Isolated effects of virtual reality training on upper limb motor function in patients with stroke: systematic review and meta-analysis.

Purpose: To synthesize evidence on the effects of virtual reality (VR) as monotherapy on upper motor function in stroke patients.

Methods: PubMed, PEDro, CINAHL, and WOS were searched from inception to December 2024.

Results: Nineteen studies were included (637 stroke patients, mean age 59.93 ± 6.52 years). The meta-analysis showed large effects sizes in VR interventions for upper extremity motor function and joint pain assessed with the Fugl-Meyer test (Cohen's d = 1.03, p < 0.001; Cohen's d = 1.49), being also superior when compared to a control group (Cohen's d = 0.68, p < 0.05, Cohen's d = 1.07). In contrast, these are not statistically significant when the analyses for motor function are done considering immersive or non-immersive VR. Non-immersive RV showed a large effect size on the Motor Activity Log Amount of Use (Cohen's d = 1.20) and Motor Activity Log Quality of Movement (Cohen's d = 1.35). RV also showed a medium effect size on the Action Research Arm Test (Cohen's d = 0.61). These results were not significant when compared to a control group.

Conclusion: VR as monotherapy improves upper limb motor function, being superior to other therapies in those functions assessed with the Fugl-Meyer scale. It is inconclusive if one VR modality is superior to another for improvements on upper limb motor function.