title: Virtual reality in acquired brain injury upper limb rehabilitation: evidence-based evaluation of clinical research.
abstract: OBJECTIVE
  Acquired brain injury (ABI) is associated with significant cognitive, behavioural, psychological and physical impairment. Hence, it has been important to leverage assessment approaches in rehabilitation by using current and emerging technologies, including virtual reality (VR). A number of VR rehabilitation programmes have been designed in recent years, mainly to improve upper limb function. However, before this technology gains widespread use, evaluation of the scientific evidence supporting VR-assisted rehabilitation is needed. The present review aimed to assess the rationale, design and methodology of research investigating the clinical impact of VR on ABI upper-limb rehabilitation.
  
  
  METHODS
  A total of 22 studies were surveyed using a Cochrane-style review.
  
  
  METHODS
  Studies were classified on a number of key criteria: theoretical bases and aims, sample populations and recruitment procedures, characteristics of the VR systems, evaluation design including control procedures and statistical analysis of results. Studies were rated using the Downs and Black (DB) scale.
  
  
  RESULTS
  The review demonstrated that few studies used a conventional randomized controlled study design. Moderate support was shown for both teacher-animation and game-like systems.
  
  
  CONCLUSIONS
  While VR-assisted rehabilitation shows early promise, clinicians are advised to be cautious about adopting these technologies before adequate data is available.
authors.affiliation: Division of Psychology, School of Health Sciences, RMIT University, Melbourne, Australia.
authors.forename: Nick
authors.initials: N
authors.lastname: Mumford
authors.forename: Peter H
authors.initials: PH
authors.lastname: Wilson
mesh_terms: D000203:Activities of Daily Living; D001930:Brain Injuries / Q000534:rehabilitation*; D003198:Computer Simulation; D019317:Evidence-Based Medicine; D006801:Humans; D020127:Recovery of Function / Q000502:physiology*; D013813:Therapy, Computer-Assisted / Q000379:methods; D034941:Upper Extremity / Q000503:physiopathology*; D014584:User-Computer Interface