Summary of findings 2. Virtual reality compared to passive intervention (short term) for rehabilitation in Parkinson's disease.
| Virtual reality compared to passive intervention (short term) for rehabilitation in Parkinson's disease | ||||||
| Patient or population: rehabilitation in Parkinson's disease Setting: not specified in the studies Intervention: virtual reality Comparison: passive intervention (short term) | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Score/value with passive intervention (short term) | Score/value with virtual reality | |||||
| Gait (stride length and velocity) | Virtual reality exercise resulted in slight improvement in gait (crossing limb stride length Cohen's d = 1.37, P = 0.003; stride velocity Cohen's d = 1.22, P = 0.011) compared to control intervention. | ‐ | 24 (1 RCT) |
⊕⊝⊝⊝ VERY LOW 1 2 | As a rule of thumb (Cohen's effect size, d), 0.2 standard deviations represents a small difference, 0.5 a moderate difference, and 0.8 a large difference. | |
|
Balance (assessed with composite measure: Berg Balance Scale, Timed Up and Go Test) (higher scores mean better outcome) |
Balance score in the virtual reality group was on average 1.02 standard deviations higher (0.38 higher to 1.65 higher) than in the control group. | ‐ | 44 (2 RCTs) | ⊕⊝⊝⊝ VERY LOW 1 2 | ||
|
Quality of life (assessed with PDQ‐39; higher values mean better outcomes) |
Virtual reality exercise resulted in slight improvement in quality of life (Cohen's d = 1.17, P = 0.004) compared to control intervention. | ‐ | 24 (1 RCT) |
⊕⊝⊝⊝ VERY LOW 1 2 | ||
| Adverse events | No adverse event was reported in the included study. | ‐ | 24 (1 RCT) |
⊕⊝⊝⊝ VERY LOW 1 2 | ||
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; OR: odds ratio; PDQ‐39: 39‐Item Parkinson’s Disease Questionnaire; RR: risk ratio | ||||||
| GRADE Working Group grades of evidence High quality: We are very confident that the true effect lies close to that of the estimate of the effect Moderate quality: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect | ||||||
1Downgraded two levels for very serious imprecision (very small sample size, N = 24 participants). 2Downgraded one level for serious risk of bias (risk of bias was unclear for at least one domain in the included studies).