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Review
. 2023 Dec 27;13(1):146.
doi: 10.3390/jcm13010146.

Effects of Immersive Virtual Reality on Upper-Extremity Stroke Rehabilitation: A Systematic Review with Meta-Analysis

Pawel Kiper  1 , Nathalie Godart  2 , Manon Cavalier  2 , Charlotte Berard  2 , Błażej Cieślik  1 , Sara Federico  1 , Aleksandra Kiper  3 , Leonardo Pellicciari  4 , Roberto Meroni  2   5
Affiliations
Review

Effects of Immersive Virtual Reality on Upper-Extremity Stroke Rehabilitation: A Systematic Review with Meta-Analysis

Pawel Kiper et al. J Clin Med. .

Abstract

Virtual reality (VR) is an innovative rehabilitation tool increasingly used in stroke rehabilitation. Fully immersive VR is a type of VR that closely simulates real-life scenarios, providing a high level of immersion, and has shown promising results in improving rehabilitation functions. This study aimed to assess the effect of immersive VR-based therapy for stroke patients on the upper extremities, activities of daily living (ADLs), and pain reduction and its acceptability and side effects. For this review, we gathered all suitable randomized controlled trials from PubMed, EMBASE, Cochrane Library, Scopus, and Web of Science. Out of 1532, 10 articles were included, with 324 participants. The results show that immersive VR offers greater benefits in comparison with conventional rehabilitation, with significant improvements observed in ADLs (SMD 0.58, 95% CI 0.25 to 0.91, I2 = 0%, p = 0.0005), overall function as measured by the Fugl-Meyer Assessment (MD 6.33, 95% CI 4.15 to 8.50, I2 = 25%, p = 0.00001), and subscales for the shoulder (MD 4.96, 95% CI-1.90-8.03, I2 = 25%, p = 0.002), wrist (MD 2.41, 95% CI-0.56-4.26, I2 = 0%, p = 0.01), and hand (MD 2.60, 95% CI-0.70-4.5°, I2 = 0%, p = 0.007). These findings highlight the potential of immersive VR as a valuable therapeutic option for stroke survivors, enhancing their ADL performance and upper-limb function. The immersive nature of VR provides an engaging and immersive environment for rehabilitation.

Keywords: hand functions; immersive VR; stroke; upper extremity; virtual reality.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
PRISMA Flow Diagram illustrating the systematic review procedures. The diagram depicts the flow of information from the initial identification of records through database searching to the final inclusion of studies in the qualitative and quantitative synthesis.
Figure 2
Figure 2
Comparison: virtual reality (VR) versus control group (CG); outcome: upper-extremity function post-intervention analysis [12,27,28,29,30,32,33].
Figure 3
Figure 3
Comparison: VR versus CG; outcome: Fugl-Meyer upper-extremity subscale post-intervention analysis [27,28,29].
Figure 4
Figure 4
Comparison: VR versus CG; outcome: activities-of-daily-living post-intervention analysis [12,26,30,32].
Figure 5
Figure 5
Risk of bias in included studies [12,25,26,27,28,29,30,31,32,33].
See this image and copyright information in PMC

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