journal article·2022-02-11Open access

Effectiveness of Augmented Reality in Stroke Rehabilitation: A Meta-Analysis

Huu Lam Phan, Thi Huong Le, Jung Min Lim, Chang Ho Hwang, Kyo-in Koo

Applied Sciences· Volume 12· Issue 4

Abstract

Augmented reality (AR)-based rehabilitation shows potential to improve upper and lower limb function after stroke. This study aims to review the effect of AR technology in the recovery of the upper and lower limb function in stroke patients. Published randomized controlled trials and observational investigations with adult stroke patients were retrieved from five electronic databases to analyze the effect of the AR systems in improving motor function and balance and gait function for stroke patients. The treatment effect was estimated by standardized mean difference (SMD) and 95% confidence interval (CI) using a random effect model for motor function outcomes at the body structure and function, body activity and participation level of the International Classification of Functioning, and balance and gait outcomes. In total, 13 investigations (9 for the upper limb and 4 for the lower limb) were identified. AR demonstrated a significant influence on the upper limb function (SMD = 0.657; 95% CI, 0.287 to 1.026; p = 0.000) and the lower limb function (SMD = 0.52; 95% CI, 0.039 to 1.001; p = 0.034). The present analysis suggests that AR applications could offer options for increasing treatment intensity and promoting motor recovery after a stroke. This approach can be used with the conventional rehabilitation methods as a new intervention for recovering upper and lower limb function.
Source: crossref · Quality: baseline

Research context

OpenAlex topics: Stroke Rehabilitation and Recovery · Spatial Neglect and Hemispheric Dysfunction · Acute Ischemic Stroke Management

SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.

Affiliations

Department of Electrical, Electronic and Computer Engineering, University of Ulsan, Ulsan 44610, Korea

Office of Si-Heung Campus, Future Innovation Institute, Seoul National University, Seoul 15011, Korea

Department of Physical & Rehabilitation Medicine, Chungnam National University Sejong Hospital, Chungnam National University College of Medicine, Sejong 30099, Korea

Funding

University of Ulsan

References (43)

Show source-provided references
1. Heart Disease and Stroke Statistics—2006 Update
2. World Health Organization (2011). World Report on Disability, World Health Organization.
3. Lunde, L.-K., Koch, M., Knardahl, S., Wærsted, M., Mathiassen, S.E., Forsman, M., Holtermann, A., and Veiersted, K.B. (2014). Musculoskeletal health and work ability in physically demanding occupations study protocol for a prospective field study on construction and health care workers. BMC Public Health, 14.10.1186/1471-2458-14-1075 ↗
4. Health, functioning, and disability in older adults—present status and future implications10.1016/S0140-6736(14)61462-8 ↗
5. Rehabilitation; Concepts, Practices and Research10.1080/15017410309512608 ↗
6. Targeted Neuromodulation of Abnormal Interhemispheric Connectivity to Promote Neural Plasticity and Recovery of Arm Function after Stroke: A Randomized Crossover Clinical Trial Study Protocol10.1155/2018/9875326 ↗
7. Neuroplastic Changes Following Brain Ischemia and their Contribution to Stroke Recovery: Novel Approaches in Neurorehabilitation10.3389/fncel.2017.00076 ↗
8. Cognitive Rehabilitation and Modulating Neuroplasticity with Brain Stimulation: Promises and Challenges10.1007/s40737-015-0027-4 ↗
9. Upper extremity rehabilitation equipment for stroke patients in Taiwan: Usage problems and improvement needs10.1002/oti.1360 ↗
10. The Efficacy of Gait Training Using a Body Weight Support Treadmill and Visual Biofeedback in Patients with Subacute Stroke: A Randomized Controlled Trial10.1155/2018/3812602 ↗
11. The use of memorised verbal scripts in the rehabilitation of action disorganisation syndrome10.1080/09602010500172277 ↗
12. Dissociations in Routine Behaviour across Patients and Everyday Tasks10.1093/neucas/8.1.151 ↗
13. Virtual Rehabilitation-Benefits and Challenges10.1055/s-0038-1634378 ↗
14. Recent Advances in Augmented Reality10.1109/38.963459 ↗
15. Augmented visual, auditory, haptic, and multimodal feedback in motor learning: A review10.3758/s13423-012-0333-8 ↗
16. MirrARbilitation: A clinically-related gesture recognition interactive tool for an AR rehabilitation system10.1016/j.cmpb.2016.07.014 ↗
17. Tang, A., and Biocca, F. (2004, January 13–15). Comparing Differences in Presence during Social Interaction in Augmented Reality versus Virtual Reality Environments An Exploratory Study. Proceedings of the PRESENCE 2004, Seventh Annual International Workshop on Presence, Valencia, Spain.
18. Ong, S.K., Shen, Y., Zhang, J., and Nee, A.Y.C. (2011). Augmented Reality in Assistive Technology and Rehabilitation Engineering, Springer.10.1007/978-1-4614-0064-6_28 ↗
19. Augmented reality applications in rehabilitation to improve physical outcomes10.1179/1743288X11Y.0000000051 ↗
20. Rosanna Maria Viglialoro, S.C., Turini, G., Carbone, M., Ferrari, V., and Gesi, M. (2019). Review of the Augmented Reality Systems for Shoulder Rehabilitation. Information, 10.10.3390/info10050154 ↗
21. Gorman, C., and Gustafsson, L.A.-O. (2020). The use of augmented reality for rehabilitation after stroke: A narrative review. Disabil. Rehabil. Assist. Technol., 1–9.
22. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement10.1136/bmj.b2535 ↗
23. WHO (2002). The International Classification of Functioning, Disability and Health, WHO.
24. What do randomized controlled trials say about virtual rehabilitation in stroke? A systematic literature review and meta-analysis of upper-limb and cognitive outcomes10.1186/s12984-018-0370-2 ↗
25. Kmet, L.M., Lee, R.C., and Cook, L.S. (2004). Standard Quality Assessmemt Criteria for Evaluating Primary Research Papers from a Variety of Fields, Institute of Health Economics.
26. An affordable, computerised, table-based exercise system for stroke survivors10.3109/17483101003718161 ↗
27. AR-based serious game framework for post-stroke rehabilitation10.1007/s00530-015-0481-6 ↗
28. Choice of Human-Computer Interaction Mode in Stroke Rehabilitation
29. Patient-Tailored Augmented Reality Games for Assessing Upper Extremity Motor Impairments in Parkinson's Disease and Stroke10.1007/s10916-018-1100-9 ↗
30. Computerised mirror therapy with Augmented Reflection Technology for early stroke rehabilitation: Clinical feasibility and integration as an adjunct therapy10.1080/09638288.2017.1291765 ↗
31. Patient engagement and clinical feasibility of Augmented Reflection Technology for stroke rehabilitation10.1515/ijdhd-2014-0328 ↗
32. An augmented reality system for upper-limb post-stroke motor rehabilitation: A feasibility study
33. Effect of a mixed reality-based intervention on arm, hand, and finger function on chronic stroke10.1186/s12984-016-0153-6 ↗
34. A pilot study of augmented reality-based postural control training in stroke rehabilitation10.14474/ptrs.2014.3.1.13 ↗
35. Augmented reality-based postural control training improves gait function in patients with stroke: Randomized controlled trial10.1016/j.hkpj.2014.04.002 ↗
36. Effects of Augmented Reality with functional electric Stimulation on Muscle Strength, Balance and Gait of Stroke patients10.1589/jpts.24.755 ↗
37. Use of Augmented Reality-Based Training with EMG-Triggered Functional Electric Stimulation in Stroke Rehabilitation10.1589/jpts.25.147 ↗
38. A Case Series Clinical Trial of a Novel Approach Using Augmented Reality That Inspires Self-body Cognition in Patients With Stroke: Effects on Motor Function and Resting-State Brain Functional Connectivity10.3389/fnsys.2019.00076 ↗
39. Reliability of the Fugl-Meyer Assessment of Sensorimotor Recovery Following Cerebrovascular Accident10.1093/ptj/63.10.1606 ↗
40. Measurement structure of the Wolf Motor Function Test: Implications for motor control theory10.1177/1545968310370749 ↗
41. Adult norms for the Box and Block Test of Manual Dexterity10.5014/ajot.39.6.386 ↗
42. Enhanced Reality Showing Long-Lasting Analgesia after Total Knee Arthroplasty: Prospective, Randomized Clinical Trial10.1038/s41598-018-20260-0 ↗
43. Phan, H.L., Kim, J.P., Kim, K., Hwang, C.H., and Koo, K.-i. (2019). Wrist Rehabilitation System Using Augmented Reality for Hemiplegic Stroke Patient Rehabilitation: A Feasibility Study. Appl. Sci., 9.10.3390/app9142892 ↗