A comparison of virtual reality training with non-computer assisted conventional cognitive training to improve the cognitive function of stroke patients: A systematic review and meta-analysis

Abstract

Objective: To compare the effect of virtual reality (VR) training with non-computer assisted conventional cognitive training (NCACCT) to improve cognitive function of stroke patients.

Background: Cognitive impairment is common in stroke survivors. Conventionally, NCACCT is effective to improve one’s cognitive function but high demand in resources. VR training maybe an alternative to improve cognitive function of stroke patients.

Method: PRISMA guidelines were followed and six databases were searched (CINAHL, Cochrane Library, Medline, PsycINFO, PubMed and Scopus). Included studies were (1) RCTs published in peerreviewed journals in English, (2) studies targeting adult stroke patients, (3) VR training for experimental group, (4) NCACCT as comparator, and (5) cognitive function as outcome. Studies cannot retrieve full-text were excluded. Quality of studies was appraised with Cochrane Collaboration’s risk of bias assessment tool.

Results: Five RCTs involving 132 stroke patients were included. They had good methodological quality. Although no statistical difference observed in global cognitive function (n=5, SMD=0.86, 95%C.I.: - 0.09, 1.81, p=0.08), VR training using lower dosage (≤ 12 training sessions) was more effective than NCACCT to improve global cognitive function of stroke patients (n=3, SMD=1.63, 95%C.I.: 1.08, 2.19, p<0.001). Statistically insignificant results were found for improving the executive function, attention and memory of participants (p>0.05).

Conclusion: Some evidence supports low dosage VR training is more effective than NCACCT in improving cognitive function of stroke patients. Future studies can explore the effect of low dosage VR training as an adjunct treatment and integrate it into stroke rehabilitation for better treatment outcomes.