Virtual reality interventions and their impact on physical function and quality of life in multiple sclerosis: A systematic review with meta-analysis.
Roberto López-Andaur, Edgar Vásquez-Carrasco, Sebastián Burgos-Carrasco et al.
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In 30 seconds
This systematic review and meta-analysis pooled randomized controlled trials of structured virtual reality (VR) rehabilitation in adults with multiple sclerosis. Nineteen trials included 781 randomized participants; 702 contributed outcome data. VR was associated with improvements in gait speed, functional mobility, balance and health-related quality of life. For functional mobility, the pooled effect was Hedges’ g = 1.00 (95% CI 0.47 to 1.54; I² = 52.4%). Evidence certainty ranged from low to very low, and the authors considered the estimates preliminary rather than evidence of a general VR effect.
Key findings
- Gait speed improved with VR (10MWT: g = 0.99, 95% CI 0.39 to 1.58; I² = 51.8%), with very low certainty.
- Functional mobility improved (TUG: g = 1.00, 95% CI 0.47 to 1.54; I² = 52.4%), with low-certainty evidence.
- Balance improved (BBS: g = 0.59, 95% CI 0.14 to 1.03; I² = 57.7%), with low-certainty evidence.
- Quality-of-life estimates favored VR for MSQOL-54 and MusiQoL, but certainty was very low for both outcomes.
Why it matters
Gait, balance and upper-limb impairments can substantially affect function in multiple sclerosis. The pooled findings suggest VR rehabilitation may benefit several functional and quality-of-life outcomes, but uncertainty and variation between trials limit confidence in the size and consistency of these effects. Distinguishing results by outcome is more informative than treating VR as a single, uniformly effective intervention.
What to keep in mind
Evidence certainty was low or very low, with moderate to considerable heterogeneity across trials. Upper-limb outcomes could not be pooled because instruments and reporting differed.