Virtual reality in Parkinson's disease: a systematic review and meta-analysis

Parkinson's disease (PD) severely affects motor and non-motor functions, leading to dependency and reduced quality of life. Conventional rehabilitation methods often fail to meet patients' diverse needs. Virtual reality (VR) offers an innovative approach by creating immersive, customizable therapeutic environments.

This systematic review and meta-analysis evaluated the efficacy of VR interventions in PD rehabilitation compared to conventional therapies.

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic search was conducted across five databases for randomized controlled trials (RCTs) published until November 2023. Inclusion criteria encompassed RCTs comparing VR with other interventions in PD patients. Data on motor and balance outcomes were extracted. Risk of bias was assessed using the RoB 2 tool.

Five RCTs, including 199 participants, were analyzed. VR interventions demonstrated significant improvements in the Time Up-to-Go (TUG) test (mean difference: -2.42; 95% confidence interval - 95%CI -3.95 to -0.89; p=0.002), indicating enhanced dynamic balance. However, the Berg Balance Scale (BBS) results favored the control group (mean difference: 3.28; 95%CI 1.92 to 4.65; p<0.00001).

VR interventions significantly improve dynamic balance and mobility in PD patients, as evidenced by TUG results. The limited impact on static balance tasks highlights the need for tailored interventions. While VR shows promise as a complementary therapy, challenges such as cost, accessibility, and standardization must be addressed to enhance its clinical utility.