality, and conventional therapy to assess the effects on balance, gait, and daily function of patients with stroke.
Data Extraction
The risk of bias was assessed using the Cochrane Risk of Bias tool (RoB 2.0) and the methodological quality of the studies was assessed using the Physiotherapy Evidence Database (PEDro) Scale. The network meta-analysis of random-effects models was performed for direct and indirect. Data were analyzed using Stata SE 17.0 and R 4.2.1.
Data Synthesis
A total of 52 randomized controlled trials involving 1,559 participants were included in this study. Based on the ranking probabilities, the robot-assisted rehabilitation combined with virtual reality was most effective in improving balance (surface under cumulative ranking curve values [SUCRCV]: 82.0%, mean difference [MD]: 4.10, 95% confidence interval [CI]: 0.43 to 7.67). Virtual reality was most effective in improving velocity (SUCRCV: 97.8%, MD= -0.15, 95%CI -0.24 to -0.06) and daily function (SUCRCV: 92.1%, MD= -7.85, 95%CI -15.18 to -1.07).
Conclusions
Compared to robot-assisted training and conventional therapy, robot-assisted training combined virtual reality was most likely the best intervention in balance, and virtual reality might be the most helpful in improving daily function for stroke patients. Further studies are needed to clarify the specific efficacy of robot-assisted training combined virtual reality and virtual reality on gait.
This study aimed to evaluate the comparative effectiveness and ranking of robot-assisted training, virtual reality, and robot-assisted rehabilitation combined with virtual reality in improving balance, gait, and daily function in patients with stroke.
Data sources
PubMed, EMBASE, the Cochrane Library, Physiotherapy Evidence Database, CINAHL, Web of Science, and ProQuest Dissertations and Theses A&I databases were comprehensively searched to include randomized controlled trials published through August 31, 2022.
Study selection
Randomized controlled trials (RCTs) comparing between robot-assisted training, virtual reality, robot-assisted rehabilitation combined with virtual reality, and conventional therapy to assess the effects on balance, gait, and daily function of patients with stroke.
Data Extraction
The risk of bias was assessed using the Cochrane Risk of Bias tool (RoB 2.0) and the methodological quality of the studies was assessed using the Physiotherapy Evidence Database (PEDro) Scale. The network meta-analysis of random-effects models was performed for direct and indirect. Data were analyzed using Stata SE 17.0 and R 4.2.1.
Data Synthesis
A total of 52 randomized controlled trials involving 1,559 participants were included in this study. Based on the ranking probabilities, the robot-assisted rehabilitation combined with virtual reality was most effective in improving balance (surface under cumulative ranking curve values [SUCRCV]: 82.0%, mean difference [MD]: 4.10, 95% confidence interval [CI]: 0.43 to 7.67). Virtual reality was most effective in improving velocity (SUCRCV: 97.8%, MD= -0.15, 95%CI -0.24 to -0.06) and daily function (SUCRCV: 92.1%, MD= -7.85, 95%CI -15.18 to -1.07).
Conclusions
Compared to robot-assisted training and conventional therapy, robot-assisted training combined virtual reality was most likely the best intervention in balance, and virtual reality might be the most helpful in improving daily function for stroke patients. Further studies are needed to clarify the specific efficacy of robot-assisted training combined virtual reality and virtual reality on gait.
| Original language | English |
|---|---|
| Journal | Archives of Physical Medicine and Rehabilitation |
| Volume | 102 |
| Issue number | 4 |
| Publication status | E-pub ahead of print - 28 Apr 2023 |