RT journal article
T1 Virtual Reality for Upper Limb Rehabilitation in Patients With Obstetric Brachial Palsy: Systematic Review and Meta-Analysis of Randomized Controlled Trials
A1 De Miguel-Rubio, Amaranta
A1 Alba Rueda, Alvaro
A1 Millán-Salguero, Elena María
A1 De Miguel-Rubio, María Dolores
A1 Moral Muñoz, José Antonio
A1 Lucena Antón, David Manuel
A2 Enfermería y Fisioterapia
K1 neonatal brachial plexus palsy
K1 virtual reality
K1 rehabilitation
K1 upper extremity
K1 review
K1 meta-analysis
AB Background: Obstetric brachial palsy (OBP) is a pathology caused by complications during childbirth because of cervical spineelongation, affecting the motor and sensory innervation of the upper limbs. The most common lesion occurs on the C5 and C6nerve branches, known as Erb-Duchenne palsy. The least common lesion is when all nerve roots are affected (C5-T1), which hasthe worst prognosis. Virtual reality (VR) is commonly used in neurological rehabilitation for the evaluation and treatment ofphysical deficits.Objective: This systematic review aims to assess the efficacy of VR in the rehabilitation of upper limb function in patients withOBP.Methods: A search was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews andMeta-Analyses) 2020 guidelines in several scientific databases—PubMed, Web of Science, PEDro, Cochrane, MEDLINE, Scopus,and CINAHL—without language or date restrictions and including articles published up to April 2023. The inclusion criteriawere established according to the population, intervention, comparison, outcome, and study (PICOS) design framework: childrenaged <18 years diagnosed with OBP, VR therapy used in addition to conventional therapy or isolated, VR therapy compared withconventional therapy, outcomes related to OBP rehabilitation therapy, and randomized controlled trials (RCTs). The PEDro scalewas used to assess the methodological quality of the RCTs, and the Cochrane Collaboration tool was used to assess the risk ofbias. The Review Manager statistical software (version 5.4; The Cochrane Collaboration) was used to conduct the meta-analysis.The results were synthesized through information extraction and presented in tables and forest plots.Results: In total, 5 RCTs were included in this systematic review, with 3 (60%) providing information for the meta-analysis.A total of 138 participants were analyzed. All the studies used semi-immersive or nonimmersive VR systems. The statisticalanalysis showed no favorable results for all outcomes except for the hand-to-mouth subtest of the Mallet scoring system (functionalactivity; standardized mean difference −0.97, 95% CI −1.67 to −0.27; P=.007).Conclusions: The evidence for the use of VR therapy for upper limb rehabilitation outcomes in patients with OBP was insufficientto support its efficacy and strongly recommend its use. Nevertheless, scientific literature supports the use of VR technologies forrehabilitation as it provides several advantages, such as enhancing the patient’s motivation, providing direct feedback, and focusingthe patient’s attention during the intervention. Thus, the use of VR for upper limb rehabilitation in patients with OBP is still inhttps://www.jmir.org/2023/1/e47391 J Med Internet Res 2023 | vol. 25 | e47391 | p. 1(page number not for citation purposes)JOURNAL OF MEDICAL INTERNET RESEARCH De Miguel-Rubio et alXSL•FORenderXits first stages. Small sample sizes; limited long-term analysis; lack of testing of different doses; and absence of InternationalClassification of Functioning, Disability, and Health–related outcomes were present in the included RCTs, so further research isneeded to fully understand the potential of VR technologies as a therapeutic approach for patients with OBP.
PB JMIR PUBLICATIONS, INC
SN 1438-8871
YR 2023
FD 2023
LK http://hdl.handle.net/10498/31477
UL http://hdl.handle.net/10498/31477
LA eng
DS Repositorio Institucional de la Universidad de Cádiz
RD 09-nov-2026