Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2021 Nov 17;23(11):e31007.
doi: 10.2196/31007.

Impact of Virtual Reality-Based Therapies on Cognition and Mental Health of Stroke Patients: Systematic Review and Meta-analysis

Qi Zhang #  1 , Yu Fu #  2 , Yanhui Lu  1 , Yating Zhang  1 , Qifang Huang  1 , Yajie Yang  1 , Ke Zhang  3 , Mingzi Li  1
Affiliations
Meta-Analysis

Impact of Virtual Reality-Based Therapies on Cognition and Mental Health of Stroke Patients: Systematic Review and Meta-analysis

Qi Zhang et al. J Med Internet Res. .

Abstract

Background: Stroke remains one of the major chronic illnesses worldwide that health care organizations will need to address for the next several decades. Individuals poststroke are subject to levels of cognitive impairment and mental health problems. Virtual reality (VR)-based therapies are new technologies used for cognitive rehabilitation and the management of psychological outcomes.

Objective: This study performed a meta-analysis to evaluate the effects of VR-based therapies on cognitive function and mental health in patients with stroke.

Methods: A comprehensive database search was performed using PubMed, MEDLINE (Ovid), Embase, Cochrane Library, and APA PsycINFO databases for randomized controlled trials (RCTs) that studied the effects of VR on patients with stroke. We included trials published up to April 15, 2021, that fulfilled our inclusion and exclusion criteria. The literature was screened, data were extracted, and the methodological quality of the included trials was assessed. Meta-analysis was performed using RevMan 5.3 software.

Results: A total of 894 patients from 23 RCTs were included in our meta-analysis. Compared to traditional rehabilitation therapies, the executive function (standard mean difference [SMD]=0.88, 95% confidence interval [CI]=0.06-1.70, P=.03), memory (SMD=1.44, 95% CI=0.21-2.68, P=.02), and visuospatial function (SMD=0.78, 95% CI=0.23-1.33, P=.006) significantly improved among patients after VR intervention. However, there were no significant differences observed in global cognitive function, attention, verbal fluency, depression, and the quality of life (QoL).

Conclusions: The findings of our meta-analysis showed that VR-based therapies are efficacious in improving executive function, memory, and visuospatial function in patients with stroke. For global cognitive function, attention, verbal fluency, depression, and the QoL, further research is required.

Trial registration: PROSPERO International Prospective Register of Systematic Reviews CRD42021252788; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=252788.

Keywords: cognition; depression; mental health; stroke; virtual reality.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Flowchart of the study selection process. VR: virtual reality.
Figure 2
Figure 2
Risk-of-bias summary.
Figure 3
Figure 3
Forest plot for VR on global cognitive function. VR: virtual reality; CI: confidence interval.
Figure 4
Figure 4
Forest plot for VR on executive function. VR: virtual reality; CI: confidence interval.
Figure 5
Figure 5
Forest plot for VR on memory. VR: virtual reality; CI: confidence interval.
Figure 6
Figure 6
Forest plot for VR on verbal fluency. VR: virtual reality; CI: confidence interval.
Figure 7
Figure 7
Forest plot for VR on visuospatial ability. VR: virtual reality; CI: confidence interval.
Figure 8
Figure 8
Forest plot for VR on attention. VR: virtual reality; CI: confidence interval.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Zhang Q, Zhang K, Li M, Gu J, Li X, Li M, Jin Y. Validity and reliability of the Mandarin version of the Treatment Burden Questionnaire among stroke patients in Mainland China. Fam Pract. 2021 Jul 28;38(4):537–42. doi: 10.1093/fampra/cmab004.6146009 - DOI - PubMed
    1. Feigin VL, Forouzanfar MH, Krishnamurthi R, Mensah GA, Connor M, Bennett DA, Moran AE, Sacco RL, Anderson L, Truelsen T, O'Donnell M, Venketasubramanian N, Barker-Collo S, Lawes CMM, Wang W, Shinohara Y, Witt E, Ezzati M, Naghavi M, Murray C. Global and regional burden of stroke during 1990–2010: findings from the Global Burden of Disease Study 2010. The Lancet. 2014 Jan 18;383(9913):245–55. doi: 10.1016/s0140-6736(13)61953-4. http://europepmc.org/abstract/MED/24449944 S0140-6736(13)61953-4 - DOI - PMC - PubMed
    1. Patel MD, Tilling K, Lawrence E, Rudd AG, Wolfe CDA, McKevitt C. Relationships between long-term stroke disability, handicap and health-related quality of life. Age Ageing. 2006 May;35(3):273–79. doi: 10.1093/ageing/afj074.35/3/273 - DOI - PubMed
    1. Donovan NJ, Kendall DL, Heaton SC, Kwon S, Velozo CA, Duncan PW. Conceptualizing functional cognition in stroke. Neurorehabil Neural Repair. 2008;22(2):122–35. doi: 10.1177/1545968307306239.1545968307306239 - DOI - PubMed
    1. Al-Qazzaz NK, Ali SH, Ahmad SA, Islam S, Mohamad K. Cognitive impairment and memory dysfunction after a stroke diagnosis: a post-stroke memory assessment. Neuropsychiatr Dis Treat. 2014;10:1677–91. doi: 10.2147/NDT.S67184. doi: 10.2147/NDT.S67184.ndt-10-1677 - DOI - DOI - PMC - PubMed