The Effectiveness of Occupation-based Virtual Reality Intervention on Upper Extremity Functional Improvement in Post-stroke Individuals: A Systematic Review

Purpose: Virtual reality (VR)-based therapy is an emerging practice in the clinical setting and still requires research documenting its efficacy. This review analyzed the effectiveness of VR-based therapy on upper extremity (UE) motor recovery in individuals with chronic stroke by analyzing multiple randomized controlled trials. Methods: Search limits for this review consisted of articles published between January 2010 and January 2020 and available in English. Search keywords were based on language in individual databases (e.g. stroke or cerebrovascular accident, upper extremity, occupational therapy). Articles were limited to include only randomized control trials consisting of adult patients (18+) with UE impairment due to chronic stroke (onset at least 3 months prior) and occupation-based virtual reality intervention. Results: 242 articles were screened; eight met the inclusion criteria. Forms of VR within the reviewed articles included traditional gaming systems, mobile-based game devices, and VR combined with real instrument training. These studies showed improved outcomes following VR training such as improvement of UE function, activity participation, and health-related quality of life. Conclusion: The results of this review suggest that VR-based therapy has efficacy equal to or greater than conventional therapy for improving function in the upper extremity of adult patients with chronic stroke. As supported by research, practitioners may incorporate virtual reality-based therapy into conventional clinical sessions to assist in improving UE function and interactions within different environments and to help enhance overall participation in daily tasks and occupational performance in their clients.