Augmented visual feedback-aided interventions for motor rehabilitation in Parkinson’s disease: a systematic review

Abstract

Purpose: A systematic review was performed to (1) evaluate the effectiveness of augmented visual feedback-based treatments for motor rehabilitation in Parkinson’s disease, and (2) examine treatment design factors associated with enhanced outcomes following these treatments.

Methods: Eight databases were searched from their start-date up to January 2017 using the key terms Parkinson’s Disease and augmented visual feedback. Two independent raters screened the abstracts and full articles for inclusion. Relevant data were extracted and summarized, and methodological quality of accepted articles was assessed.

Results: Eight single-group studies and 10 randomized control trials were included in the review. Augmented visual feedback-based treatments resulted in improved outcomes with small to large effect sizes post-treatment for the majority of impairment, activity, participation, and global motor function measures, and these improvements were often superior to traditional rehabilitation/education programs. Enhanced treatment outcomes were observed in studies that provided large amounts and high intensities of treatment; gamified feedback; and provided knowledge of performance feedback in real-time on 100% of practice trials.

Conclusion: Augmented visual feedback appears to be a useful motor rehabilitation tool in Parkinson’s disease; however, high-quality, rigorous studies remain limited. Future studies should consider factors that enhance rehabilitation outcomes when designing augmented visual feedback-based interventions.

Implications for rehabilitation

• Augmented visual feedback is a useful tool for motor rehabilitation in Parkinson’s disease; augmented visual feedback-based treatments are often superior to traditional programs.

• These treatments are associated with improved outcomes in impairment, activity, participation, and global motor function domains.

• Rehabilitation professionals can optimize their use of augmented visual feedback-based treatments by providing large amounts and a high intensity of treatment, gamifying feedback, and providing knowledge of performance feedback in real-time and at a high frequency.

Keywords:

• Parkinson’s disease
• motor rehabilitation
• augmented visual feedback
• systematic review

Acknowledgements

We would like to thank Jessica Babineau, MLIS (University Health Network-Toronto Rehabilitation Institute), for her assistance in formulating the search strategy for this review.

Disclosure statement

The authors report no conflicts of interest.

Additional information

Funding

This work was supported by the Parkinson Society Canada Pilot Project Grant and the Natural Sciences and Engineering Research Council Discovery Grant, both awarded to Y.Y. Author R.M. was supported by a Canada Research Chair (Tier II) in Swallowing Disorders.