Virtual Reality for Improving Cognitive Outcomes After Brain Injury & Stroke: A Systematic Review

Virtual reality (VR) has gained popularity in occupational therapy (OT) as an immersive technology that can simulate real-world tasks, although there is limited information regarding its impact on cognitive outcomes. A systematic review was conducted to summarize the current evidence for the use of VR interventions to improve cognitive outcomes in adults with brain injury and stroke. This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards and the American Occupational Therapy Association (AOTA) guidelines. Six databases were searched using the terms ‘cognit’, ‘occupational therapy’, and ‘virtual reality’. Twenty-three articles were selected for this review. The inclusion criteria consisted of intervention research within the scope of OT practice, published in English, targeting outcome measures related to cognition, and involving adult participants with brain injury or stroke. Scoping or systematic reviews were excluded. This review examined articles from a range of evidence levels to evaluate the potential of VR in improving cognition in adults with brain injury and stroke. The selected articles provided strong evidence supporting the use of various types of VR in conjunction with OT to improve a variety of cognitive outcomes, namely executive function and attention (Maier et al., 2020; Rogers et al., 2019). This systematic review highlights the unique benefits of VR in improving cognition for brain injury and stroke populations, and contributes to a better understanding of how occupational therapists can apply such benefits to their practice.

IMPACT STATEMENT: Virtual reality, when used alongside occupational therapy, holds promise as a means to deliver ecologically-sound rehabilitation that produces long-lasting effects (Rogers et al., 2019). As it emerges into OT practice, VR should be considered as an intervention modality for clients with cognitive impairments.

References

Maier, M., Ballester, B. R., Bañuelos, N. L., et al. (2020). Adaptive conjunctive cognitive training (ACCT) in virtual reality for chronic stroke patients: A randomized controlled pilot trial. Journal of NeuroEngineering and Rehabilitation, 17(1), 42. https://doi.org/10.1186/s12984-020-0652-3

Rand, D., Weiss, P. L. (Tamar), & Katz, N. (2009). Training multitasking in a virtual supermarket: A novel intervention after stroke. American Journal of Occupational Therapy, 63(5), 535–542. https://doi.org/10.5014/ajot.63.5.535

Rogers, J. M., Duckworth, J., Middleton, S., et al. (2019). Elements virtual rehabilitation improves motor, cognitive, and functional outcomes in adult stroke: Evidence from a randomized controlled pilot study. Journal of NeuroEngineering and Rehabilitation, 16, 56. https://doi.org/10.1186/s12984-019-0531-y