UTILIZATION OF VIRTUAL REALITY (VR) IN PATIENTS AS POST-STROKE REHABILITATION TOOL

Abstract

Background. Virtual reality (VR) has emerged as a promising adjunct to conventional rehabilitation in post-stroke patients, offering interactive and engaging environments that may enhance motor recovery and functional outcomes. However, the rapidly growing and heterogeneous body of evidence requires up-to-date synthesis.

Aim. To narratively review recent randomized controlled trials (RCTs) published in 2025 that investigated the use of immersive and non-immersive VR as part of post-stroke rehabilitation.

Material and methods. A narrative review was conducted using PubMed and Google Scholar. Searches combined terms related to stroke and virtual reality (“stroke”, “cerebrovascular incident”, “virtual reality”, “immersive virtual reality”, “augmented reality”, “rehabilitation”, “treatment”, “therapy”) and were limited to peer-reviewed RCTs published in English between 1 January and October 2025. Studies involving only healthy participants, meta-analyses, and trials without clear methodology were excluded. Data on patient characteristics, VR systems, intervention protocols, and clinical outcomes were extracted and qualitatively synthesized.

Results. Nine RCTs involving a total of 391 post-stroke patients (pooled mean age 58.56 years) were included. VR interventions ranged from fully immersive head-mounted display systems (e.g. Oculus Rift, Oculus Quest, NJIT RAVR) to non-immersive or semi-immersive platforms (e.g. Kinect-based systems, BioRescue, smartphone VR). Most studies delivered VR as an adjunct to conventional physiotherapy or occupational therapy. Improvements in motor recovery assessed by the Fugl–Meyer Assessment were consistently greater in VR groups compared with controls. Several trials also reported significant gains in balance (Berg Balance Scale), mobility (Timed Up and Go, 6-Minute Walk Test), trunk control (Trunk Impairment Scale), and functional independence (Barthel Index/Modified Barthel Index), although results for balance and gait were more variable, with at least one trial showing no additional benefit of home-based non-immersive VR on BBS or TUG. Heterogeneity in stroke chronicity, sample sizes, VR equipment, training intensity, and outcome measures limited direct comparability across studies.

Conclusions. Recent RCTs suggest that VR can be a useful adjunct to conventional post-stroke rehabilitation, particularly for improving limb motor function and, in selected populations, balance, mobility, and activities of daily living. Nonetheless, the evidence remains heterogeneous, and small sample sizes and variable protocols restrict generalizability. Larger, methodologically robust trials with standardized VR interventions, direct comparisons of immersive versus non-immersive systems, and long-term follow-up are needed to better define which patients benefit most from VR-based rehabilitation.