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Augmented Reality in Physical Therapy: Systematic Review and Meta-analysis

BACKGROUND: Augmented reality (AR) is a rapidly expanding technology; it comprises the generation of new images from digital information in the real physical environment of a person, which simulates an environment where the artificial and real are mixed. The use of AR in physiotherapy has shown bene...

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Autores principales: Vinolo Gil, Maria Jesus, Gonzalez-Medina, Gloria, Lucena-Anton, David, Perez-Cabezas, Veronica, Ruiz-Molinero, María Del Carmen, Martín-Valero, Rocío
Formato: Online Artículo Texto
Lenguaje:English
Publicado: JMIR Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8717132/
https://www.ncbi.nlm.nih.gov/pubmed/34914611
http://dx.doi.org/10.2196/30985
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author Vinolo Gil, Maria Jesus
Gonzalez-Medina, Gloria
Lucena-Anton, David
Perez-Cabezas, Veronica
Ruiz-Molinero, María Del Carmen
Martín-Valero, Rocío
author_facet Vinolo Gil, Maria Jesus
Gonzalez-Medina, Gloria
Lucena-Anton, David
Perez-Cabezas, Veronica
Ruiz-Molinero, María Del Carmen
Martín-Valero, Rocío
author_sort Vinolo Gil, Maria Jesus
collection PubMed
description BACKGROUND: Augmented reality (AR) is a rapidly expanding technology; it comprises the generation of new images from digital information in the real physical environment of a person, which simulates an environment where the artificial and real are mixed. The use of AR in physiotherapy has shown benefits in certain areas of patient health. However, these benefits have not been studied as a whole. OBJECTIVE: This study aims to ascertain the current scientific evidence on AR therapy as a complement to physiotherapy and to determine the areas in which it has been used the most and which variables and methods have been most effective. METHODS: A systematic review registered in PROSPERO (International Prospective Register of Systematic Reviews) was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta‐Analyses) recommendations. The search was conducted from July to August 2021 in the PubMed, PEDro, Web of Science, Scopus, and Cochrane Library scientific databases using the keywords augmented reality, physiotherapy, physical therapy, exercise therapy, rehabilitation, physical medicine, fitness, and occupational therapy. The methodological quality was evaluated using the PEDro scale and the Scottish Intercollegiate Guidelines Network scale to determine the degree of recommendation. The Cochrane Collaboration tool was used to evaluate the risk of bias. RESULTS: In total, 11 articles were included in the systematic review. Of the 11 articles, 4 (36%) contributed information to the meta-analysis. Overall, 64% (7/11) obtained a good level of evidence, and most had a B degree of recommendation of evidence. A total of 308 participants were analyzed. Favorable results were found for the Berg Balance Scale (standardized mean change 0.473, 95% CI −0.0877 to 1.0338; z=1.65; P=.10) and the Timed Up and Go test (standardized mean change −1.211, 95% CI −3.2005 to 0.7768; z=−1.194; P=.23). CONCLUSIONS: AR, in combination with conventional therapy, has been used for the treatment of balance and fall prevention in geriatrics, lower and upper limb functionality in stroke, pain in phantom pain syndrome, and turning in place in patients with Parkinson disease with freezing of gait. AR is effective for the improvement of balance; however, given the small size of the samples and the high heterogeneity of the studies, the results were not conclusive. Future studies using larger sample sizes and with greater homogeneity in terms of the devices used and the frequency and intensity of the interventions are needed. TRIAL REGISTRATION: PROSPERO International Prospective Register of Systematic Reviews CRD42020180766; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=180766
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spelling pubmed-87171322022-01-14 Augmented Reality in Physical Therapy: Systematic Review and Meta-analysis Vinolo Gil, Maria Jesus Gonzalez-Medina, Gloria Lucena-Anton, David Perez-Cabezas, Veronica Ruiz-Molinero, María Del Carmen Martín-Valero, Rocío JMIR Serious Games Review BACKGROUND: Augmented reality (AR) is a rapidly expanding technology; it comprises the generation of new images from digital information in the real physical environment of a person, which simulates an environment where the artificial and real are mixed. The use of AR in physiotherapy has shown benefits in certain areas of patient health. However, these benefits have not been studied as a whole. OBJECTIVE: This study aims to ascertain the current scientific evidence on AR therapy as a complement to physiotherapy and to determine the areas in which it has been used the most and which variables and methods have been most effective. METHODS: A systematic review registered in PROSPERO (International Prospective Register of Systematic Reviews) was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta‐Analyses) recommendations. The search was conducted from July to August 2021 in the PubMed, PEDro, Web of Science, Scopus, and Cochrane Library scientific databases using the keywords augmented reality, physiotherapy, physical therapy, exercise therapy, rehabilitation, physical medicine, fitness, and occupational therapy. The methodological quality was evaluated using the PEDro scale and the Scottish Intercollegiate Guidelines Network scale to determine the degree of recommendation. The Cochrane Collaboration tool was used to evaluate the risk of bias. RESULTS: In total, 11 articles were included in the systematic review. Of the 11 articles, 4 (36%) contributed information to the meta-analysis. Overall, 64% (7/11) obtained a good level of evidence, and most had a B degree of recommendation of evidence. A total of 308 participants were analyzed. Favorable results were found for the Berg Balance Scale (standardized mean change 0.473, 95% CI −0.0877 to 1.0338; z=1.65; P=.10) and the Timed Up and Go test (standardized mean change −1.211, 95% CI −3.2005 to 0.7768; z=−1.194; P=.23). CONCLUSIONS: AR, in combination with conventional therapy, has been used for the treatment of balance and fall prevention in geriatrics, lower and upper limb functionality in stroke, pain in phantom pain syndrome, and turning in place in patients with Parkinson disease with freezing of gait. AR is effective for the improvement of balance; however, given the small size of the samples and the high heterogeneity of the studies, the results were not conclusive. Future studies using larger sample sizes and with greater homogeneity in terms of the devices used and the frequency and intensity of the interventions are needed. TRIAL REGISTRATION: PROSPERO International Prospective Register of Systematic Reviews CRD42020180766; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=180766 JMIR Publications 2021-12-15 /pmc/articles/PMC8717132/ /pubmed/34914611 http://dx.doi.org/10.2196/30985 Text en ©Maria Jesus Vinolo Gil, Gloria Gonzalez-Medina, David Lucena-Anton, Veronica Perez-Cabezas, María Del Carmen Ruiz-Molinero, Rocío Martín-Valero. Originally published in JMIR Serious Games (https://games.jmir.org), 15.12.2021. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Serious Games, is properly cited. The complete bibliographic information, a link to the original publication on https://games.jmir.org, as well as this copyright and license information must be included.
spellingShingle Review
Vinolo Gil, Maria Jesus
Gonzalez-Medina, Gloria
Lucena-Anton, David
Perez-Cabezas, Veronica
Ruiz-Molinero, María Del Carmen
Martín-Valero, Rocío
Augmented Reality in Physical Therapy: Systematic Review and Meta-analysis
title Augmented Reality in Physical Therapy: Systematic Review and Meta-analysis
title_full Augmented Reality in Physical Therapy: Systematic Review and Meta-analysis
title_fullStr Augmented Reality in Physical Therapy: Systematic Review and Meta-analysis
title_full_unstemmed Augmented Reality in Physical Therapy: Systematic Review and Meta-analysis
title_short Augmented Reality in Physical Therapy: Systematic Review and Meta-analysis
title_sort augmented reality in physical therapy: systematic review and meta-analysis
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8717132/
https://www.ncbi.nlm.nih.gov/pubmed/34914611
http://dx.doi.org/10.2196/30985
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