Efficacy of virtual reality training on motor performance, activity of daily living, and quality of life in patients with Parkinson's disease: an umbrella review comprising meta-analyses of randomized controlled trials.

GRADE quality is very low for 4 of 8 outcomes and low for 2; only 2 outcomes reached moderate quality. No participants or therapists were blinded in the underlying trials, introducing observer bias. All included trials ran 3 to 12 weeks; there is no data on whether benefits last beyond that window. Heterogeneity was high for the two balance outcomes (I² = 84 for TUG, I² = 62 for BBS), meaning the true effect could vary substantially between settings. No data on upper-extremity function, cognitive function, or long-term adverse effects were available. Three of the eight meta-analyses were rated very low methodological quality by AMSTAR-2. None of the four meta-analyses that were recalculated reported the funding source of their included studies.

Funded by the Research Foundation for Young Teacher of Shenzhen University, the High-level Scientific Research Foundation for the Introduction of Talent of Shenzhen University, the Natural Science Featured Innovation Projects in Ordinary Universities in Guangdong Province, and the Scientific Research Platform and Project of Colleges and Universities of Education Department of Guangdong Province. No industry or device-manufacturer funding is declared. None of the four meta-analyses that were recalculated reported the funding source of their included RCTs.

Do not read the balance and stride length improvements as strong, practice-changing evidence. The GRADE rating for those specific outcomes is very low, heterogeneity is high (I² = 84 for TUG), the trials were unblinded and short (3 to 12 weeks), and the same review found no significant effect on walking speed or overall motor function. A single very-low-quality pooled estimate should not drive a change in your Monday schedule.