Use of virtual reality in gait recovery among post stroke patients – a systematic literature review

Abstract

Purpose: To conduct a systematic literature review focusing on the use of virtual reality (VR) for the improvement of gait in post-stroke patients. Methods: We performed a search of Randomized-controlled trials published from 1966 to 2011 in the databases: Medline, Lilacs, CINAHL, Cochrane and SciELO. Keywords used in the selection were: Virtual reality in combination with (AND) “Nervous System Diseases”, (OR) “Motor Skill Disorders” (OR) “neurologic impairments” (OR) “motor function” (OR) function* (OR) locomotion (OR) ambulation (OR) gait (OR) “motor activity” (OR) Stroke. Selected articles were evaluated using the individual’s components of methodological quality assessment and analysis of outcomes of each study was based on the domains of the International Classification of Functioning, Disability and Health (ICF). Results: A total of 6520 references were found, however, based on the inclusion and exclusion criteria only four studies were considered and analyzed. These articles demonstrated that the use of VR promotes changes in gait parameters, despite the diversity of protocols, participants’ characteristics, as well as the number of participants included in each study. Conclusions: The research studies analyses suggest that VR is a promising method to improve the gait of patients with stroke. Nevertheless, some questions still need to be answered. Some aspects should be investigated to confirm the true benefits and application of VR in this population.

Implications for Rehabilitation:

• Stroke is the second cause of death and the leading cause of disability worldwide.

• The loss or impairment of ambulation is one of the most devasting sequelae of stroke. Restoration of gait can be considered the main goal of rehabilitation after stroke.

• Conventional interventions tend to be tedious, providing few opportunities to increase the difficulty level of the proposed tasks and do not encourage adaptive postural reactions.

• There is evidence to support the use of virtual reality for the promotion of walking in people with sequelae of stroke.

• Virtual reality is a feature that has been used in clinical practice, however, the details on how to use this instrument must be set according to the therapeutic goals.

• Gait
• hemiparetic
• physical therapy
• stroke
• virtual reality