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Abstract

Background: Stroke is a leading cause of adult disability worldwide, often resulting in long-term motor impairments that compromise independence and quality of life. While conventional physiotherapy remains the cornerstone of rehabilitation, limitations in patient engagement and treatment outcomes have led to the exploration of innovative approaches. Virtual reality (VR)-based physiotherapy has emerged as a promising modality that offers immersive, task-specific training. Despite growing interest, there remains a lack of consensus on its efficacy across diverse post-stroke populations, warranting a systematic synthesis of current evidence.
Objective: This systematic review aims to evaluate the effectiveness of virtual reality-based physiotherapy interventions in improving motor function among post-stroke patients compared to conventional physiotherapy or no intervention.
Methods: A systematic review was conducted following PRISMA guidelines. Electronic databases including PubMed, Scopus, Web of Science, and Cochrane Library were searched for studies published between 2019 and 2025. Inclusion criteria comprised randomized controlled trials, controlled clinical trials, and observational studies involving adult stroke patients receiving VR-based physiotherapy targeting motor recovery. Data extraction and risk of bias assessment were independently performed by two reviewers using standardized tools (Cochrane Risk of Bias 2.0, Newcastle-Ottawa Scale). Due to heterogeneity, a narrative synthesis was employed.
Results: Eight studies met the inclusion criteria, encompassing a total of 439 participants. Interventions included immersive VR, exoskeleton-assisted systems, and haptic-enhanced platforms. Across studies, VR-based interventions significantly improved upper limb motor function, balance, trunk control, and functional independence, as measured by outcomes such as FMA-UE, BBS, TIS, and FIM (p < 0.05). Risk of bias was generally low to moderate.
Conclusion: VR-based physiotherapy demonstrates significant benefits in post-stroke motor recovery and may serve as a valuable adjunct to traditional rehabilitation. However, variability in study design and small sample sizes limit the generalizability of findings. Further large-scale, standardized trials are needed to confirm long-term efficacy and optimize implementation strategies.