Min Zhang,1 Erping Wang,2 Hua Shan,1 Suijun Zhu1 

1Department of Neurosurgery, The First People’s Hospital of Linping District, Hangzhou, Zhejiang, People’s Republic of China; 2Department of Urology, The First People’s Hospital of Linping District, Hangzhou, Zhejiang, People’s Republic of China

Correspondence: Min Zhang, Department of Neurosurgery, The First People’s Hospital of Linping District, Hangzhou, Zhejiang, People’s Republic of China, Email Zm15958015768@outlook.com

Background: Virtual reality technology, as an emerging intervention method, has garnered widespread attention in recent years for the rehabilitation of cognitive and psychological functions in patients with brain injuries. However, systematic evidence regarding its efficacy remains inconsistent. This study aims to evaluate the comprehensive effects of VR intervention in improving cognitive function, alleviating depressive symptoms, and enhancing self-efficacy in patients with brain injuries through a meta-analysis.
Methods: This study conducted literature search and screening in accordance with the PRISMA guidelines. The literature search databases included PubMed, Web of Science, Wiley Library, and OVID. Randomised controlled trials and observational studies were included, and the assessment metrics included MoCA, FAB, WEIGL Test, TMT-BA, HRS-D, and self-efficacy scores. The pooled analysis of effect sizes was performed using RevMan 5.4, with the I² statistic employed to assess heterogeneity. Either a fixed-effect or random-effects model was selected based on the observed heterogeneity. Sensitivity analysis and publication bias testing were subsequently conducted.
Results: This Meta-analysis synthesised nine studies with a total of 279 brain-injured patients to assess the effect of virtual reality intervention. The experimental group showed a statistically significant improvement in MoCA scores compared to the control group (P < 0.00001). FAB score analysis also showed a statistically significant improvement (P = 0.0007). The results of the combined analysis of the WEIGL Test scores combined analysis showed a mean difference of 2.39 (P < 0.00001), and a decrease in HRS-D scores also indicated that the VR intervention may be beneficial in alleviating depressive symptoms (P = 0.02). However, improvements in TMT-BA scores (P = 0.10) and self-efficacy scores (P = 0.43) did not reach statistical significance.
Conclusion: The VR intervention demonstrated potential benefits in improving cognitive functioning and alleviating depressive symptoms in brain-injured patients, but the effect on self-efficacy was not significant. Although some studies showed high heterogeneity, the overall results support the value of VR in brain injury rehabilitation.

Keywords: virtual reality exposure therapy, traumatic brain injury, cognitive rehabilitation, self-efficacy, meta-analysis