Effects of Virtual Reality Therapy and Range of Motion Exercise on Range of Motion in Stroke Patients: Meta-Analysis

Authors

  • Septyan Dwi Nugroho Master’s Program in Public Health, Universitas Sebelas Maret
  • Didik Tamtomo Medical Faculty, Universitas Sebelas Maret
  • Hanung Prasetya Study Program of Acupuncture, Health Polytechnics, Ministry of Health Surakarta

Abstract

Background: Stroke is a disease caused by interference with blood flow in the brain which is still a global problem today. Post-stroke care needs to be done to prevent the worsening of the condition. One of the right interventions that can be done is virtual reality therapy and range of motion exercise. This study aims to examine, analyze and estimate changes in the range of motion of stroke patients with virtual reality therapy and range of motion exercise.

Subjects and Method: Metaanalysis was carried out according to the PRISMA flow chart and the PICO model (Population: stroke patients, Intervention: virtual reality therapy and range of motion exercise, Comparison: not performed virtual reality therapy and range of motion exercise Outcome: range of motion). The databases used are Google Scholar, PubMed, and Science Direct. The keywords used (“virtual reality” OR VR) AND (stroke OR CVD) AND (“range of motion exercise” OR ROM OR “motor exercise”) AND (stroke OR CVD) AND “Randomized Control Trial”. The inclusion criteria were full-text articles with RCT studies published in 2012-2022, articles in English, and bivariate and multivariate analysis. Analysis was performed using ReVman 5.3.

Results: There were 20 articles with a randomized control trial design originating from Iran, Turkey, China, Egypt, Myanmar, South Korea, Spain, the Netherlands, Italy, Switzerland, and Canada involving 799 people. A meta-analysis of 10 RCT studies concluded that virtual reality therapy increased the range of motion of stroke patients by 2.77 units (SMD= 2.77; 95% CI = 1.29 to 4.24; p<0.001) compared to no virtual reality therapy. In addition, the range of motion exercise intervention can also increase the stroke patient's range of motion by 0.84 units (SMD= 0.84; 95% CI= 0.35 to 1.33; p<0.001) compared to not being given range of motion exercise.

Conclusion: Virtual Reality Therapy and Range of Motion exercises can increase the range of motion of stroke patients.

Keywords: virtual reality therapy, range of motion exercise, stroke, range of motion, meta-analysis.

Correspondence: Septyan Dwi Nugroho. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir Sutami 36A, Surakarta 57126, Central Java. Email: septyandwin@gmail.com. Mobile: 081804418933.

Indonesian Journal of Medicine (2023), 08(01): 23-36
https://doi.org/10.26911/theijmed.2023.08.01.03

References

Afsar SI, Mirzayev I, Umit Yemisci O, Cosar Saracgil SN (2018). Virtual reality in upper extremity rehabilitation of stroke patients: a randomized controlled trial. J. Stroke Cerebrovasc. Dis. 27(12): 3473–3478. Doi: 10.1016/j.jstrokecerebrovasdis.2018.08.007.

Aida J, Chau B, Dunn J (2018). Immersive virtual reality in traumatic brain injury rehabilitation: a literature review. NeuroRehabilitation 42(4): 441–448. Doi:10.3233/NRE172361.

Aoyama T, Kanazawa A, Kohno Y, Watanabe S, Tomita K, Kaneko F (2021). Influence of visual stimulation-induced passive reproduction of motor images in the brain on motor paralysis after stroke. Front. Hum. Neurosci. 15. Doi: 10.3389/fnhum.2021.674139.

Bevilacqua, Maranesi, Riccardi, Donna, Pelliccioni, Luzi, Lattanzio, et al. (2019). Non-immersive virtual reality for the rehabilitation of the older people: a systematic review into efficacy and effectiveness. J. Clin. Med. 8(11): 1882. Doi: 10.3390/jcm8111882.

Bui J, Luauté J, Farnè A. (2021). Enhancing upper limb rehabilitation of stroke patients with virtual reality: a mini-review. Front. Virtual Real. 2. Doi: 10.3389/frvir.2021.595771

Calabrò RS, Naro A, Russo M, Leo A, De Luca R, Balletta T, Buda A, et al. (2017). The role of virtual reality in improving motor performance as revealed by EEG: a randomized clinical trial. J. Neuroeng. Rehabil. 14(1): 53. Doi: 10.1186/s1298401702684

Chen L, Chen Y, Fu W Bin, Huang DF, Lo WLA (2022). The effect of virtual reality on motor anticipation and hand function in patients with subacute stroke: a randomized trial on movement-related potential. Neural Plast. 2022. Doi: 10.1155/2022/7399995.

Dehno NS, Kamali F, Shariat A, Jaberzadeh S. (2021). Unilateral strength training of the less affected hand improves cortical excitability and clinical outcomes in patients with subacute stroke: a randomized controlled trial. Arch. Phys. Med. Rehabil. 102(5): 914–924. Doi: 10.1016/j.apmr.2020.12.012

Ellis MD, Carmona C, Drogos J, Dewald JPA. (2018). Progressive abduction loading therapy with horizontal plane viscous resistance targeting weakness and flexion synergy to treat upper limb function in chronic hemiparetic stroke: a randomized clinical trial. Front. Neurol. 9. Doi: 10.3389/fneur.2018.00071.

Feigin VL, Brainin M, Norrving B, Martins S, Sacco RL, Hacke W, Fisher M, et al. (2022). World stroke organization (wso): global stroke fact sheet 2022. Int. J. Stroke 17(1): 18–29. Doi: 10.1177/17474930211065917.

Feigin VL, Stark BA, Johnson CO, Roth GA, Bisignano C, Abady GG, Abbasifard M, et al. (2021). Global, regional, and national burden of stroke and its risk factors, 1990–2019: a systematic analysis for the global burden of disease study 2019. Lancet Neurol. 20(10): 795–820. Doi: 10.1016/S14744422(21)002520.

Graef P, Michaelsen SM, Dadalt MLR, Rodrigues DAMS, Pereira F, Pagnussat A de S. (2016). Effects of functional and analytical strength training on upper-extremity activity after stroke: A randomized controlled trial. Brazilian J. Phys. Ther. 20(6): 543–552. Doi: 10.1590/bjptrbf.2014.0187.

Hegazy RM, Alkhateeb AM, Abdelmohsen AM. (2022). Impact of virtual reality program on upper limb function post-stroke: a randomized controlled trial. 30.

Hosseini ZS, Peyrovi H, Gohari M. (2019). The effect of early passive range of motion exercise on motor function of people with stroke: a randomized controlled trial. J. Caring Sci. 8(1): 39–44. Doi: 10.15171/jcs.2019.006.

Hung JW, Chou CX, Chang YJ, Wu CY, Chang KC, Wu WC, Howell S. (2019). Comparison of kinect2scratch game-based training and therapist based training for the improvement of upper extremity functions of patients with chronic stroke: a randomized controlled single-blinded trial. Eur. J. Phys. Rehabil. Med. 55(5). Doi: 10.23736/S19739087.19.055989.

Ju YW, Lee JS, Choi YA, Kim YH. (2022). Causes and trends of disabilities in community-dwelling stroke survivors: a population-based study. Brain & Neurorehabilitation 15(1). 0.12786/bn.2022.15.e5

Juli C, Heryaman H, Arnengsih, Ang ET, Defi IR, Gamayani U, Atik N. (2022). The number of risk factors increases the recurrence events in ischemic stroke. Eur. J. Med. Res. 27(1): 138. Doi: 10.1186/s4000102200768y

Kemenkes RI. (2018). Hasil Riset Kesehatan Dasar Tahun 2018. Kementrian Kesehat. RI. 53(9): 1689–1699.

Khallaf ME, Ameer MA, Fayed EE. (2017). Effect of task-specific training and wrist fingers extension splint on hand joints range of motion and function after stroke. NeuroRehabilitation 41(2):437–444. Doi: 10.3233/NRE162128.

Lenja A, Demissie T, Yohannes B, Yohannis M. (2016). Determinants of exclusive breastfeeding practice to infants aged less than six months in Offa district, Southern Ethiopia : a cross-sectional study. Int. Breastfeed. J. 1–8. Doi: 10.1186/s1300601600918

Moola S, Munn Z, Tufanaru C, Aromataris E, Sears K, Sfetcu R, Currie M, et al. (2017). Checklist for cohort studies. Joanna Briggs Inst. Rev. Man. 1–7.

Oh Y, Kim G, Han K, Won YH, Park S, Seo J. (2021). Efficacy of virtual reality combined with real instrument training for patients with stroke : a randomized controlled trial. Arch. Phys. Med. Rehabil. 100(8): 1400–1408. Doi: 10.1016/j.apmr.2019.03.013

Salvalaggio S, Kiper P, Pregnolato G, Baldan F, Agostini M, Maistrello L, Turolla A. (2022). Virtual feedback for arm motor function rehabilitation after stroke: a randomized controlled trial. Healthc. 10(7): 1–13. Doi: 10.3390/healthcare10071175

Schoenfeld BJ, Grgic J. (2020). Effects of range of motion on muscle development during resistance training interventions: A systematic review. SAGE Open Med. 8: Doi: 10.1177/2050312120901559

Sevcenko K, Lindgren I. (2022). The effects of virtual reality training in stroke and Parkinson’s disease rehabilitation: a systematic review and a perspective on usability. Eur. Rev. Aging Phys. Act. 19(1): 4. Doi: 10.1186/s11556022002833

Venketasubramanian N, Yudiarto FL, Tugasworo D. (2022). Stroke burden and stroke services in Indonesia. Cerebrovasc. Dis. Extra 12(1): 53–57.Doi: 10.1159/000524161

Yumei L, Sun Q, Li J, Zhang W, He Y, Zhou Y. (2021). Disability status and its influencing factors among stroke patients in northeast china: a 3year follow-up study. Neuropsychiatr. Dis. Treat. Volume 17: 2567–2573. Doi: 10.2147/NDT.S320785

Downloads

Published

2023-01-10

Issue

Section

Articles