Realidad virtual inmersiva en la rehabilitación intrahospitalaria del ACV: evidencia reciente y perspectivas clínicas

Abstract

Introduction

Stroke is one of the leading causes of acquired disability worldwide and poses significant challenges for inpatient rehabilitation during the acute phase. In this context, immersive virtual reality (IVR) has emerged as a potentially useful tool to complement conventional rehabilitation through interactive, multisensory therapeutic environments.

Objective

To critically analyse recent evidence on the use of IVR in post-stroke rehabilitation, with emphasis on the inpatient setting, and to discuss cautious perspectives for its clinical implementation.

Methods

A narrative literature review was conducted in PubMed/MEDLINE, Scopus, Web of Science and Cochrane Library, from January 2015 to December 2025, focused on IVR interventions in individuals with stroke. The literature search was conducted and last updated on March 6, 2026. Systematic reviews, meta-analyses, clinical trials, feasibility studies and clinical practice guidelines related to neurorehabilitation and immersive technologies were included; non-immersive or semi-immersive virtual reality studies were also incorporated when they provided relevant context. Given the narrative nature of this review, no formal risk-of-bias assessment or meta-analysis was performed.

Results

The available literature suggests that IVR may support motor function, balance, functional mobility, active participation and therapeutic adherence in post-stroke rehabilitation, particularly when used as a complement to conventional therapy. However, most studies have been conducted in outpatient settings or during subacute and chronic phases, and specific evidence in hospitalised patients during the acute phase remains limited and heterogeneous.

Implementation perspectives

IVR is emerging as a complementary tool within comprehensive inpatient neurorehabilitation programmes, provided it is applied in an individualised manner and under strict criteria for patient selection, safety and clinical monitoring.

Conclusion

IVR represents a promising strategy to complement inpatient stroke rehabilitation; however, specific evidence in the acute phase remains insufficient to recommend its routine implementation. More robust clinical studies, with improved methodological quality and focused on hospitalised patients, are needed.