The Effect Of Visual Feedback On Balance In Patients With Parkinson's Disease: A Meta-analysis

PURPOSE: To evaluate whether visual feedback combined with balance training is effective in improving the balance ability in patients with Parkinson's disease. METHODS: Two databases were searched using the key words Parkinson's disease,visual feedback /VR and balance. Three researchers screened the articles independently for inclusion. All accepted articles were assessed for methodological quality,and relevant data were extracted and analyzed. RESULTS: 10 randomized control trials were included in the review. BBS, TUGT and UPDRS-III were selected for meta-analysis. The results showed that there was no statistical heterogeneity between the experimental and the control group in BBS score using the fixed effect model (P = 0.58, I2 = 0%).The combined results are statistically significant, RR (95%CI) = 0.47 (0.26 ~ 0.68), P < 0.0001, indicating that the BBS evaluation of the virtual reality technology group was significantly higher than that of the control group. Eight studies used TUGT as an evaluation indicator. Heterogeneity was observed between study groups but was low (P = 0.16, I2 = 33%). Since there were significant differences between the experimental and control group in the baseline data of three of the documents, large heterogeneity was found when using post-treatment data for meta-analysis and the combined results were not statistically significant, so the the mean and standard deviation was introduced and analyzed. In the fixed effects model, the combined results are statistically significant, RR (95% CI) = -0.29 (-0.55 ~ -0.03), P = 0.03, showing that virtual technology can effectively shorten the TUG time.UPDRS-III reflects the subjects’ motor function-related conditions. There was significant heterogeneity among the study groups (P = 0.09, I2 = 53%). Using the random effects model, there was no significant statistical difference in the combined results (P = 0.77). CONCLUSION: Compared with conventional rehabilitation training, virtual reality intervention, as a novel research area, can effectively improve the balance ability in patients with Parkinson disease. However, the quantity and quality of the included articles is limited. Future studies should focus on the enhancement of balance ability through visual feedback intervention.