Virtual Reality-Based Therapy Improves Fatigue, Impact, and Quality of Life in Patients with Multiple Sclerosis. A Systematic Review with a Meta-Analysis

Patients with multiple sclerosis (PwMS) have a high level of fatigue and a reduced quality of life (QoL) due to the impact of multiple sclerosis (MS). Virtual reality-based therapy (VRBT) is being used to reduce disability in PwMS. The aim of this study was to assess the effect of VRBT on fatigue, t...

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Autores principales:	Irene Cortés-Pérez, Marcelina Sánchez-Alcalá, Francisco Antonio Nieto-Escámez, Yolanda Castellote-Caballero, Esteban Obrero-Gaitán, María Catalina Osuna-Pérez
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	multiple sclerosis virtual reality videogames fatigue quality of life meta-analysis Chemical technology TP1-1185
Acceso en línea:	https://doaj.org/article/04e30bac855f48edaeff6a55f14f632a
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spelling	oai:doaj.org-article:04e30bac855f48edaeff6a55f14f632a2021-11-11T19:19:05ZVirtual Reality-Based Therapy Improves Fatigue, Impact, and Quality of Life in Patients with Multiple Sclerosis. A Systematic Review with a Meta-Analysis10.3390/s212173891424-8220https://doaj.org/article/04e30bac855f48edaeff6a55f14f632a2021-11-01T00:00:00Zhttps://www.mdpi.com/1424-8220/21/21/7389https://doaj.org/toc/1424-8220Patients with multiple sclerosis (PwMS) have a high level of fatigue and a reduced quality of life (QoL) due to the impact of multiple sclerosis (MS). Virtual reality-based therapy (VRBT) is being used to reduce disability in PwMS. The aim of this study was to assess the effect of VRBT on fatigue, the impact of MS, and QoL in PwMS. Methods: A systematic review with meta-analysis was conducted through a bibliographic search on PubMed, Scopus, Web of Science, and PEDro up to April 2021. We included randomized controlled trials (RCTs) with PwMS that received VRBT in comparison to conventional therapy (CT) including physiotherapy, balance and strength exercises, and stretching or physical activity, among others; or in comparison to simple observation; in order to assess fatigue, MS-impact, and QoL. The effect size was calculated using Cohen’s standardized mean difference with a 95% confidence interval (95% CI). Results: Twelve RCTs that provided data from 606 PwMS (42.83 ± 6.86 years old and 70% women) were included. The methodological quality mean, according to the PEDro Scale, was 5.83 ± 0.83 points. Our global findings showed that VRBT is effective at reducing fatigue (SMD −0.33; 95% CI −0.61, −0.06), lowering the impact of MS (SMD −0.3; 95% CI −0.55, −0.04), and increasing overall QoL (0.5; 95% CI 0.23, 0.76). Subgroup analysis showed the following: (1) VRBT is better than CT at reducing fatigue (SMD −0.4; 95% CI −0.7, −0.11), as well as in improving the mental dimension of QoL (SMD 0.51; 95% CI 0.02, 1); (2) VRBT is better than simple observation at reducing the impact of MS (SMD −0.61; 95% CI −0.97, −0.23) and increasing overall QoL (SMD 0.79; 95% CI 0.3, 1.28); and (3) when combined with CT, VRBT is more effective than CT in improving the global (SMD 0.6, 95% CI 0.13, 1.07), physical (SMD 0.87; 95% CI 0.3, 1.43), and mental dimensions (SMD 0.6; 95% CI 0.08, 1.11) of QoL. Conclusion: VRBT is effective at reducing fatigue and MS impact and improving QoL in PwMS.Irene Cortés-PérezMarcelina Sánchez-AlcaláFrancisco Antonio Nieto-EscámezYolanda Castellote-CaballeroEsteban Obrero-GaitánMaría Catalina Osuna-PérezMDPI AGarticlemultiple sclerosisvirtual realityvideogamesfatiguequality of lifemeta-analysisChemical technologyTP1-1185ENSensors, Vol 21, Iss 7389, p 7389 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	multiple sclerosis virtual reality videogames fatigue quality of life meta-analysis Chemical technology TP1-1185
spellingShingle	multiple sclerosis virtual reality videogames fatigue quality of life meta-analysis Chemical technology TP1-1185 Irene Cortés-Pérez Marcelina Sánchez-Alcalá Francisco Antonio Nieto-Escámez Yolanda Castellote-Caballero Esteban Obrero-Gaitán María Catalina Osuna-Pérez Virtual Reality-Based Therapy Improves Fatigue, Impact, and Quality of Life in Patients with Multiple Sclerosis. A Systematic Review with a Meta-Analysis
description	Patients with multiple sclerosis (PwMS) have a high level of fatigue and a reduced quality of life (QoL) due to the impact of multiple sclerosis (MS). Virtual reality-based therapy (VRBT) is being used to reduce disability in PwMS. The aim of this study was to assess the effect of VRBT on fatigue, the impact of MS, and QoL in PwMS. Methods: A systematic review with meta-analysis was conducted through a bibliographic search on PubMed, Scopus, Web of Science, and PEDro up to April 2021. We included randomized controlled trials (RCTs) with PwMS that received VRBT in comparison to conventional therapy (CT) including physiotherapy, balance and strength exercises, and stretching or physical activity, among others; or in comparison to simple observation; in order to assess fatigue, MS-impact, and QoL. The effect size was calculated using Cohen’s standardized mean difference with a 95% confidence interval (95% CI). Results: Twelve RCTs that provided data from 606 PwMS (42.83 ± 6.86 years old and 70% women) were included. The methodological quality mean, according to the PEDro Scale, was 5.83 ± 0.83 points. Our global findings showed that VRBT is effective at reducing fatigue (SMD −0.33; 95% CI −0.61, −0.06), lowering the impact of MS (SMD −0.3; 95% CI −0.55, −0.04), and increasing overall QoL (0.5; 95% CI 0.23, 0.76). Subgroup analysis showed the following: (1) VRBT is better than CT at reducing fatigue (SMD −0.4; 95% CI −0.7, −0.11), as well as in improving the mental dimension of QoL (SMD 0.51; 95% CI 0.02, 1); (2) VRBT is better than simple observation at reducing the impact of MS (SMD −0.61; 95% CI −0.97, −0.23) and increasing overall QoL (SMD 0.79; 95% CI 0.3, 1.28); and (3) when combined with CT, VRBT is more effective than CT in improving the global (SMD 0.6, 95% CI 0.13, 1.07), physical (SMD 0.87; 95% CI 0.3, 1.43), and mental dimensions (SMD 0.6; 95% CI 0.08, 1.11) of QoL. Conclusion: VRBT is effective at reducing fatigue and MS impact and improving QoL in PwMS.
format	article
author	Irene Cortés-Pérez Marcelina Sánchez-Alcalá Francisco Antonio Nieto-Escámez Yolanda Castellote-Caballero Esteban Obrero-Gaitán María Catalina Osuna-Pérez
author_facet	Irene Cortés-Pérez Marcelina Sánchez-Alcalá Francisco Antonio Nieto-Escámez Yolanda Castellote-Caballero Esteban Obrero-Gaitán María Catalina Osuna-Pérez
author_sort	Irene Cortés-Pérez
title	Virtual Reality-Based Therapy Improves Fatigue, Impact, and Quality of Life in Patients with Multiple Sclerosis. A Systematic Review with a Meta-Analysis
title_short	Virtual Reality-Based Therapy Improves Fatigue, Impact, and Quality of Life in Patients with Multiple Sclerosis. A Systematic Review with a Meta-Analysis
title_full	Virtual Reality-Based Therapy Improves Fatigue, Impact, and Quality of Life in Patients with Multiple Sclerosis. A Systematic Review with a Meta-Analysis
title_fullStr	Virtual Reality-Based Therapy Improves Fatigue, Impact, and Quality of Life in Patients with Multiple Sclerosis. A Systematic Review with a Meta-Analysis
title_full_unstemmed	Virtual Reality-Based Therapy Improves Fatigue, Impact, and Quality of Life in Patients with Multiple Sclerosis. A Systematic Review with a Meta-Analysis
title_sort	virtual reality-based therapy improves fatigue, impact, and quality of life in patients with multiple sclerosis. a systematic review with a meta-analysis
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/04e30bac855f48edaeff6a55f14f632a
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Virtual Reality-Based Therapy Improves Fatigue, Impact, and Quality of Life in Patients with Multiple Sclerosis. A Systematic Review with a Meta-Analysis

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