Serious games and virtual reality in Parkinson's disease rehabilitation: A systematic review of randomized controlled trials.

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BackgroundSerious games (SG) and virtual reality (VR) are emerging rehabilitation tools in Parkinson's disease (PD); however, clinical evidence from randomized controlled trials (RCTs) remains heterogeneous.ObjectiveTo systematically review RCTs evaluating SG and VR-based rehabilitation on motor and cognitive outcomes in PD.MethodsPRISMA 2020-compliant search of PubMed/MEDLINE, Embase, CENTRAL, Web of Science, and Scopus (January 2015-January 2025), augmented with visuomotor-adaptation search terms. RCTs involving adults with idiopathic PD using SG or VR versus conventional rehabilitation were included. Risk of bias was assessed using Cochrane RoB 2.0.ResultsEleven RCTs (N = 242; Hoehn-Yahr I-III) were included. Balance (BBS), gait speed (10MWT), and mobility (TUG) improved consistently. UPDRS-III improvements were observed with protocols ≥8 weeks. Three trials reported significant gains in executive function and attention. Adherence was high and no serious adverse events were reported.ConclusionsSG and VR-based rehabilitation are safe, feasible, and effective adjuncts to conventional therapy for improving balance, gait, and selected cognitive domains in PD. Standardized protocols and long-term follow-up are needed.

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