Are Virtual Reality Interventions Effective in Improving Outcomes in People with Multiple Sclerosis? A Cochrane Review Summary with Commentary.

Abstract

BackgroundA wide range of virtual reality (VR) applications are currently used in rehabilitation to support people with multiple sclerosis (pwMS) in improving limb function, balance, postural control, gait training, and cognitive abilities. Despite its widespread use, there is a lack of systematic evaluation for the effectiveness of VR in the rehabilitation.ObjectiveCommentary on the systematic review by De Keersmaecker et al. (2025) which assessed the effects of VR interventions on lower limb and gait function, and balance and postural control in pwMS.MethodsThis review conducted a comprehensive search of the health science databases for (quasi-) randomized controlled trials (RCTs) that assessed virtual reality (VR) interventions in adult pwMS.ResultsThe review included 33 RCTs with a total of 1,294 participants. VR interventions varied across studies, including immersive and non-immersive approaches targeting motor and cognitive rehabilitation. Compared to no intervention, VR demonstrated a moderate positive effect on upper limb function and quality of life, suggesting that it could be a viable rehabilitation tool for improving motor performance and patient well-being. Compared with conventional therapy, VR interventions were more effective in improving balance and postural control. However, for other rehabilitation outcomes, such as gait function, cognitive function, and fatigue management, VR did not show significant differences compared to conventional therapy.ConclusionsVR can be a useful adjunct to traditional rehabilitation, but it may not be superior in all aspects of MS rehabilitation, unambiguous evidence regarding the effect of virtual reality training in multiple sclerosis is still missing. The authors emphasized the need for further research, particularly high-quality, large-scale RCTs, to strengthen the evidence base for VR in MS rehabilitation.