The role of virtual reality in balance training for Parkinson's disease: a systematic review and meta-analysis.

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Background and objectivesThe use of virtual reality (VR) as a therapeutic modality to improve balance in patients with Parkinson's disease (PD) is promising due to its interactive simulations. However, the advantage of VR over conventional balance training has yet to be established. This systematic review and meta-analysis evaluates and summarizes randomized controlled trials (RCTs) comparing VR interventions to conventional physiotherapy.Materials and methodsA comprehensive search of the PubMed, EBSCOHost, and SciELO databases was performed. Article selection and filtering were performed using Rayyan software.ResultsThe search yielded 185 research articles, of which 162 remained after removing duplicates. Screening the titles and abstracts for the use of VR and reviewing the full-texts for the RCT design yielded 17 articles, six of which used the Berg Balance Scale (BBS). The data from these remaining six trials were included in this systematic review. Data extraction resulted in 214 participants (105 controls and 109 in the VR intervention). The average age of the participants was 61.43 ± 13.3 years, with 74 (34.6%) women and a mean PD duration of 7.11 ± 1.91 years. The average number of sessions was 25 (10-60), with an average follow-up period of 3.5 months. At follow-up, the control group improved by an average of 1.64 ± 1.84 points on the BBS, whereas the VR group improved by an average of 2.85 ± 1.74 points. There was no significant difference (p = 0.269) between the groups for the absolute change on the BBS.ConclusionsVR-based interventions for patients with PD are as effective as conventional physiotherapy for improving balance in short-term follow-ups. VR-based interventions alongside conventional physiotherapy may deliver efficient and tailor-made balance training.

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