Comparison of virtual reality exercise versus conventional exercise on balance in patients with functional ankle instability: A randomized controlled trial

The Efficacy of Virtual Reality Training in the Rehabilitation of Orthopedic Ankle Injuries: A Systematic Review and Meta-analysis

Introduction

Orthopedic ankle injuries are considered among the most common musculoskeletal injuries. A wide variety of modalities and techniques have been used for the management of these injuries, and virtual reality (VR) is one modality that has been examined in ankle injuries rehabilitation.

Purpose

This study aims to systemically review previous studies evaluating the effect of virtual reality in rehabilitating orthopedic ankle injuries.

Methods

We searched six online databases: PubMed, Web of Science (WOS), Scopus, the Physiotherapy Evidence Database (PEDro), Virtual Health Library (VHL), and Cochrane Central Register of Controlled Trials (CENTRAL).

Results

Ten randomized clinical trials met the inclusion criteria. Our results showed that VR had a significant effect on overall balance compared to conventional physiotherapy (SMD = 0.359, 0.009-0.710 P = 0.04), [I 2= 17%, P = 0.30]. Compared with conventional physiotherapy, VR programs significantly improved gait parameters such as speed and cadence, muscle power, and perceived ankle instability; however, no significant difference was detected in the foot and ankle ability measure (FAAM). Additionally, significant improvements in static balance and perceived ankle instability were reported after the use of VR balance and strengthening programs. Finally, only two articles were deemed to have good quality, and the other studies' quality ranged from poor to fair.

Conclusion

VR rehabilitation programs can be used to rehabilitate ankle injuries, as they are regarded as safe interventions and have promising effects. However, there is a need for studies with high quality since most included studies' quality varied from poor to fair.

Effects of Conservative Interventions on Static and Dynamic Balance in Individuals With Chronic Ankle Instability: A Systematic Review and Meta-analysis

OBJECTIVE

To determine which conservative interventions are effective for static and dynamic balance in patients with chronic ankle instability (CAI).

DATA SOURCES

PubMed, Cochrane Library, Web of Sciences, and CINAHL databases were searched up to March 20, 2022.

STUDY SELECTION

Randomized controlled trials investigating the effects of conservative interventions on static and/or dynamic balance in patients with CAI compared with those of different conservative interventions or controls were included.

DATA EXTRACTION

Two independent reviewers extracted the data. Certainty of the evidence was assessed using the GRADE approach.

DATA SYNTHESIS

Forty-eight studies (1906 participants) were included. Whole-body vibration training (WBVT) was significantly more effective than controls for both static (standardized mean difference, 1.13; 95% confidence interval [CI], 0.58-1.68; moderate-certainty evidence) and dynamic balance (0.56; CI, 0.24-0.88; low-certainty evidence). Balance training (BT) and joint mobilization were significantly more effective than controls for dynamic balance (0.77; CI, 0.41-1.14; and 0.75; CI, 0.35-1.14, respectively), but not for static balance (very low to low-certainty evidence). Adding other interventions to BT had no significant effect on either type of balance compared with that of BT alone (moderate to low-certainty evidence). Strength training (ST) and taping had no significant effect on either type of balance (very low- to low-certainty evidence). Multimodal interventions were significantly effective in improving dynamic balance (0.76; CI, 0.32-1.20; low-certainty evidence). Adding transcranial direct current stimulation to ST was significantly more effective for dynamic balance than ST (0.81; CI, 0.08-1.53; moderate-certainty evidence). The effects on balance were not significantly different among BT, ST, and WBVT (very low- to low-certainty evidence).

CONCLUSIONS

The significantly effective interventions reviewed may be treatment options for balance impairments associated with CAI. However, interventions should be chosen carefully, as much of the certainty of evidence is very low to low.

Touch, Texture and Haptic Feedback: A Review on How We Feel the World around Us

Touch is one most of the important aspects of human life. Nearly all interactions, when broken down, involve touch in one form or another. Recent advances in technology, particularly in the field of virtual reality, have led to increasing interest in the research of haptics. However, accurately capturing touch is still one of most difficult engineering challenges currently being faced. Recent advances in technology such as those found in microcontrollers which allow the creation of smaller sensors and feedback devices may provide the solution. Beyond capturing and measuring touch, replicating touch is also another unique challenge due to the complexity and sensitivity of the human skin. The development of flexible, soft-wearable devices, however, has allowed for the creating of feedback systems that conform to the human form factor with minimal loss of accuracy, thus presenting possible solutions and opportunities. Thus, in this review, the researchers aim to showcase the technologies currently being used in haptic feedback, and their strengths and limitations.

Effect of Virtual Reality on Functional Ankle Instability Rehabilitation: A Systematic Review

Objective

To systematically evaluate the effectiveness of virtual reality (VR) in the rehabilitation of patients with functional ankle instability (FAI).

Methods

Nine databases were researched, including PubMed, Cochrane Library, Web of Science, Embase, OVID, CNKI, VIP, WanFang, SinoMed, ResearchGate, and WorldWildScience. The publication date deadline was May 22, 2021. To analyze the effect of VR rehabilitation of FAI, we systematically reviewed the literature using the RevMan 5.4 software. Main Results. Five randomized controlled trials (RCTs) were included in the analysis, consisting of 137 patients with FAI; 68 of them were in the experimental group, 69 were in the control group, and all were university students. A comparison study was conducted between the two groups in terms of balance function, muscle performance, and proprioception. VR rehabilitation in the treatment of FAI was found to be significantly more effective using a 30-second single-leg standing test than conventional rehabilitation. The angular offset index of VR rehabilitation training was significantly lower than that of conventional balance training (0.66 ± 0.18 vs. 0.95 ± 0.21; P = 0.005).

Conclusion

VR rehabilitation is effective at treating FAI. However, RCTs with higher homogeneity are needed to provide a more reliable evidence-based foundation for clinical rehabilitation.