Effect of serious games over conventional therapy in the rehabilitation of people with multiple sclerosis – a systematic review and meta-analysis
Creators: name: Saragih, Ita Daryanti
name: Gervais, Willy
name: Lamora, Jean-Philippe
name: Batcho, Charles Sebiyo
name: Everard, Gauthier
Publisher: name: Taylor & Francis
Year: 2024
Subjects: Medicine
Biological Sciences not elsewhere classified
Science Policy
Mental Health

description: This meta-analysis aimed to quantify the effect of serious games over conventional therapy on upper-limb activity, balance, gait, fatigue, and cognitive functions in people with multiple sclerosis. Search strategies were developed for PubMed, Embase, Cochrane Library, and Scopus. Studies were selected if participants were adults with multiple sclerosis; the intervention consisted of a virtual reality serious game-based program; the control group received conventional therapy; outcomes included upper limb activity, balance, gait, fatigue, or cognitive functions; and used a randomized controlled trial design. Data were synthesized using a standardized mean difference with a random-effects model. From 2532 studies, seventeen trials were selected (<i>n</i> = 740). Overall, serious games programs effect on upper limb activity, gait, verbal memory, verbal fluency and attention seemed neutral. Balance functions appeared to be improved by semi-immersive virtual reality serious games (SMD = 0.48;95%CI = 0.12–0.84;<i>p</i> = 0.01;I<sup>2</sup>=0%), fatigue by treadmill serious games (SMD = 0.80;95%CI = 0.40–1.20;<i>p</i> &lt; 0.001) and visuo-spatial memory by semi-immersive virtual reality general cognitive serious games (SMD = 0.35;95%CI = 0.04–0.65;<i>p</i> = 0.03;I<sup>2</sup>=0%). This review suggests, with a very-low-to-low certainty of evidence, that while some specific serious games may improve balance, fatigue and visuo-spatial memory, their overall effect on upper limb activity, gait, and other cognitive functions appears neutral. Serious games may enhance engagement and adherence to rehabilitation by making the process more interactive and motivating.Their design, which often includes adaptive difficulty levels and relevant feedback, can provide a tailored and dynamic rehabilitation experience for people with multiple sclerosis.Some specific serious games programs involving the use of semi- and non-immersive virtual reality devices seem to lead to benefits in balance, fatigue and visuo-spatial memory.Serious games’ overall effect on activity, gait and other cognitive functions does not seem superior to conventional therapy. Serious games may enhance engagement and adherence to rehabilitation by making the process more interactive and motivating. Their design, which often includes adaptive difficulty levels and relevant feedback, can provide a tailored and dynamic rehabilitation experience for people with multiple sclerosis. Some specific serious games programs involving the use of semi- and non-immersive virtual reality devices seem to lead to benefits in balance, fatigue and visuo-spatial memory. Serious games’ overall effect on activity, gait and other cognitive functions does not seem superior to conventional therapy.