TY  - JOUR
AU  - Wu, Jinlong
AU  - Zeng, Aihua
AU  - Chen, Ziyan
AU  - Wei, Ye
AU  - Huang, Kunlun
AU  - Chen, Jiafeng
AU  - Ren, Zhanbing
PY  - 2021
DA  - 2021/10/12
TI  - Effects of Virtual Reality Training on Upper Limb Function and Balance in Stroke Patients: Systematic Review and Meta-Meta-Analysis
JO  - J Med Internet Res
SP  - e31051
VL  - 23
IS  - 10
KW  - virtual reality
KW  - stroke
KW  - motor function
KW  - review
KW  - meta-meta-analysis
KW  - mental health
KW  - motor skills
KW  - rehabilitation
KW  - digital intervention
KW  - health care
KW  - stroke patients
AB  - Background: Virtual reality (VR) training is a promising intervention strategy that has been utilized in health care fields like stroke rehabilitation and psychotherapy. Current studies suggest that VR training is effective in improving the locomotor ability of stroke patients. Objective: This is the first meta-meta-analysis of the effects of VR on motor function in stroke patients. This study aimed to systematically summarize and quantify the present meta-analyses results of VR training and produce high-quality meta-meta-analysis results to obtain a more accurate prediction. Methods: We searched 4 online databases (Web of Science, Scopus, PubMed, and Chinese National Knowledge Infrastructure) for meta-analysis studies. After accounting for overlap, 10 studies (accounting for almost 550 stroke patients) were obtained. Based on the meta-meta-analysis of these patients, this study quantified the impact of VR training on stroke patients’ motor performance, mainly including upper limb function, balance, and walking ability. We combined the effects under the random effect model and pooled the estimates as standardized mean differences (SMD). Results: The results of the meta-meta-analysis showed that VR training effectively improves upper limb function (SMD 4.606, 95% CI 2.733-6.479, P<.05) and balance (SMD 2.101, 95% CI 0.202-4.000, P<.05) of stroke patients. However, the results showed considerable heterogeneity and thus, may need to be treated with caution. Due to the limited research, a meta-meta-analysis of walking ability was not performed. Conclusions: These findings represent a comprehensive body of high-quality evidence that VR training is more effective at improving upper limb function and balance of stroke patients. 
SN  - 1438-8871
UR  - https://www.jmir.org/2021/10/e31051
UR  - https://doi.org/10.2196/31051
UR  - http://www.ncbi.nlm.nih.gov/pubmed/34636735
DO  - 10.2196/31051
ID  - info:doi/10.2196/31051
ER  -