Use of Virtual Reality-based Exergames in Patients with Parkinson’s Disease: A Systematic Review and Meta-analysis
Hamilton Roberto Moreira de Oliveira Carrico1, Carolina Nenonena Calderoni2, Andreza Fernanda Amaral3, Carolina Vieira4, Larissa Emi Tanimoto5, Pedro Henrique de Souza Wagner6, Denisarth Oliveira Nery Filho7, Wingrid Raiane Barreto Goncalves Conceicao8, Artur Menegaz de Almeida9
1University of Southern Santa Catarina, 2University of Santo Amaro, 3University Center of Varzea Grande, 4Federal University of Amazonas, 5University of Buenos Aires, 6Federal University of Santa Catarina, 7University Center UNINOVAFAPI, 8Community University of Chapeco Region, 9Federal University of Mato Grosso
Objective:
This study aims to assess the efficacy of virtual reality-based exergames in improving motor symptoms among PD patients.
Background:
Parkinson's Disease is the most prevalent neurodegenerative disorder among older adults, with tremor, rigidity, and bradykinesia as its most common debilitating symptoms. Exergaming-based interventions have shown promising results in improving mobility and balance. However, uncertainty remains regarding their impact on motor symptoms, particularly in PD patients.
Design/Methods:
PubMed, Web of Science and Cochrane Library databases were searched for studies comparing exergames with usual approaches or conventional exercises, and reporting physical, psychological, or cognitive outcomes in PD patients. A random-effects model with a 95% confidence interval (CI) measured the mean difference (MD) and heterogeneity was examined with I² statistics. R software, version 4.4.1, was used for statistical analysis.
Results:
23 RCTs and 811 patients were included, of which 328 (40.44%) underwent virtual reality-based exergames. No significant differences were found in motor symptoms measured by the Unified Parkinson's Disease Rating Scale-III (UPDRS-III) (MD -0.29; 95% CI [-2.92, 2.34]; P = 0.826; I² = 6%) or in the Timed Up and Go test (TUG) (MD -0.63; 95% CI [-1.49, 0.22]; P = 0.148; I² = 0%). However, significant improvements were observed in the Berg Balance Scale (BBS) (MD 1.43; 95% CI [0.43, 2.42]; P = 0.0049; I² = 49%), and in the Falling Efficacy Scale-International (FES-I) (MD -1.09; 95% CI [-1.98, -0.20]; P = 0.0167; I² = 38%).
Conclusions:
Our findings indicate that virtual reality-based exergames presented promising results associated with beneficial mobility improvement when compared to traditional physical training in PD patients.
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