Faculty Collaboration Database

Effectiveness of virtual reality rehabilitation for cervical spinal cord injury: A systematic review and meta-analysis. Proc Inst Mech Eng H 2025 May;239(5):413-422

Date

05/05/2025

Pubmed ID

40320702

DOI

10.1177/09544119251337381

Scopus ID

2-s2.0-105004572754 (requires institutional sign-in at Scopus site)   1 Citation

Abstract

This systematic review and meta-analysis evaluated the effectiveness of virtual reality (VR) rehabilitation in improving functional performance for patients with cervical spinal cord injury (CSCI), which affects both upper and lower limb function. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, electronic databases including PubMed, Medline, Embase, Scopus, and Cochrane Library were searched. Meta-analysis was conducted on studies reporting common functional outcomes, with standardized mean difference (SMD) used to quantify effect sizes. Nine studies were included in the systematic review, and seven were analyzed in the meta-analysis. Three studies focused on upper limb outcomes, and six on lower limb function. Of the seven studies, four included only CSCI patients, while three had mixed injury cohorts (cervical and thoracic). Meta-analysis revealed no statistically significant improvements in function for mixed injury cohorts across various outcomes: Timed-Up and Go test (SMD 0.94 [-0.21, 2.09]), Berg Balance Scale (-0.83 [-1.72, 0.07]), Walking Index for Spinal Cord Injury II (-0.38 [-0.86, 0.09]), Spinal Cord Independence Measure (-0.41 [-0.92, 0.10]), and 10 Meter Walk Test (-1.43 [-3.58, -0.73]). However, the Timed-Up and Go test showed significant results favoring VR-based rehabilitation when excluding mixed cohorts (SMD 2.02 [1.24, 2.79]). VR rehabilitation shows promise for improving lower limb function in CSCI patients, but overall evidence remains inconclusive due to study variability. Standardizing outcome measures and further research on upper limb rehabilitation are essential to enhance the impact of VR-based interventions for CSCI.

Author List

Raju VB, Schmit BD, Vedantam A

Authors

Brian Schmit PhD Professor in the Biomedical Engineering department at Marquette University
Aditya Vedantam MBBS Associate Professor in the Neurosurgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Cervical Cord
Cervical Vertebrae
Humans
Spinal Cord Injuries
Treatment Outcome
Virtual Reality