JMIR Publications

ABSTRACT

Background:

Virtual reality-based exercise rehabilitation (VRER) was a promising intervention of rehabilitation treatment for patients with cancer-related dysfunctions (CRDs). However, studies focused on VRER for CRDs were lacking with inconsistent results.

Objective:

To review the application of VRER in patients with CRDs.

Methods:

The scoping review was conducted following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist framework. Publications were included from the establishment of the database to Oct 14, 2023 of PubMed, Embase, Scopus, Cochrane, Web of Science, ProQuest, arXiv, IEEE Xplore, MedRxiv, CNKI, Wanfang Data, VIP and SinoMed. The population involved patients with cancer. A VR system or device should be provided in exercise rehabilitation as an intervention method. The eligible studies focused on VRER that were utilized in CRDs. Studies selection and data extraction were performed by two reviewers independently. Extracted data included author, year, country, study type, groups, sample size and age; cancer type, existing or potential CRDs, VR models and devices, intervention programs and duration; effectiveness, compliance, satisfaction and safety.

Results:

A total of 25 articles were included, among which 48% (12/25) were randomized clinical trials (RCTs), 44% (11/25) were other experimental studies and 8% (2/25) were observational studies. The total sample size was 1174, ranging from 6 to 136. Among all 25 studies, 22 (88%), 2 (8%) and 1 (4%) included models of VRER of non-immersive virtual reality (VR), immersive VR and augmented reality, respectively. Commercial game programs (17/25, 68%) were the most popular interventions of VRER, with the duration ranged from 3 to 12 weeks. Applying these models and devices, VRER was mostly applied in patients with breast cancer (14/25, 56%), leukemia (8/25, 32%), and lung cancer (3/25, 12%). Besides, 6 CRDs were intervened by VRER, of which postmastectomy syndromes were the most (10/25, 40%) common. Overall, 74% (17/23) reported the positive results, included the significant improvements in limb function, joint ROM, edema rates, cognition, respiratory disturbance index, number of apnea, ADL, QoL, etc. The compliance rate was ranging from 56% to 100%. Eight studies (32%) reported patients’ satisfaction and 88% (7/8) were satisfied with VRER. One in eight (1/8, 13%) reported light sickness as the adverse event.

Conclusions:

We found that around half of VRER was used in patients with breast cancer and postmastectomy dysfunctions through non-immersive model and commercial game programs with 3~12 weeks duration. Besides, most studies showed VRER were effective due to the virtualization and interaction. Therefore, VRER may be an alternate intervention for patients with CRDs. However, for the conclusions were drawn from acknowledged inconsistencies data and limited satisfaction reports, studies with larger sample size and more outcomes indictors are required.