Hanan Hassan Fouad

INTRODUCTION: Orthopedic ankle injuries are considered among the most common musculoskeletal injuries. A wide variety of modalities and techniques have been used for the management of these injuries, and virtual reality (VR) is one modality that has been examined in ankle injuries rehabilitation.

PURPOSE: This study aims to systemically review previous studies evaluating the effect of virtual reality in rehabilitating orthopedic ankle injuries.

METHODS: We searched six online databases: PubMed, Web of Science (WOS), Scopus, the Physiotherapy Evidence Database (PEDro), Virtual Health Library (VHL), and Cochrane Central Register of Controlled Trials (CENTRAL).

RESULTS: Ten randomized clinical trials met the inclusion criteria. Our results showed that VR had a significant effect on overall balance compared to conventional physiotherapy (SMD = 0.359, 0.009-0.710  = 0.04), [ = 17%,  = 0.30]. Compared with conventional physiotherapy, VR programs significantly improved gait parameters such as speed and cadence, muscle power, and perceived ankle instability; however, no significant difference was detected in the foot and ankle ability measure (FAAM). Additionally, significant improvements in static balance and perceived ankle instability were reported after the use of VR balance and strengthening programs. Finally, only two articles were deemed to have good quality, and the other studies' quality ranged from poor to fair.

CONCLUSION: VR rehabilitation programs can be used to rehabilitate ankle injuries, as they are regarded as safe interventions and have promising effects. However, there is a need for studies with high quality since most included studies' quality varied from poor to fair.

Burn injury is a complicated traumatic event with both systemic and local consequences. These complications include long periods of bed rest, pain, muscle weakness, vitamin D deficiency and bone-mineral density loss. Whole body vibration demonstrated effectiveness in improving muscle power and bone-mineral density in various musculoskeletal populations. This systematic review of randomized controlled trials aims to assess evidence for the effectiveness of using whole-body vibration on post burn survivors with at least 1% total body surface area on sensory and motor outcomes. A systematic search was conducted across six databases i.e., PubMed, Cochrane, PEDro, Scopus, Web of Science and Google Scholar, from inception till March 2022. Retrieved studies were screened by title and abstract and full-text in two-stages using Rayyan web-based. Included studies were assessed for risk of bias using the Cochrane risk of bias tool ROB 2.0. Six RCTs with 203 participants were included. Five of the included studies demonstrated overall high risk of bias. Compared to conventional physiotherapy programs, whole-body vibration demonstrated improvement in functional mobility and balance using Timed Up and Go and Biodex balance assessment respectively. However, there were no differences between whole-body vibration and conventional physiotherapy program alone in bone mineral density and muscle power. Although the current evidence of whole-body vibration is limited, whole body vibration combined with traditional physical therapy programs may improve functional mobility and balance in post-burn survivors compared to physical therapy programs alone.