Effect of Home-based Virtual Reality Training on Upper Extremity Recovery in Patients with Stroke: Systematic Review.

Background: Stroke is a leading cause of long-term disability, often resulting in upper extremity dysfunction. Traditional rehabilitation methods often face challenges such as limited patient access to resources and lack of sustained motivation. Home-based virtual reality (VR) training is gaining traction as an innovative, sustainable and interactive alternative. However, the effect of home-based VR, specifically for upper extremity recovery in patients with stroke, remains insufficiently explored.

Objective: This systematic review aims to synthesize existing evidence to evaluate the impact of home-based VR interventions on upper extremity function recovery in patients with stroke.

Methods: This systematic review followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A comprehensive literature search was conducted across PubMed, Web of Science, Scopus, and CINAHL Ultimate databases, targeting English-language randomized controlled trials (RCTs) published up to June 30, 2024. Eligible studies involved stroke patients with upper extremity dysfunction who received home-based VR interventions. Data extraction was performed by two independent reviewers, and study quality was assessed using the PEDro scale. Due to heterogeneity in study designs and outcome measures, a narrative synthesis was performed instead of a meta-analysis.

Results: Eight RCTs with 392 participants were included. This review shows that home-based VR training positively affects upper extremity function recovery in patients with stroke, especially in motor control improvement. Customized VR systems were more effective than commercial VR systems in patients with moderate to severe disorders. Although studies generally showed positive results, differences in intervention protocols and small sample sizes limited the validity of results. The effect of VR therapy also varied based on the VR system type, intervention intensity, and the functional level of patients.

Conclusions: This systematic review shows that home-based VR training has a positive impact on upper extremity rehabilitation for stroke patients, particularly in those with varying degrees of dysfunction. However, heterogeneity in study design and differences in outcome measures affect the reliability of the current conclusions. Future studies should include larger, standardized RCTs with long-term follow-up to assess their continued effects. Future research should explore how VR technology can be integrated into comprehensive rehabilitation programs, focusing on patient-centered approaches that incorporate sustainable, personalized technology and support services to optimize recovery outcomes.

Clinicaltrial: PROSPERO CRD42024526650; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024526650.