Virtual reality-based treatment for regaining upper extremity function induces cortex grey matter changes in persons with acquired brain injury.
Jiří Keller, Ivana Štětkářová, Vince Macri and 6 others
PMID 32919473WHAT IT FOUND
Virtual reality arm exercises showed promise for improving strength and movement in chronic brain injury patients, with associated brain volume changes.
However, the study was small and non-randomized, so these benefits are not yet proven compared to standard therapy.
Key findings
01The primary outcomes were changes in cortical grey matter volume and motor skills (strength and range of motion), with no secondary outcomes.
02After controlling for therapy hours, the group receiving only virtual reality showed the highest improvements in key pinch and three-jaw chuck strength, though differences were not always statistically significant.
03Volumetric grey matter increases were found in five brain areas in the subgroup that underwent MRI, including the hippocampus and caudate nucleus.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study was not fully randomized; Group A participants were self-selected and had more severe impairments and longer time since injury than other groups. The sample size was small (35 participants), limiting the generalizability of the findings. There was no control for the placebo effect or expectation bias in the self-selected group. MRI scans were only performed on a subgroup of Group A, so brain changes cannot be compared across groups. The groups differed significantly in the amount of therapy received, making direct comparisons difficult despite statistical adjustments.
Declared interests
The study was supported by non-U.S. government funds. No specific conflicts of interest involving commercial entities were declared in the provided text.
The easy way to misread this
Do not conclude that virtual reality therapy is superior to standard physical or occupational therapy. The study was small, not fully randomized, and the group receiving only virtual reality had more severe impairments at the start. The observed brain changes and motor improvements are preliminary and require confirmation in larger, randomized trials.