Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Feb 11, 2025
Date Accepted: May 5, 2025
Effect of Virtual Reality-Based Therapies on Lower Limb Functional Recovery in Stroke Survivors: A Systematic Review and Meta-Analysis
ABSTRACT
Background:
Virtual reality (VR) therapy has gained attention as a promising intervention in stroke rehabilitation, particularly for its potential to enhance motor function and promote neuroplasticity. However, its specific effects on balance, mobility, and gait remain underexplored.
Objective:
This review aims to provide a comprehensive evaluation of the effectiveness of VR therapy on the recovery of lower limb function in stroke survivors.
Methods:
Randomized controlled trials (RCTs) comparing VR therapy with conventional therapy were eligible for inclusion. All studies were identified through Medline, Embase, PubMed, Cochrane Library, Web of Science, and PsycINFO (up to July 2024). The primary outcomes included balance, assessed using the Berg Balance Scale (BBS), and mobility, measured with the Timed Up and Go Test (TUG) and 10-Meter Walk Test (10-MWT). RevMan 5.4 software was used for the meta-analysis.
Results:
A total of 2145 studies were screened, and 24 RCTs that met the inclusion criteria were included, involving 768 participants. Meta-analysis results showed that VR therapy, compared to conventional therapy, significantly improved BBS (MD 3.29, 95% CI [0.52 to 6.06]; P = 0.02) and TUG (MD -1.67, 95% CI [-2.89 to -0.46]; P = 0.007). However, no significant difference was observed between the two groups in 10-MWT (MD -0.91, 95% CI [-3.33, 1.50]; P = 0.46). In the subgroup analyses, significant improvements in balance and mobility were observed in patients receiving greater than or equal to 20 sessions, with BBS improved by 5.14 points (95% CI [0.43 to 9.85]; P = 0.03) and TUG reduced by 1.98 seconds (95% CI [-3.33 to -0.63]; P = 0.004). In addition, patients who received VR therapy more than six months after stroke showed greater improvements in BBS (MD 1.64, 95% CI [0.14 to 3.14]; P = 0.03), compared to those who received VR therapy between 7 days and 6 months after stroke.
Conclusions:
Long-term virtual reality-based exercises were more effective in improving functional ability after stroke. VR therapy has demonstrated significant potential for improving lower limb function among stroke patients, particularly when applied with higher frequencies.
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