International journal of nursing studies advances · 2026
Effectiveness of virtual reality-based rehabilitation on quality of life and upper extremity functions among stroke survivors: A systematic review and meta-analysis.
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Tan Ranee Reesa, Liaw Sok Ying, Thng Yasmine Yan Qi, Ruksakulpiwat Suebsarn, Batalik Ladislav, Chong Mei Sin
Аннотация
BACKGROUND: Stroke rehabilitation faces challenges such as limited accessibility and engagement, prompting interest in virtual reality-based interventions. While virtual reality shows promise, its effectiveness in improving quality of life (QoL) and upper extremity (UE) functions in stroke survivors remains unclear.
OBJECTIVES: To evaluate (1) the effectiveness of virtual reality-based interventions in QoL and UE functions among stroke survivors and (2) the feasibility and safety indicators across trials.
DATA SOURCES: A comprehensive search was conducted across six electronic databases: PubMed, EMBASE, Cochrane, Scopus, PsycINFO, and CINAHL to identify relevant articles published between Jan 2014 and December 2024. The search was updated on 9 May 2026.
REVIEW METHODS: The Cochrane Handbook for Systematic Reviews of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were employed to ensure methodological rigor and standardized reporting. Two independent reviewers assessed the eligibility of the articles, and the quality of the studies were appraised using the Revised Cochrane Risk of Bias Assessment Tool for Randomized Trials (RoB2). Feasibility indicators (participation, adherence, attrition) and adverse events were also extracted.
RESULTS: Thirty-four randomized controlled trials involving 1834 participants were included. Two studies had a low risk of bias, 19 had some concerns, and 13 had a high risk. Meta-analyses revealed non-significant effects of virtual reality-based interventions on QoL (SMD = -0.09, 95% CI -0.30 to 0.11, p = .36; low certainty) and UE functions assessed by upper extremity Fugl-Meyer (SMD = 0.56, 95% CI -0.02 to 1.15, p = .06; very low certainty) and Action Research Arm Test (SMD = 0.15, 95% CI -0.22 to 0,52, p = .41; low certainty). Narrative synthesis yielded mixed findings. Feasibility outcomes were generally favorable: participation among eligible patients was typically >80%, attrition <20%, and adherence exceeded 80% in the few trials reporting it. Adverse events were mainly mild and comparable to those in control groups.
CONCLUSION: Current evidence does not demonstrate the superiority of virtual reality-based interventions over conventional rehabilitation for improving QoL or UE functions in stroke survivors, despite generally favorable feasibility and safety profiles. The low-to-very low certainty of evidence highlights the need for stronger methodological rigor, theoretical frameworks, and long-term follow-up. Virtual reality may serve as a complementary option when access to traditional rehabilitation is limited.
REGISTRATION: PROSPERO (CRD42024619427).
OBJECTIVES: To evaluate (1) the effectiveness of virtual reality-based interventions in QoL and UE functions among stroke survivors and (2) the feasibility and safety indicators across trials.
DATA SOURCES: A comprehensive search was conducted across six electronic databases: PubMed, EMBASE, Cochrane, Scopus, PsycINFO, and CINAHL to identify relevant articles published between Jan 2014 and December 2024. The search was updated on 9 May 2026.
REVIEW METHODS: The Cochrane Handbook for Systematic Reviews of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were employed to ensure methodological rigor and standardized reporting. Two independent reviewers assessed the eligibility of the articles, and the quality of the studies were appraised using the Revised Cochrane Risk of Bias Assessment Tool for Randomized Trials (RoB2). Feasibility indicators (participation, adherence, attrition) and adverse events were also extracted.
RESULTS: Thirty-four randomized controlled trials involving 1834 participants were included. Two studies had a low risk of bias, 19 had some concerns, and 13 had a high risk. Meta-analyses revealed non-significant effects of virtual reality-based interventions on QoL (SMD = -0.09, 95% CI -0.30 to 0.11, p = .36; low certainty) and UE functions assessed by upper extremity Fugl-Meyer (SMD = 0.56, 95% CI -0.02 to 1.15, p = .06; very low certainty) and Action Research Arm Test (SMD = 0.15, 95% CI -0.22 to 0,52, p = .41; low certainty). Narrative synthesis yielded mixed findings. Feasibility outcomes were generally favorable: participation among eligible patients was typically >80%, attrition <20%, and adherence exceeded 80% in the few trials reporting it. Adverse events were mainly mild and comparable to those in control groups.
CONCLUSION: Current evidence does not demonstrate the superiority of virtual reality-based interventions over conventional rehabilitation for improving QoL or UE functions in stroke survivors, despite generally favorable feasibility and safety profiles. The low-to-very low certainty of evidence highlights the need for stronger methodological rigor, theoretical frameworks, and long-term follow-up. Virtual reality may serve as a complementary option when access to traditional rehabilitation is limited.
REGISTRATION: PROSPERO (CRD42024619427).