Effects of virtual reality on upper limb outcomes and quality of life in people with multiple sclerosis: a systematic review

Abstract

BackgroundVarious virtual reality (VR) approaches in rehabilitation aim to improve the functional status of people with Multiple Sclerosis (PwMS). This systematic review examines the VR tools used, identifying key factors for efficiency and improvement in upper limb (UL) function and quality of life (QoL). Given the ongoing need for PwMS to maintain or improve their quality of life, rehabilitation interventions hold significant potential.MethodsTwo independent investigators conducted the primary search for eligible studies using PubMed, Science Direct, Web of Science, Cinahl, and PEDro databases. Data on design, methods, and results were then extracted from the retrieved articles and analysed for validity and bias using the RoB 2 tool and PEDro scale by three independent assessors.ResultsFrom 343 articles, we selected 12 randomised controlled trials using VR environments in PwMS that evaluated UL function and QoL. Studies differed greatly regarding the therapy content, setting, and therapy dosage, but they often indicated improvement in fine and gross motor skills, manual dexterity, improved UL functioning, bimanual coordination, and grip strength within the intervention group. In most cases, the effect on QoL was non-significant except for one finding that the intervention had a positive impact on the physical domain of MSQoL-54.ConclusionWe conclude that virtual reality is a suitable tool for rehabilitation in PwMS with substantial benefits. This improvement in perceived health and QoL was mostly not reflected. The question also remains whether and to what extent VR could be more effective than standard therapy.