Virtual reality in acquired brain injury upper limb rehabilitation: Evidence-based evaluation of clinical research

Abstract

Primary objective: Acquired brain injury (ABI) is associated with significant cognitive, behavioural, psychological and physical impairment. Hence, it has been important to leverage assessment approaches in rehabilitation by using current and emerging technologies, including virtual reality (VR). A number of VR rehabilitation programmes have been designed in recent years, mainly to improve upper limb function. However, before this technology gains widespread use, evaluation of the scientific evidence supporting VR-assisted rehabilitation is needed. The present review aimed to assess the rationale, design and methodology of research investigating the clinical impact of VR on ABI upper-limb rehabilitation. Research design: A total of 22 studies were surveyed using a Cochrane-style review. Research methods: Studies were classified on a number of key criteria: theoretical bases and aims, sample populations and recruitment procedures, characteristics of the VR systems, evaluation design including control procedures and statistical analysis of results. Studies were rated using the Downs and Black (DB) scale. Results: The review demonstrated that few studies used a conventional randomized controlled study design. Moderate support was shown for both teacher-animation and game-like systems. Conclusion: While VR-assisted rehabilitation shows early promise, clinicians are advised to be cautious about adopting these technologies before adequate data is available.