Effects of Virtual Reality Intervention on Motor Function and Activities of Daily Living of Children and Adolescents with Cerebral Palsy: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

Abstract

To explore the impact of virtual reality (VR) intervention on motor function (MF) and activities of daily living (ADL) in children and adolescents with cerebral palsy (CP), and to identify effective VR intervention strategies. Searches were conducted in PubMed, Wiley Online Library, Embase, Cochrane Library, and Web of Science (all collections). All randomized controlled trials (RCTs) of VR intervention on MF and ADL in children and adolescents with CP. We conducted dual data abstraction, quality assessment, and strength of evidence. Outcomes include gait, balance, gross MF (GMF), ADL, and hand function. This review encompassed 41 RCTs focusing on the use of VR intervention for children and adolescents with CP. The effect of VR intervention on gait (standardized mean difference [SMD]=0.52; 95% confidence interval [CI], 0.18-0.85) and GMF (SMD=0.76; 95% CI: 0.17, 1.34) has a moderate effect, while balance (SMD=1.1; 95% CI, 0.61-1.59), ADL (SMD=1.46; 95% CI, 0.71-2.2), and hand function (SMD=1.08; 95% CI, 0.17-2) have a great effect. Subgroup analysis reveals the influence of different intervention parameters on different functions. For example, balance is related to the intervention duration of >10 weeks, the frequency of 1-2 times per week, the Nintendo Wii platform, and nonimmersive VR. Although the results show that VR intervention has a positive impact on MF and ADL, the high heterogeneity limits the stability of the conclusion. Future research needs to further explore the mechanism of VR intervention and try to set a reliable personalized intervention model.