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Meta-Analysis
. 2017 Nov 20;11(11):CD008349.
doi: 10.1002/14651858.CD008349.pub4.

Virtual reality for stroke rehabilitation

Kate E Laver  1 , Belinda Lange, Stacey George, Judith E Deutsch, Gustavo Saposnik, Maria Crotty
Affiliations
Meta-Analysis

Virtual reality for stroke rehabilitation

Kate E Laver et al. Cochrane Database Syst Rev. .

Update in

  • Virtual reality for stroke rehabilitation.
    Laver KE, Lange B, George S, Deutsch JE, Saposnik G, Chapman M, Crotty M. Laver KE, et al. Cochrane Database Syst Rev. 2025 Jun 20;6(6):CD008349. doi: 10.1002/14651858.CD008349.pub5. Cochrane Database Syst Rev. 2025. PMID: 40537150 Free PMC article.

Abstract

Background: Virtual reality and interactive video gaming have emerged as recent treatment approaches in stroke rehabilitation with commercial gaming consoles in particular, being rapidly adopted in clinical settings. This is an update of a Cochrane Review published first in 2011 and then again in 2015.

Objectives: Primary objective: to determine the efficacy of virtual reality compared with an alternative intervention or no intervention on upper limb function and activity.Secondary objectives: to determine the efficacy of virtual reality compared with an alternative intervention or no intervention on: gait and balance, global motor function, cognitive function, activity limitation, participation restriction, quality of life, and adverse events.

Search methods: We searched the Cochrane Stroke Group Trials Register (April 2017), CENTRAL, MEDLINE, Embase, and seven additional databases. We also searched trials registries and reference lists.

Selection criteria: Randomised and quasi-randomised trials of virtual reality ("an advanced form of human-computer interface that allows the user to 'interact' with and become 'immersed' in a computer-generated environment in a naturalistic fashion") in adults after stroke. The primary outcome of interest was upper limb function and activity. Secondary outcomes included gait and balance and global motor function.

Data collection and analysis: Two review authors independently selected trials based on pre-defined inclusion criteria, extracted data, and assessed risk of bias. A third review author moderated disagreements when required. The review authors contacted investigators to obtain missing information.

Main results: We included 72 trials that involved 2470 participants. This review includes 35 new studies in addition to the studies included in the previous version of this review. Study sample sizes were generally small and interventions varied in terms of both the goals of treatment and the virtual reality devices used. The risk of bias present in many studies was unclear due to poor reporting. Thus, while there are a large number of randomised controlled trials, the evidence remains mostly low quality when rated using the GRADE system. Control groups usually received no intervention or therapy based on a standard-care approach.

Primary outcome: results were not statistically significant for upper limb function (standardised mean difference (SMD) 0.07, 95% confidence intervals (CI) -0.05 to 0.20, 22 studies, 1038 participants, low-quality evidence) when comparing virtual reality to conventional therapy. However, when virtual reality was used in addition to usual care (providing a higher dose of therapy for those in the intervention group) there was a statistically significant difference between groups (SMD 0.49, 0.21 to 0.77, 10 studies, 210 participants, low-quality evidence).

Secondary outcomes: when compared to conventional therapy approaches there were no statistically significant effects for gait speed or balance. Results were statistically significant for the activities of daily living (ADL) outcome (SMD 0.25, 95% CI 0.06 to 0.43, 10 studies, 466 participants, moderate-quality evidence); however, we were unable to pool results for cognitive function, participation restriction, or quality of life. Twenty-three studies reported that they monitored for adverse events; across these studies there were few adverse events and those reported were relatively mild.

Authors' conclusions: We found evidence that the use of virtual reality and interactive video gaming was not more beneficial than conventional therapy approaches in improving upper limb function. Virtual reality may be beneficial in improving upper limb function and activities of daily living function when used as an adjunct to usual care (to increase overall therapy time). There was insufficient evidence to reach conclusions about the effect of virtual reality and interactive video gaming on gait speed, balance, participation, or quality of life. This review found that time since onset of stroke, severity of impairment, and the type of device (commercial or customised) were not strong influencers of outcome. There was a trend suggesting that higher dose (more than 15 hours of total intervention) was preferable as were customised virtual reality programs; however, these findings were not statistically significant.

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Conflict of interest statement

Kate Laver: none known.

Belinda Lange: none known.

Stacey George: none known.

Judith Deutsch conducts research on virtual reality for stroke rehabilitation. This research is funded by various sources and presented at scientific and professional meetings. She is co‐owner of a company that develops virtual reality for rehabilitation.

Gustavo Saposnik is the first author on two of the studies included in the review. He was not involved in assessment of these studies for inclusion or risk of bias and did not extract data for these studies. He is supported by the Distinguished Clinician‐Scientist Award given by the Heart and Stroke Foundation of Canada following an open peer‐reviewed competition.

Maria Crotty: none known.

Figures

1
1
Study flow diagram
2
2
Methodological quality summary: review authors' judgements about each methodological quality item for each included study
3
3
Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies
1.1
1.1. Analysis
Comparison 1 Virtual reality versus conventional therapy: effect on upper limb function post intervention, Outcome 1 Upper limb function post intervention (composite measure).
1.2
1.2. Analysis
Comparison 1 Virtual reality versus conventional therapy: effect on upper limb function post intervention, Outcome 2 Upper limb function post intervention (Fugl Meyer).
1.3
1.3. Analysis
Comparison 1 Virtual reality versus conventional therapy: effect on upper limb function post intervention, Outcome 3 Hand function post intervention (grip strength).
1.4
1.4. Analysis
Comparison 1 Virtual reality versus conventional therapy: effect on upper limb function post intervention, Outcome 4 Upper limb function post intervention: amount of use (subjective).
1.5
1.5. Analysis
Comparison 1 Virtual reality versus conventional therapy: effect on upper limb function post intervention, Outcome 5 Upper limb function at short term follow‐up (up to 3 months).
2.1
2.1. Analysis
Comparison 2 Virtual reality versus conventional therapy: upper limb function: subgroup analyses, Outcome 1 Dose of intervention.
2.2
2.2. Analysis
Comparison 2 Virtual reality versus conventional therapy: upper limb function: subgroup analyses, Outcome 2 Time since onset of stroke.
2.3
2.3. Analysis
Comparison 2 Virtual reality versus conventional therapy: upper limb function: subgroup analyses, Outcome 3 Specialised or gaming.
2.4
2.4. Analysis
Comparison 2 Virtual reality versus conventional therapy: upper limb function: subgroup analyses, Outcome 4 Severity of impairment.
3.1
3.1. Analysis
Comparison 3 Additional virtual reality intervention: effect on upper limb function post intervention, Outcome 1 Upper limb function (composite measure).
4.1
4.1. Analysis
Comparison 4 Additional virtual reality intervention: effect on upper limb function post intervention: subgroup analyses, Outcome 1 Dose of intervention.
4.2
4.2. Analysis
Comparison 4 Additional virtual reality intervention: effect on upper limb function post intervention: subgroup analyses, Outcome 2 Time since onset of stroke.
4.3
4.3. Analysis
Comparison 4 Additional virtual reality intervention: effect on upper limb function post intervention: subgroup analyses, Outcome 3 Specialised or gaming.
5.1
5.1. Analysis
Comparison 5 Virtual reality versus conventional therapy: effect on lower limb activity post intervention, Outcome 1 Gait speed.
5.2
5.2. Analysis
Comparison 5 Virtual reality versus conventional therapy: effect on lower limb activity post intervention, Outcome 2 Timed Up and Go Test.
5.3
5.3. Analysis
Comparison 5 Virtual reality versus conventional therapy: effect on lower limb activity post intervention, Outcome 3 Balance.
6.1
6.1. Analysis
Comparison 6 Virtual reality versus conventional therapy: effect on lower limb activity post intervention: subgroup analyses, Outcome 1 Dose of intervention: effect on gait speed.
7.1
7.1. Analysis
Comparison 7 Additional virtual reality intervention: effect on lower limb activity post intervention, Outcome 1 Gait speed.
7.2
7.2. Analysis
Comparison 7 Additional virtual reality intervention: effect on lower limb activity post intervention, Outcome 2 Functional mobility (Timed Up and Go).
7.3
7.3. Analysis
Comparison 7 Additional virtual reality intervention: effect on lower limb activity post intervention, Outcome 3 Balance.
8.1
8.1. Analysis
Comparison 8 Additional virtual reality intervention: effect on global motor function post intervention, Outcome 1 Global motor function.
9.1
9.1. Analysis
Comparison 9 Virtual reality versus conventional therapy: effect on activity limitation, Outcome 1 ADL outcome.
10.1
10.1. Analysis
Comparison 10 Additional virtual reality intervention: effect on activity limitation, Outcome 1 ADL outcome.
See this image and copyright information in PMC

Update of

References

References to studies included in this review

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Jannink 2008 {published data only}
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Jung 2012 {published data only}
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Kang 2009 {published data only}
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Kim 2009 {published data only}
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Kim 2011a {published data only}
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Kim 2012a {published data only}
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Klamroth‐Marganska 2014 {published data only}
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Kong 2014 {published data only}
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Kwon 2012 {published data only}
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Lam 2006 {published data only}
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Lee 2013 {published data only}
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Lee 2014a {published data only}
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Lee 2015a {published data only}
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Levin 2012 {published data only}
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Linder 2015 {published data only}
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Llorens 2015 {published data only}
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Low 2012 {published data only}
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Manlapaz 2010 {published and unpublished data}
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Mao 2015 {published and unpublished data}
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Matsuo 2013 {published data only}
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McNulty 2015 {published data only}
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Nara 2015 {published data only}
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Piron 2007 {published data only}
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Rajaratnam 2013 {published data only}
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Sin 2013 {published data only}
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Xiang 2014 {published data only}
    1. Xiang X, Yu‐rong M, Jiang‐li Z, Li L, Guang‐qing X, Dong‐feng H. Virtual reality enhanced body weight supported treadmill training improved lower limb motor function in patients with cerebral infarction. Chinese Journal of Tissue Engineering Research 2014;18(7):1143‐8.
Yang 2008 {published data only}
    1. Yang YR, Tsai MP, Chuang TY, Sung WH, Wang RY. Virtual reality‐based training improves community ambulation in individuals with stroke: a randomized controlled trial. Gait and Posture 2008;28:201‐6. - PubMed
Yang 2011 {published data only}
    1. Yang S, Hwang WH, Tsai YC, Liu FK, Hsieh LF, Chern JS. Improving balance skills in patients who had stroke through virtual reality treadmill training. American Journal of Physical Medicine and Rehabilitation 2011;90:969‐78. - PubMed
Yavuzer 2008 {published data only}
    1. Yavuzer G, Senel A, Atay MBG, Stam HJ. 'Playstation EyeToy games' improve upper extremity‐related motor functioning in subacute stroke: a randomized controlled clinical trial. European Journal of Physical and Rehabilitation Medicine 2008;44:237‐44. - PubMed
Yin 2014 {published data only}
    1. Yin CW, Sien NY, Ying LA, Chung SFM, Leng DTM. Virtual reality for upper extremity rehabilitation in early stroke: a pilot randomized controlled trial. Clinical Rehabilitation 2014;28(11):1107‐14. - PubMed
You 2005 {published data only}
    1. You SH, Jang SH, Kim YH, Hallett M, Ahn SH, Kwon YH, et al. Virtual reality‐induced cortical reorganization and associated locomotor recovery in chronic stroke: an experimenter‐blind randomized study. Stroke 2005;36:1166‐71. - PubMed
Zucconi 2012 {published and unpublished data}
    1. Zucconi C, Valt V, Agostini M, Turolla A, Tonin P, Piron L. Assessment of a virtual teacher feedback for the recovery of the upper limb after stroke. Neurorehabilitation and Neural Repair 2012;26(4):407.

References to studies excluded from this review

Abdollahi 2014 {published data only}
    1. Abdollahi F, Case Lazarro ED, Listenberger M, Kenyon RV, Kovic M, Bogey RA. Error augmentation enhancing arm recovery in individuals with chronic stroke: randomized crossover design. Neurorehabilitation and Neural Repair 2014;28(2):120‐8. - PMC - PubMed
Bower 2014 {published data only}
    1. Bower KJ, Clark RA, McGinley JL, Martin CL, Miller KJ. Clinical feasibility of the Nintendo WiiTM for balance training post‐stroke: a phase II randomized controlled trial in an inpatient setting. Clinical Rehabilitation 2014;28(9):912‐23. - PubMed
Braun 2016 {published data only}
    1. Braun T, Marks D, Thiel C, Zietz D, Zutter D, Gruneberg C. Effects of additional, dynamic supported standing practice on functional recovery in patients with sub‐acute stroke: a randomized pilot and feasibility trial. Clinical Rehabilitation 2016;30(4):374‐82. - PubMed
Broeren 2008 {published data only}
    1. Broeren J, Claesson L, Goude D, Rydmark M, Sunnerhagen K. Virtual rehabilitation in an activity centre for community‐dwelling persons with stroke. Cerebrovascular Diseases 2008;26:289‐96. - PubMed
Cameirao 2012 {published data only}
    1. Cameirao M, Badia S, Duarte E, Frisoli A, Verschure P. The combined impact of virtual reality neurorehabilitation and its interfaces on upper extremity functional recovery in patients with chronic stroke. Stroke 2012;43(10):2720‐8. - PubMed
Cho 2013 {published data only}
    1. Cho KH, Lee WH. Virtual walking training program using a real‐world video recording for patients with chronic stroke. American Journal of Physical Medicine and Rehabilitation 2013;92:371‐84. - PubMed
Cho 2015 {published data only}
    1. Cho KH, Kim MK, Lee HJ, Lee WH. Virtual reality training with cognitive load improves walking function in chronic stroke patients. Tohoku Journal of Experimental Medicine 2015;236(4):273‐80. - PubMed
Chortis 2008 {published data only}
    1. Chortis A, Standen PJ, Walker M. Virtual reality system for upper extremity rehabilitation of chronic stroke patients living in the community. International Conference on Disability, Virtual Reality & Associated Technologies (ICDVRAT). 2008:221‐8.
Cikaljo 2012 {published data only}
    1. Cikaljo I, Rudolf M, Goljar N, Burger H, Matjacic Z. Telerehabilitation using virtual reality task can improve balance in patients with stroke. Disability and Rehabilitation 2012;34(1):13‐8. - PubMed
Der‐Yeghiaian 2009 {published data only}
    1. Der‐Yeghiaian L, Sharp K, See J, Abidi N, Mai K, Cramer S. Robotic therapy after stroke and the influence of baseline motor status. International Stroke Conference Poster Presentations. 2009:e169.
Edmans 2009 {published data only}
    1. Edmans J, Gladman J, Hilton D, Walker M, Sunderland A, Cobb S, et al. Clinical evaluation of a non‐immersive virtual environment in stroke rehabilitation. Clinical Rehabilitation 2009;23:106‐16. - PubMed
Fischer 2007 {published data only}
    1. Fischer HC, Stubblefield K, Kline T, Luo X, Kenyon RV, Kamper DG. Hand rehabilitation following stroke: a pilot study of assisted finger extension training in a virtual environment. Topics in Stroke Rehabilitation 2007;14(1):1‐12. - PubMed
Fritz 2013 {published data only}
    1. Fritz S, Peters D, Merlo A, Donley J. Active video‐gaming effects on balance and mobility in individuals with chronic stroke: a randomized controlled trial. Topics in Stroke Rehabilitation 2013;20(3):218‐25. - PubMed
Gnajaraj 2007 {published data only}
    1. Gnajaraj J, Chowdry H, Kumar S. Influence of virtual reality environment on the recovery after stroke. Archives of Physical Medicine and Rehabilitation 2007;88:E3.
Hollenstein 2011 {published data only}
    1. Hollenstein C, Cabri J. Supplementary therapy with computer‐assisted training system compared to ergotherapeutic arm group therapy [Zusatztherapie mit computerunterstütztem Trainingssystem im Vergleich zu ergotherapeutischer Armgruppentherapie]. NeuroRehabilitation 2011;3.01:40‐2.
In 2012 {published data only}
    1. In T, Jung K, Lee S, Song C. Virtual reality reflection therapy improves motor recovery and motor function in the upper extremities of people with chronic stroke. Journal of Physical Therapy Science 2012;24(4):339‐43.
Katz 2005 {published data only}
    1. Katz N, Ring H, Naveh Y, Kizony R, Feintuch U, Weiss PL. Interactive virtual environment training for safe street crossing of right hemisphere stroke patients with unilateral spatial neglect. Disability and Rehabilitation 2005;27(20):1235‐43. - PubMed
Kim 2012b {published data only}
    1. Kim IC, Lee BH. Effects of augmented reality with functional electric stimulation on muscle strength, balance and gait of stroke patients. Journal of Physical Therapy Science 2012;24(8):755‐62.
Kim 2015a {published data only}
    1. Kim HS, Choi WJ, Lee K, Song CH. Virtual dual‐task treadmill training using video recording for gait of chronic stroke survivors: a randomized controlled trial. Journal of Physical Therapy Science 2015;27(12):3693‐7. - PMC - PubMed
Kim 2015b {published data only}
    1. Kim N, Park Y, Lee BH. Effects of community‐based virtual reality treadmill training on balance ability in patients with chronic stroke. Journal of Physical Therapy Science 2015;27(3):655‐8. - PMC - PubMed
Krebs 2008 {published data only}
    1. Krebs HI, Mernoff S, Fasoli SE, Hughes R, Stein J, Hogan N. A comparison of functional and impairment‐based robotic training in severe to moderate chronic stroke: a pilot study. NeuroRehabilitation 2008;23:81‐7. - PMC - PubMed
Lee 2014b {published data only}
    1. Lee D, Lee M, Lee K, Song C. Asymmetric training using virtual reality reflection equipment and the enhancement of upper limb function in stroke patients: a randomized controlled trial. Journal of Stroke and Cerebrovascular Diseases 2014;23(6):1319‐26. - PubMed
Llorens 2014 {published data only}
    1. Llorens R, Albiol S, Gil‐Gomez J, Alcaniz M, Colomer C, Noe E. Balance rehabilitation using custom‐made Wii Balance Board exercises: clinical effectiveness and maintenance of gains in an acquired brain injury population. International Journal on Disability and Human Development 2014;13(3):327‐332.
Masiero 2014 {published data only}
    1. Masiero S, Armani M, Ferlini G, Rosati G, Rossi A. Randomized trial of a robotic assistive device for the upper extremity during early inpatient stroke rehabilitation. Neurorehabilitation and Neural Repair 2014;28(4):377‐86. - PubMed
McEwen 2014 {published data only}
    1. McEwen D, Taillon‐Hobson A, Bilodeau M, Sveistrup H, Finestone H. Virtual reality exercise improves mobility after stroke: an inpatient randomized controlled trial. Stroke 2014; Vol. 45, issue 6:1853‐1855. - PubMed
Rand 2014 {published data only}
    1. Rand D, Givon N, Weingarden H, Nota A, Zeilig G. Eliciting upper extremity purposeful movements using video games: a comparison with traditional therapy for stroke rehabilitation. Neurorehabilitation and Neural Repair 2014;28(8):733‐9. - PubMed
Rutz‐LaPitz 2011 {published data only}
    1. Rutz‐LaPitz L, Hollenstein C, Baumann Y, Kaufeler R, Gosoniu N. Effectiveness of armeo versus task‐oriented arm group as augmentation to upper extremity conventional therapy in acute rehabilitation post stroke. Physiotherapy 2011;97:eS1072‐3.
Shin 2010 {published data only}
    1. Shin WS, Lee DY, Lee SW. The effects of rehabilitation exercise using a home video game (PS2) on gait ability of chronic stroke patients. Journal of the Korea Academia‐Industrial Cooperation Society 2010;11(1):368‐74.
Song 2010 {published data only}
    1. Song CH, Seo SM, Lee GC. Video game‐based exercise for upper extremity function rehabilitation of chronic stroke patients: results from a randomized, controlled, single‐blind trial. International Journal of Stroke 2010;5:304.
Turolla 2013 {published data only}
    1. Turolla A, Dam M, Ventura L, Tonin P, Agostini M, Zucconi C. Virtual reality for the rehabilitation of the upper limb motor function after stroke: a prospective controlled trial. Journal of NeuroEngineering and Rehabilitation 2013;10(85):doi: 10.1186/1743‐0003‐10‐85. - PMC - PubMed
Viana 2014 {published data only}
    1. Viana RT, Laurentino GE, Souza RJ, Fonseca JB, Silva Filho EM, Dias SN. Effects of the addition of transcranial direct current stimulation to virtual reality therapy after stroke: a pilot randomized controlled trial. Neurorehabilitation 2014;34:437‐46. - PubMed
Wolf 2015 {published data only}
    1. Wolf S, Sahu K, Bay C, Buchanan S, Reiss A, Linder S, et al. The HAAPI (Home Arm Assistance Progression Initiative) Trial. Neurorehabilitation & Neural Repair 2015;29(10):958‐68. - PMC - PubMed
Yom 2015 {published data only}
    1. Yom C, Cho HY, Lee B. Effects of virtual reality‐based ankle exercise on the dynamic balance, muscle tone, and gait of stroke patients. Journal of Physical Therapy Science 2015;27(3):845‐9. - PMC - PubMed
Yoo 2015 {published data only}
    1. Yoo C, Yong M, Chung J, Yang Y. Effect of computerized cognitive rehabilitation program on cognitive function and activities of living in stroke patients. Journal of Physical Therapy Science 2015;27(8):2487‐9. - PMC - PubMed

References to studies awaiting assessment

Almeida 2014 {published data only}
    1. Almeida J, Castro P, Dos Santoa Moreira C, Battistella LR. Development of a protocol for treatment of post stroke patients with virtual reality: preliminary results. PM & R : the Journal of Injury, Function, and Rehabilitation 2014;6(8 Suppl 2):S110.
    1. Do Amaral Santos PL, Castro PCG, Dos Santos Moreira C, Battistella LR. Retaining the effects of virtual reality therapy on posture control of patients with stroke: preliminary results. PM & R : the Journal of Injury, Function, and Rehabilitation 2014;6(8 Suppl 2):S110.
Connor 2016 {published data only}
    1. Connor D, Stockley R, Moss S, Allsop L, Edge W. Using virtual reality for upper limb recovery post stroke: a pilot study. Cerebrovascular Diseases 2016;41:49.
de Paula Oliveira 2015 {published data only}
    1. Oliveira TDP, Miranda CS, Gouvea J, Perez DB, Marques AP, Piemonte MEP. Improvement of balance and gait in patients with stroke after training based on Nintendo Wii fitTM games: randomized controlled trial. Physiotherapy 2015;101:eS1207.
    1. Paula Oliveira T, Miranda CS, Gouva JXM, Perez DB, Marques AP, Piemonte MEP. Balance training in virtual reality in patients with chronic sequels of stroke: effects on ICF domains, preliminary data. 3rd Workshop on ICTs for improving Patients Rehabilitation Research Techniques, REHAB 2015, 1‐2 October 2015. 2015.
Faria 2016 {published data only}
    1. Faria AL, Andrade A, Soares L, Badia SB. Benefits of virtual reality based cognitive rehabilitation through simulated activities of daily living: a randomized controlled trial with stroke patients. Journal of NeuroEngineering and Rehabilitation 2016;13(1):1‐12. - PMC - PubMed
In 2016 {published data only}
    1. In T, Lee K, Song C. Virtual reality reflection therapy improves balance and gait in patients with chronic stroke: randomized controlled trials. Medical Science Monitor 2016;22:4046‐53. - PMC - PubMed
Lee 2015c {published data only}
    1. Lee HJ, Kim MK, Lee KB, Lee WH. The effects of treadmill training using real‐walk simulation in stroke patients. Physiotherapy 2015;May:eS846.
Lee 2016a {published data only}
    1. Lee M, Son J, Kim J, Pyun SB, Eun SD, Yoon B. Comparison of individualized virtual reality‐ and group‐based rehabilitation in older adults with chronic stroke in community settings: a pilot randomized controlled trial. European Journal of Integrative Medicine 2016;8(5):738‐46.
Lee 2016b {published data only}
    1. Lee MM, Shin DC, Song CH. Canoe game‐based virtual reality training to improve trunk postural stability, balance, and upper limb motor function in subacute stroke patients: a randomized controlled pilot study. Journal of Physical Therapy Science 2016;28(7):2019‐24. - PMC - PubMed
Lin 2015 {published data only}
    1. Lin CH, Chou LW, Luo HJ, Tsai PY, Lieu FK, Chiang AL, et al. Effects of computer‐aided interlimb force coupling training on paretic hand and arm motor control following chronic stroke: a randomized controlled trial. PLoS ONE 2015; Vol. 10, issue 7. - PMC - PubMed
Marshall 2016 {published data only}
    1. Marshall J, Booth T, Devane N, Galliers J, Greenwood H, Hilari K, et al. Evaluating the benefits of aphasia intervention delivered in virtual reality: results of a quasi‐randomised study. PLoS ONE 2016; Vol. DOI: 10.1371/journal.pone.0160381. - PMC - PubMed
Nijenhuis 2017 {published data only}
    1. Nijenhuis SM, Prange‐Lasonder GB, Stienen AHA, Rietman JS, Buurke JH. Effects of training with a passive hand orthosis and games at home in chronic stroke: a pilot randomised controlled trial. Clinical Rehabilitation 2017;31(2):207‐16. - PubMed
Simsek 2016 {published data only}
    1. Simsek T, Cekok K. The effects of Nintendo WiiTM‐based balance and upper extremity training on activities of daily living and quality of life in patients with sub‐acute stroke: a randomized controlled study. International Journal of Neuroscience 2016;126(12):1061‐70. - PubMed
Turkbey 2017 {published data only}
    1. Turkbey T, Kutlay S, Gok H. Clinical feasibility of Xbox Kinect training for stroke rehabilitation: a single blind randomized controlled pilot study. Journal of Rehabilitation Medicine 2017;49(1):22‐9. - PubMed
Zondervan 2016 {published data only}
    1. Zondervan D, Friedman N, Chang E, Zhao X, Augburger R, Reinkensmeyer D, et al. Home‐based hand rehabilitation after chronic stroke: randomized, controlled single‐blind trial comparing the music glove with a conventional exercise program. Journal of Rehabilitation Research and Development 2016;53(4):457‐72. - PubMed

References to ongoing studies

ACTRN12614000427673 {published data only}
    1. Bird ML, Cannell J, Callisaya ML, Moles E, Rathjen A, Lane K, et al. "FIND Technology": investigating the feasibility, efficacy and safety of controller‐free interactive digital rehabilitation technology in an inpatient stroke population: study protocol for a randomized controlled trial. Trials 2016;17(1):203. - PMC - PubMed
Deutsch 2010 {published data only}
    1. Deutsch J. Interactive video gaming compared to optimal standard of care to improve balance and mobility. Personal communication 2010.
Duff 2013 {published data only}
    1. Duff A, Nirme J, Rubio B, Duarte E, Cuxart A, Rodriguez S, et al. The optimal dosage of the rehabilitation gaming system: the longer impact of a longer period of virtual reality based and standard occupational training on upper limb recovery in the acute phase of stroke. Cerebrovascular Diseases 2013;35:146.
Dunsky 2014 {published data only}
    1. Dunsky AD, Hutzler YH, Fishbein PF. Dual task training using virtual reality: influence on walking and balance in individuals post‐stroke. European Geriatric Medicine 2014;5:S165.
Kairy 2015 {published data only}
    1. Kairy D, Poissant L, Higgins J, Hernandez A, Archambault PS, Norouzi‐Gheidari N. Using a virtual reality gaming system to supplement upper extremity rehabilitation post stroke. Archives of Physical Medicine and Rehabilitation 2015;96:e17. - PMC - PubMed
Kairy 2016 {published data only}
    1. Kairy D, Veras M, Archambault P, Hernandez A, Higgins J, Levin M, et al. Maximizing post‐stroke upper limb rehabilitation using a novel telerehabilitation interactive virtual reality system in the patient's home: study protocol of a randomized clinical trial. Contemporary Clinical Trials 2016;47:49‐53. - PubMed
Karatas 2014 {published data only}
    1. Karatas GK, Karasu AU, Balevi E. Wii‐based balance rehabilitation is effective in stroke: a randomized controlled study. Neurorehabilitation and Neural Repair 2012;26:767.
Kiper 2014 {published data only}
    1. Kiper P, Agostini M, Luque‐Moreno C, Tonin P, Turolla A. Reinforced feedback in virtual environment for rehabilitation of upper extremity dysfunction after stroke: preliminary data from a randomized controlled trial. BioMed Research International 2014. - PMC - PubMed
Kizony 2013 {published data only}
    1. Kizony R, Weiss PL, Feldman Y, Shani M, Elion O, Kizony R, et al. Evaluation of a tele‐health system for upper extremity stroke rehabilitation. 2013 10th International Conference on Virtual Rehabilitation, ICVR 2013, 26‐29 August 2013. 2013.
NCT01365858 {published and unpublished data}
    1. NCT01365858. Virtual action planning in stroke: a control rehabilitation study. clinicaltrials.gov/ct2/show/NCT01365858 (accessed December 2013). [NCT01365858]
NCT01806883 {published data only}
    1. Bensmail B. Evaluation of the Effects of Rehabilitation Using the "Wii" on Upper Limb Kinematics in Chronic Stroke Patients. clinicaltrials.gov 2013.
NCT02013999 {published data only}
    1. NCT02013999. The development of upper extremity rehabilitation program using virtual reality for the stroke patients. clinicaltrials.gov/ct2/show/NCT02013999 (accessed December 2013). [NCT02013999]
NCT02079103 {published data only}
    1. Brunner I, Skouen J, Hofstad H, Strand L, Becker F, Sanders AM, et al. Virtual reality training for upper extremity in subacute stroke (VIRTUES): study protocol for a randomized controlled multicenter trial. BMC Neurology 2014; Vol. 14, issue 1. - PMC - PubMed
NCT02553993 {published data only}
    1. Hung, JW. Comparing the Cognitive Effects of Two Exergame Training and Traditional Training in Patients With Chronic Stroke. ClinicalTrials.gov.
NCT02592759 {published data only}
    1. Gil Seo H. Effects of Upper Extremity Rehabilitation Using Smart Glove in Stroke Patients. ClinicalTrials.gov.
NCT02688413 {published data only}
    1. Caso V. Study Evaluating the MindMotionPRO for Early Post‐stroke Upper‐limb Rehabilitation (MOVE‐Rehab). ClinicalTrials.gov.
NCT02857803 {unpublished data only}
    1. Faria AL, Bermudez i Badia S. Development and evaluation of a web‐based cognitive task generator for personalized cognitive training: a proof of concept study with stroke patients. REHAB 2015: 3rd workshop on ICTs for improving patients research techniques. 2015:1‐4.
    1. Faria AL, Pinho M, Bermudez i Badia S. Personalizing cognitive rehabilitation through a web‐based Task Generator: an evaluation study with stroke patients. International Neuropsychological Society 2016 Mid year meeting. 2016; Vol. 2016.
    1. Faria Al, Vourvopoulos A, Cameirao MS, Fernandes JC, Bermudez i Badia S. An integrative virtual reality cognitive‐motor intervention approach in stroke rehabilitation: a pilot study. 10th International Conference, Disability, Virtual Reality and Associated Technologies (ICDVRAT). 2014.
    1. NCT02857803. A randomised controlled trial comparing the impact of virtual reality, paper and pencil and conventional methods on stroke rehabilitation. ClinicalTrials.gov 2016.
    1. Vourvopoulos A, Faria AL, Ponnam K, Bermudez i Badia S. RehabCity: design and validation of a cognitive assessment and rehabilitation tool through gamified simulations of activities of daily living. 11th Advances in Computer Entertainment Technology Conference. November 2014.
NTR2247 {published data only}
    1. NTR2247. Effect of virtual reality training on reach after stroke. www.trialregister.nl/trialreg/admin/rctview.asp?TC=2247 (accessed December 2013). [NTR2247]
Piemonte 2014 {published data only}
    1. Piemonte MEP, Oliveira TP, Miranda C, Muzzi J, Perez DB. Motor‐cognitive intervention based on Nintendo Wii Fit games to improve balance and cognitive functions in patients with stroke: a randomized controlled trial. Personal communication (to be presented at the Neurorehabilitation Congress) 2014.
Rand 2015 {published data only}
    1. Rand D, Yacoby A, Weiss R, Reif S, Malka R, Weingarden H, et al. Home‐based self‐training using video‐games: preliminary data from a randomised controlled trial. Virtual Rehabilitation Proceedings (ICVR), 2015. 2015:86‐91.
Schuster‐Amft 2014 {published data only}
    1. Schuster‐Amft C, Eng K, Thalers I, Lehmann I, Signer S, McCaskey MA, et al. Evaluating efficacy and users' expectations of a virtual reality training system: a multicenter randomized controlled trial. Annals of physical and rehabilitation medicine 2014;57:e85.
Sheehy 2016 {published data only}
    1. Sheehy L, Taillon‐Hobson A, Sveistrup H, Bilodeau M, Fergusson D, Levac D, et al. Does the addition of virtual reality to a standard program of inpatient rehabilitation improve sitting balance ability and function after stroke? Protocol for a single‐blind randomized controlled trial. BMC Neurology 2016; Vol. 16, issue 42. - PMC - PubMed

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References to other published versions of this review

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