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To examine the effects of virtual reality-based cognitive interventions on cognitive function and activities of daily living among stroke patients, and to identify the optimal design for such intervention.
Systematic review and meta-analysis.
Medline, EMBASE, Cochrane, CINANL, JBI-EBP and Web of Science from inception to October 2023.
Methodological quality was assessed by Risk of Bias Tool. Meta-analyses were assessed by Review Manager 5.4. Subgroup analyses were conducted to explore the influence of study design. Grading of Recommendations Assessment, Development and Evaluation approach was adopted to assess the certainty of evidence.
Twenty-five randomized controlled trials (1178 participants) were included. Virtual reality-based cognitive interventions demonstrated moderate-to-large effects in improving global cognitive function (SMD = 0.43; 95% CI [0.01, 0.85]), executive function (SMD = 0.84; 95% CI [0.25, 1.43]) and memory (SMD = 0.65; 95% CI [0.15, 1.16]) compared to control treatments. No significant effects were found on language, visuospatial ability and activities of daily living. Subgroup analyses indicated one-on-one coaching, individualized design and dynamic difficulty adjustment, and interventions lasting ≥ 6 weeks had particularly enhanced effects, especially for executive function.
Virtual reality-based cognitive interventions improve global cognitive function, executive function and memory among stroke patients.
This review underscores the broad cognitive advantages offered by virtual technology, suggesting its potential integration into standard stroke rehabilitation protocols for enhanced cognitive recovery.
The study identifies key factors in virtual technology interventions that effectively improve cognitive function among stroke patients, offering healthcare providers a framework for leveraging such technology to optimize cognitive outcomes in stroke rehabilitation.
PRISMA 2020 statement.
CRD42022342668.
Commentary on: Shields GE, Rowlandson A, Dalal G, Nickerson S, Cranmer H, Capobianco L, Doherty P. Cost-effectiveness of home-based cardiac rehabilitation: a systematic review. Heart. 2023 Feb 27:heartjnl-2021-320459. doi: 10.1136/heartjnl-2021-320459. Epub ahead of print.
Home-based cardiac rehabilitation (CR) is a cost-effective alternative/supplementary model to increase CR accessibility, improve health benefits and reduce health service use. More robust clinical trials are needed as the heterogeneity in design, particularly the intervention dosage, staffing models, telehealth features, hybrid approach and individual costs, challenges the evidence base. The psychological care component is missing in the current cost-effectiveness analysis of home-based CR.
Despite evidence that exercise-based cardiovascular rehabilitation (CR) is an effective intervention, patient uptake and adherence are uncertain. Recent research suggests that home-based CR interventions are as effective and safe as those supervised in a centre.
FreshRSS 