Virtual reality-based therapy improves balance and reduces fear of falling in patients with multiple sclerosis. a systematic review and meta-analysis of randomized controlled trials.
Irene Cortés-Pérez, María Catalina Osuna-Pérez, Desirée Montoro-Cárdenas and 3 others
PMID 37041557WHAT IT FOUND
Virtual reality therapy, alone or added to conventional or robotic gait therapy, improved balance and reduced fear of falling in multiple sclerosis, but it did not improve gait speed.
Most trials used non-immersive systems, and effects were short-term only.
Key findings
01Virtual reality-based therapy, alone or added to conventional therapy or robotic gait training, increased Berg Balance Scale scores by 3.36 points compared with control groups.
02Virtual reality-based therapy reduced fear of falling by 2.86 points on the Falls Efficacy Scale compared with conventional therapy.
03There was no significant difference in gait speed between virtual reality-based therapy and control groups.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Participants and therapists could not be blinded, and outcome assessors were not blinded in some trials, so performance and detection bias could influence results. The included trials had moderate methodological quality overall, with a mean PEDro score of 6.2 ± 1. Several outcomes rested on few trials: confidence of balance, fear of falling, and sway area each came from 3 RCTs. All outcomes were measured only shortly after treatment, so medium- and long-term effects are unknown. Some pooled effects showed publication bias or sensitivity-analysis changes, including dynamic balance and fear of falling. Most VR systems were non-immersive, so results may not apply to immersive head-mounted setups.
The easy way to misread this
Do not conclude that virtual reality alone caused every improvement. Some trials added it to conventional therapy or robotic gait training, and in those comparisons the contribution of virtual reality alone cannot be separated.