Improving gait and balance through virtual reality rehabilitation in individuals with Parkinson’s disease

Abstract

An overview of the topic: Parkinson’s Disease is a condition which leads to significant physical disability, mainly postural instability, and difficulty in gait. Apart from the reduced quality of life and independence, these symptoms cause around 45% to 68% of diagnosed individuals to succumb to falls (Pelicioni et al., 2019). To target this side effect, physical therapy is encouraged. This dissertation investigates the use of physical therapy in conjunction with visual stimulation as ‘Virtual Reality Rehabilitation’ to improve symptoms of such individuals. The research question and PICO elements: Does Virtual Reality (VR) rehabilitation help patients with Parkinson’s Disease (PD) in improving gait and balance, when compared to conventional rehabilitation? The Population (P) studied were individuals diagnosed with Parkinson’s Disease. The Intervention (I) consists of Virtual Reality as a form of rehabilitative therapy compared (C) to conventional therapy. The outcome (O) being sought after was the improvement of balance and gait. Method of Search Strategy: An extensive systematic literature search was carried out across four databases; MEDLINE (ProQuest), PubMed, CINAHL Complete, and HyDi using the inclusion criteria of patients diagnosed with PD (with no specification on age or stage of disease progression) using VR Therapy with visual stimulation and physical activity (disregarding other technologies related to other senses). The Comparison could be physiotherapy or other alternatives and the outcome was improvement of gait and balance, excluding articles focusing on motivation as their primary outcome. The search yielded two Systematic Reviews (SRs) with Meta-Analyses, four Systematic Reviews and two Randomized Control Trials (RCTs), all of which were appraised by their respective CASP tool. The main results & recommendations: The main results from the literature appraised show that in patients diagnosed with Parkinson’s Disease, the use of Virtual Reality Therapy significantly improves balance when compared to conventional rehabilitation. However, although improvement was observed, there was no significant difference in improvement of gait when comparing VR therapy to conventional therapy. Recommendations for practice, management, research, education, and policy makers are detailed and the need for further local research is outlined.