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Comparison of virtual reality rehabilitation and conventional rehabilitation in Parkinson's disease: a randomised controlled trial
Pazzaglia C, Imbimbo I, Tranchita E, Minganti C, Ricciardi D, Lo Monaco R, Parisi A, Padua L
Physiotherapy 2020 Mar;106:36-42
clinical trial
5/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To compare a 6-week virtual reality (VR) rehabilitation programme with a conventional rehabilitation programme in patients with Parkinson's disease. DESIGN: Prospective, single-blinded, randomised controlled trial. SETTING: Outpatients. PARTICIPANTS: Fifty-one patients with Parkinson's disease were assigned at random to a VR rehabilitation programme or a conventional rehabilitation programme. INTERVENTIONS: Both programmes ran for 6 consecutive weeks, with a 40-minute session three times per week. MAIN OUTCOME MEASURES: The Balance Berg Scale (BBS) was used to measure balance. Secondary outcome measures were: Dynamic Gait Index (DGI) to evaluate ability to adapt gait to complex walking tasks; Disabilities of the Arm, Shoulder and Hand (DASH) scale to measure performance of the upper limb; and Short Form 36 (SF-36) to evaluate quality of life. RESULTS: The VR rehabilitation programme led to an increase in BBS score (45.6 (standard deviation (SD) 7.9) versus 49.2 (SD 8.1), mean difference 3.6, 95% confidence interval (CI) 1.3 to 5.9; p = 0.003), DGI score (18.7 (SD 4.7) versus 20.2 (SD 4.2), mean difference 1.6, 95% CI 0.6 to 2.5; p = 0.003) and SF-36 mental composite score (37.7 (SD 11.4) versus 43.5 (SD 9.2), mean difference 5.8, 95% CI 0.4 to 11.3; p = 0.037), and a decrease in DASH scale score (29.6 (SD 17.5) versus 21.6 (SD 15.1), mean difference -7.9, 95% CI -13.7 to -2.2; p = 0.009). In contrast, the conventional rehabilitation programme only led to a decrease in DASH scale score (30.3 (SD 18.1) versus 25.1 (SD 15.8), mean difference -5.2, 95% CI -8.8 to -1.5; p = 0.007). CONCLUSION: These findings suggest that rehabilitation is useful in Parkinson's disease, and the VR rehabilitation programme was more effective in determining overall improvement than the conventional rehabilitation programme. CLINICAL TRIAL REGISTRATION NUMBER: NCT02807740.

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