Innovative technology-based interventions in Parkinson's disease: A systematic review and meta-analysis

Area of Science:

• Neurology
• Rehabilitation Science
• Biomedical Engineering

Background:

• Novel technology-based interventions, including virtual reality (VR) training, robotic assistance, and biofeedback, are being explored to enhance motor function and gait in Parkinson's disease (PD).
• The comparative effectiveness of these emerging treatments for PD symptom management remains incompletely understood, necessitating rigorous analysis.

Purpose of the Study:

• To conduct a Bayesian network meta-analysis evaluating the efficacy of technology-based interventions for improving motor symptoms and quality of life (QoL) in Parkinson's disease (PD).

Main Methods:

• A systematic search of major databases (Medline, Embase, Cochrane CENTRAL, Clinicaltrials.gov) was performed, including only randomized controlled trials (RCTs) published up to April 2, 2024.
• Key outcomes assessed included changes in motor function (UPDRS-III/MDS-UPDRS-III), gait parameters (stride length, 10-meter walk test, timed up-and-go), balance, and QoL.
• Results were synthesized using Bayesian network meta-analysis, reporting mean differences (MD) or standardized mean differences (SMD) with 95% credible intervals (95% CrI).

Main Results:

• The analysis included 51 RCTs involving 2095 patients. While all interventions showed similar efficacy for UPDRS motor scores, virtual reality (VR) intervention was most effective in improving the timed up-and-go (TUG) test.
• Proprioceptive intervention significantly enhanced stride length compared to control, outperforming VR, robotic, and exercise interventions.
• VR intervention demonstrated significant improvements in balance scale scores and quality of life (QoL) compared to control and other interventions.

Conclusions:

• Virtual reality (VR)-based and proprioceptive interventions emerged as the most promising treatments, consistently ranking highest across multiple outcome measures for Parkinson's disease (PD).
• These interventions hold significant potential for integration into clinical practice to effectively manage motor symptoms and improve the quality of life for individuals with PD.