title: A Decade of Progress Using Virtual Reality for Poststroke Lower Extremity Rehabilitation: Systematic Review of the Intervention Methods.
abstract: OBJECTIVE
  To develop a systematic review of the literature, to describe the different virtual reality (VR) interventions and interactive videogames applied to the lower extremity (LE) of stroke patients, and to analyse the results according to the most frequently used outcome measures.
  
  
  METHODS
  An electronic search of randomized trials between January 2004 and January 2014 in different databases (Medline, Cinahl, Web of Science, PEDro, and Cochrane) was carried out. Several terms (virtual reality, feedback, stroke, hemiplegia, brain injury, cerebrovascular accident, lower limb, leg, and gait) were combined, and finally 11 articles were included according to the established inclusion and exclusion criteria.
  
  
  RESULTS
  The reviewed trials showed a high heterogeneity in terms of study design and assessment tools, which makes it difficult to compare and analyze the different types of interventions. However, most of them found a significant improvement on gait speed, balance and motor function, due to VR intervention.
  
  
  CONCLUSIONS
  Although evidence is limited, it suggests that VR intervention (more than 10 sessions) in stroke patients may have a positive impact on balance, and gait recovery. Better results were obtained when a multimodal approach, combining VR and conventional physiotherapy, was used. Flexible software seems to adapt better to patients' requirements, allowing more specific and individual treatments.
authors.affiliation: Department of Physical Therapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, C/Avicena s/n, 41009 Seville, Spain ; Motion Analysis Laboratory, "Virgen del Rocio" Hospital, Physiotherapy Area, Avenida Manuel Siurot, 41013 Seville, Spain ; Laboratory of Kinematics and Robotics, IRCCS San Camillo Hospital Foundation, Via Alberoni 70, 30126 Venice, Italy.
authors.forename: Carlos
authors.initials: C
authors.lastname: Luque-Moreno
authors.affiliation: Department of Nursing and Physiotherapy, University of the Balearic Islands, Carretera de Valldemossa, km 7,5, 07122 Palma de Mallorca, Spain.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Ferragut-Garcías
authors.affiliation: Department of Physical Therapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, C/Avicena s/n, 41009 Seville, Spain.
authors.forename: Cleofás
authors.initials: C
authors.lastname: Rodríguez-Blanco
authors.affiliation: Department of Physical Therapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, C/Avicena s/n, 41009 Seville, Spain.
authors.forename: Alberto Marcos
authors.initials: AM
authors.lastname: Heredia-Rizo
authors.affiliation: Department of Physical Therapy, Francisco Maldonado University School of Osuna, Camino de los Cipreses 1, Osuna, 41640 Seville, Spain.
authors.forename: Jesús
authors.initials: J
authors.lastname: Oliva-Pascual-Vaca
authors.affiliation: Laboratory of Kinematics and Robotics, IRCCS San Camillo Hospital Foundation, Via Alberoni 70, 30126 Venice, Italy.
authors.forename: Pawel
authors.initials: P
authors.lastname: Kiper
authors.affiliation: Department of Physical Therapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, C/Avicena s/n, 41009 Seville, Spain.
authors.forename: Ángel
authors.initials: Á
authors.lastname: Oliva-Pascual-Vaca
mesh_terms: D006429:Hemiplegia / Q000534:rehabilitation*; D006801:Humans; D035002:Lower Extremity / Q000503:physiopathology; D026741:Physical Therapy Modalities; D016032:Randomized Controlled Trials as Topic; D020127:Recovery of Function; D000071939:Stroke Rehabilitation; D014584:User-Computer Interface; D018910:Video Games