Date of Award

2020

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Abstract

OBJECTIVE: The objective of this selective EBM review is to determine whether or not virtual reality training is effective in improving the quality of life for adults with Parkinson’s disease.

STUDY DESIGN: A systematic review of two randomized controlled trials (RCTs) and one case series published between the years of 2017 and 2018.

DATA SOURCES: All articles were published in English and were taken from peer-reviewed journals using CINAHL Plus. All articles were selected based on relevance to clinical question, evaluation of patient-oriented outcomes, and date of publication.

OUTCOMES MEASURED: Each of the three articles analyzed the effects of virtual reality training on improving quality of life (QOL) for adults with Parkinson’s disease. The Parkinson’s Disease Questionnaire-39 (PDQ-39) and Parkinson’s Disease Questionnaire-8 (PDQ-8) were used to measure quality of life, which were reported as mean change from baseline.

RESULTS: In the RCT conducted by Tollar et al., (J Cent Nerv Syst Dis. 2018;10: 1179573518813541. doi:10.1177/1179573518813541) researchers found that PDQ-39 scores did improve following virtual reality rehabilitation (p<0.001). In the RCT by Gandolfi et al., (Arch Phys Med Rehabil. 2018;99(12):247-2484.e1. doi: //doi.org/10.1016/j.apmr.2018.05.007.) there was also significant improvement in the PDQ-8 scores before and after the intervention of virtual reality training (p<0.001). However, the case series performed by Souza et al. (Fisioterapia em Movimento. 2018;31. doi:10.1590/1980-5918.031.ao12.) showed insignificant findings in the overall PDQ-39 scores after the intervention was implemented (p=0.135).

CONCLUSIONS: The three studies evaluated in this review provided inconclusive evidence on whether or not virtual reality training is effective in improving quality of life for adults with Parkinson’s disease. Tollar et al. (J Cent Nerv Syst Dis. 2018;10: 1179573518813541. doi:10.1177/1179573518813541) and Gandolfi et al. (Archives of Physical Medicine and Rehabilitation. 2018;99(12):247-2484.e1. doi: //doi.org/10.1016/j.apmr.2018.05.007.) demonstrated a statistically significant improvement in quality of life whereas Souza et al. (Fisioterapia em Movimento. 2018;31. doi:10.1590/1980-5918.031.ao12.) showed no significance. Due to the conflicting results and limitations mentioned in each study, further investigation is warranted to more effectively evaluate the effects of virtual reality rehabilitation in improving quality of life for adults with Parkinson’s disease.

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