Table 2.
Methodological characteristics of included studies (n = 25).
| Studies | Design | Sample/dropout (n/n) | Type of therapy | VR characteristics | N/T of sessions | Sessions per week | Follow-up time (weeks) | Outcome measurements |
|---|---|---|---|---|---|---|---|---|
| Villiger et al. [14] | Prospective, before and after design, noncontrolled, nonrandomized, nonblinded | 14/0 | VR | VR-augmented therapy system (games) | 16 or 20/45 min | 4 or 5 | 12–16 | Numeric Rating Scale, 10-Meter Walk Test, lower extremity motor score, Spinal Cord Independence Measure, Walking Index for Spinal Cord Injury II, Patients' Global Impression of Change, Berg Balance Scale |
| Carlozzi et al. [15] | Prospective, controlled, randomized, nonblinded | 54/2 | VR | Virtual reality driving simulator | — | — | — | Simulator Sickness Questionnaire and software driving simulator variables |
| Dimbwadyo-Terrer et al. [10] | Prospective, controlled, randomized, nonblinded | 15/6 | VR + occupational therapy and physiotherapy | CyberGlove® + 3D objects (reach and release) | 10/30 min | 2 | — | Muscle Balance, Barthel Index scale for functional capacity, Spinal Cord Independence Measure, Nine-Hole Peg Test, Jebsen–Taylor Hand Function |
| Dimbwadyo-Terrer et al. [27] | Prospective, controlled, double-blinded, randomized | 31/0 | VR + occupational therapy and physiotherapy | VR system Toyra (games) | 15/30 min | 3 | 12 | Functional Independence Measure, Spinal Cord Injury Independence Measure, Motricity Index, Manual Muscle Test, Quebec User Evaluation of Satisfaction 2.0 |
| Fizzotti et al. [30] | Prospective, before and after design, noncontrolled, nonrandomized, nonblinded | 15/0 | VR + traditional neurologic exercises | Apple iPad 2 (games) | 6–36∗/— | 2 or 3 | — | Scores in the games and Trunk Recovery Scale |
| Gaffurini et al. [21] | Prospective, before and after design, noncontrolled, nonrandomized, nonblinded | 10/0 | VR | Wii Sports (games) | —/10 min | — | — | Oxygen consumption, pulmonary ventilation, heart rate, energy expenditure |
| Gil-Agudo et al. [21] | Prospective, controlled, randomized, nonblinded | 10/0 | VR + occupational therapy | Toyra system (games) | 15/30 min | 3 | — | Variables of Toyra, Spinal Cord Injury Independence Measure, Nine-Hole Peg Test, Jebsen–Taylor Hand Function Test, Manual Muscle Test |
| Jordan et al. [18] | Prospective, controlled, single-blinded, randomized | 35/0 | VR | Visual illusory walking | —/20 min | — | — | Numeric Rating Scale and Quantitative Sensory Test |
| O'connor et al. [26] | Prospective, before and after design, noncontrolled, nonrandomized |
10/0 | VR | GAMEWheels (games) | <3/3–12 min | — | — | Submaximal oxygen consumption, heart rate. |
| Roosink et al. [17] | Prospective, before and after design, noncontrolled, nonrandomized, nonblinded | 9/0 | VR | Visual illusory walking | 2/90 min | NA | — | Motor imagery vividness, effort and speed, Basic Pain Data Set, Kinesthetic and Visual Imagery Questionnaire |
| Sayenko et al. [19] | Prospective, before and after design, noncontrolled, nonrandomized, nonblinded | 6/0 | VR | Game-based exercises | 12/5 min | 3 | — | Force plate analysis system “Stabilan-01” |
| Villiger et al. [31] | Prospective, controlled, nonrandomized, nonblinded | 9/0 | VR | VR games | 16 or 20/45 min | 4 or 5 | 12–16 | Longitudinal magnetic resonance |
| Wall et al. [13] | Prospective, before and after design, noncontrolled, nonrandomized | 6/1 | VR | Nintendo™ Wii Fit (games) | 14/— | 2 | 4 | Timed Up and Go Test, 10-Meter Walk Test, 6-Minute Walk Test, Walking Index for Spinal Cord Injury II, Berg Balance Scale, Forward Functional Reach Test, Lateral Functional Reach Test, RAND SF-36 |
| Hasnan et al. [22] | Prospective, before and after design, noncontrolled, nonrandomized, nonblinded | 8/0 | VR | Taxi Magic VR Trainer | —/32 or 48 min | 2 or 3 | — | Cardiorespiratory responses and power output |
| D'Addio et al. [20] | Prospective, controlled, randomized, nonblinded | 30/0 | VR + traditional physical therapy | Nintendo™ Wii Fit | 36/— | 3 | — | Posturography (center of pressure data), Berg Balance Scale, Spinal Cord Independence Measure |
| Sung et al. [29] | Prospective, before and after design, noncontrolled, nonrandomized, nonblinded | 12/0 | VR | Driving simulator | — | — | — | Simulator performance measure |
| Dimbwadyo-Terrer et al. [16] | Prospective, controlled, nonrandomized, nonblinded | 20/2 | VR + occupational therapy and physiotherapy | Toyra system | 12/— | 4 | 12 | Kinematic variables, Motor Index, Muscle Balance, Functional Independence Measure, Spinal Cord Independence Measure II, Barthel Index |
| Kowalczewski et al. [39] | Prospective, controlled, single-blinded, randomized | 21/8 | VR + conventional exercise therapy | ReJoyce Workstation | —/60 min | — | 30 | Action Research Arm Test and ReJoyce Automated Hand Function Test |
| Chen et al. [7] | Prospective, controlled, nonblinded, randomized | 30/0 | VR | EON Studio 4.0 | —/— | — | — | Endurance, Borg's Rating-of-Perceived-Exertion Scale, Activation-Deactivation Adjective Check List, Simulator Sickness Questionnaire |
| An and Park [32] | Prospective, before and after design, noncontrolled, nonrandomized, nonblinded | 10/0 | VR | Interactive Rehabilitation and Exercise (IREX; GestureTek, Toronto, Canada) | 18/30 min | 3 | — | Limit of stability, Berg Balance Scale, Timed Up and Go Test, Activities-Specific Balance Confidence Scale, Walking Index for Spinal Cord Injury II |
| Khurana et al. [33] | Prospective, before and after design, controlled, randomized, double-blinded | 36/6 | VR + conventional physiotherapy | Sony PlayStation 2 and EyeToy (Sony Computer Entertainment Inc., Beijing, China) | 20/45 min | 4 | — | Modified Functional Reach Test, t-shirt test, self-care components of the Spinal Cord Independence Measure III |
| Pozeg et al. [34] | Single-session, cross-sectional, controlled, randomized, nonblinded | 40/0 | VR + tactile stimulation (synchronous and asynchronous) | Virtual leg illusion and full-body illusion | 1/1 min | 1 | — | Sense of leg ownership (questionnaires) and perceived neuropathic pain (visual analogue scale pain ratings) |
| Prasad et al. [35] | Prospective, pilot, controlled, single-blinded, randomized | 22/2 | VR + conventional hand therapy and strength training | Wii Sports Resort game (Table Tennis, Swordplay Speed Slice, Bowling, and Cycling) | 12/60 min | 3 | 6 | Capabilities of Upper Extremity Questionnaire, Box and Block Test for gross motor dexterity, Spinal Cord Independence Measure-Self Report, World Health Organization Quality of Life-BREF |
| van Dijsseldonk et al. [36] | Prospective, before and after design, noncontrolled, nonrandomized, nonblinded | 17/2 | VR | Gait Real-time Analysis Interactive Lab (GRAIL) training | 12/60 min | 2 | 20 | Gait (spatiotemporal parameters and stability measures) and Activities-specific Balance Confidence (ABC) Scale |
| Villiger et al. [37] | Prospective, before and after design, noncontrolled, nonrandomized, nonblinded | 12/1 | VR | Mobile prototype of the YouKicker system (YouRehab AG, Schlieren, Switzerland) for the lower limbs | 16–20/30–45 min | 4-5 | 10–13 | Muscle strength, balance, and mobility: lower extremity motor score, Berg Balance Scale, Timed Up and Go Test, 10-Meter Walk Test, 6-Minute Walk Test, Spinal Cord Independence Measure III, Walking Index for Spinal Cord Injury II, Motivational Scale and Global Impression of Change |
Note. n or N, number; VR, virtual reality; T, time; NA, not applicable; —, information not available. ∗The number is not specified (ranges from min. to max.).