Utilization of Virtual Reality for Upper Limb Motoric Rehabilitation of Post-Stroke Patients: A Systematic Review
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Published:
Jun 17, 2025
Keywords:
Stroke, Virtual Reality, Motoric Function, Upper Limb, Rehabilitation
Main Article Content
Abstract
Background: Stroke is a neurological disorder which is classified as ischemic or hemorrhagic. The increasing incidence of stroke worldwide has increased the need for rehabilitation. Virtual Reality (VR) is a new technology that is still being developed for the rehabilitation of post-stroke patients. Several studies have shown that VR has good benefits to help the rehabilitation of post-stroke patients, especially in terms of patient motor skills.
Methods: A systematic review was conducted by searching the PubMed and Science Direct databases with all articles using English, randomized controlled trials and articles published in 2020-2024. The keywords used were "Virtual Reality", "VR", "Neurorehabilitation", "Rehabilitation", "Motor Function", "Stroke", "Recovery".
Results: A total of 870 studies were initially identified, 10 of those studies fulfilled the inclusion criteria for this systematic review. Total of 348 participants (178 VR groups and 170 control groups) were included in this systematic review and the results showed from most of the studies show a significant increase in the VR group in patient motor skills based on FMA-UE, ARAT, AROM, Grip Strength Test, DASH, JTT, WMFT and 9HPT assessments.
Conclusion: This systematic review shows that the use of VR for motor rehabilitation of post-stroke patients has better outcomes compared to patients who only receive conventional therapy.
Keywords: Stroke, Virtual Reality, Motoric Function, Upper Limb, Rehabilitation
Methods: A systematic review was conducted by searching the PubMed and Science Direct databases with all articles using English, randomized controlled trials and articles published in 2020-2024. The keywords used were "Virtual Reality", "VR", "Neurorehabilitation", "Rehabilitation", "Motor Function", "Stroke", "Recovery".
Results: A total of 870 studies were initially identified, 10 of those studies fulfilled the inclusion criteria for this systematic review. Total of 348 participants (178 VR groups and 170 control groups) were included in this systematic review and the results showed from most of the studies show a significant increase in the VR group in patient motor skills based on FMA-UE, ARAT, AROM, Grip Strength Test, DASH, JTT, WMFT and 9HPT assessments.
Conclusion: This systematic review shows that the use of VR for motor rehabilitation of post-stroke patients has better outcomes compared to patients who only receive conventional therapy.
Keywords: Stroke, Virtual Reality, Motoric Function, Upper Limb, Rehabilitation
Article Details
How to Cite
Harjanto, J. P., Irawan, A. A., Ma’ruf, I., & Silakarma, D. (2025). Utilization of Virtual Reality for Upper Limb Motoric Rehabilitation of Post-Stroke Patients: A Systematic Review. Indonesian Journal of Physical Medicine and Rehabilitation, 14(1), 135 - 147. https://doi.org/10.36803/indojpmr.v14i1.460
Section
Literature Review
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References
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2. Feigin VL, Brainin M, Norrving B, Martins S, Sacco RL, Hacke W, et al. World Stroke Organization (WSO): Global Stroke Fact Sheet 2022. International Journal of Stroke. 2022; 17(1): 18-29.
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5. Kim WS, Cho S, Ku J, Kim Y, Lee W, Hwang HJ, et al. Clinical Application of Virtual Reality for Upper Limb Motor Rehabilitation in Stroke: Review of Technologies and Clinical Evidence. J Clin Med. 2020; 9(10): 3369.
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7. Mekbib DB, Debeli DK, Zhang L, Fang S, Shao Y, Yang W, et al. A novel fully immersive virtual reality environment for upper extremity rehabilitation in patients with stroke. Ann N Y Acad Sci. 2021; 1493(1): 75-89.
8. Rodríguez-Hernández M, Polonio-López B, Corregidor-Sánchez AI, Martín-Conty JL, Mohedano-Moriano A, Criado-Álvarez JJ. Can specific virtual reality combined with conventional rehabilitation improve poststroke hand motor function? A randomized clinical trial. J Neuroeng Rehabil 2023; 20(1):3 8.
9. Amin F, Waris A, Syed S, Amjad I, Umar M, Iqbal J. Effectiveness of Immersive Virtual Reality-Based Hand Rehabilitation Games for Improving Hand Motor Functions in Subacute Stroke Patients. IEEE Trans Neural Syst Rehabil Eng. 2024; 32: 2060-2069.
10. Huang CY, Chiang WC, Yeh YC, Fan SC, Yang WH, Kuo HC, et al. Effects of virtual reality-based motor control training on inflammation, oxidative stress, neuroplasticity and upper limb motor function in patients with chronic stroke: a randomized controlled trial. BMC Neurol 2022; 22(1): 21.
11. Hegazy RM, Alkhateeb AM, Abdelmohsen AM. Impact of a virtual reality program on post-stroke upper limb function: a randomized controlled trial. Physiotherapy Quarterly 2022;30(4):81-
12. Huang Q, Jiang X, Jin Y, Wu B, Vigotsky AD, Fan L, et al. Immersive virtual reality-based rehabilitation for subacute stroke: a randomized controlled trial. J Neurol 2024; 271(3): 1256-1266.
13. Aguilera-Rubio Á, Alguacil-Diego IM, Mallo-López A, Jardón Huete A, Oña ED, Cuesta-Gómez A. Use of low-cost virtual reality in the treatment of the upper extremity in chronic stroke: a randomized clinical trial. J Neuroeng Rehabil 2024; 21(1): 12.
14. Hernandez A, Bubyr L, Archambault PS, Higgins J, Levin MF, Kairy D. Virtual Reality-Based Rehabilitation as a Feasible and Engaging Tool for the Management of Chronic Poststroke Upper-Extremity Function Recovery: Randomized Controlled Trial. JMIR Serious Games 2022;10(3):e37506.
15. Lee HS, Lim JH, Jeon BH, Song CS. Non-immersive Virtual Reality Rehabilitation Applied to a Task-oriented Approach for Stroke Patients: A Randomized Controlled Trial. Restor Neurol Neurosci 2020; 38(2): 165-172.
16. Wilson PH, Rogers JM, Vogel K, Steenbergen B, McGuckian TB, Duckworth J. Home-based (virtual) rehabilitation improves motor and cognitive function for stroke patients: a randomized controlled trial of the Elements (EDNA-22) system. J Neuroeng Rehabil 2021; 18(1): 165.
17. Rutkowski S, Kiper P, Cacciante L, Cieslik B, Mazurek J, Turolla A. Use of virtual reality-based training in different fields of rehabilitation: A systematic review and meta-analysis. J Rehabil Med. 2020; 52(11): jrm00121.
18. Patsaki I, Dimitriadi N, Despoti A, Tzoumi D, Leventakis N, Roussou G. The effectiveness of immersive virtual reality in physical recovery of stroke patients: A systematic review. Front Syst Neurosci 2022; 16: 880447.
19. Maier M, Rubio Ballester B, Duff A, Duarte Oller E, Verschure PFMJ. Effect of Specific Over Nonspecific VR-Based Rehabilitation on Poststroke Motor Recovery: A Systematic Meta-analysis. Neurorehabilitation and Neural Repair. 2019; 33(2): 112-129.
20. Hao J, He Z, Yu X, Remis A. Comparison of immersive and non-immersive virtual reality for upper extremity functional recovery in patients with stroke: a systematic review and network meta-analysis. Neurol Sci 2023;44(8):2679-2697
2. Feigin VL, Brainin M, Norrving B, Martins S, Sacco RL, Hacke W, et al. World Stroke Organization (WSO): Global Stroke Fact Sheet 2022. International Journal of Stroke. 2022; 17(1): 18-29.
3. Stinear CM, Lang CE, Zeiler S, Byblow WD. Advances and challenges in stroke rehabilitation. Lancet Neurol 2020; 19(4): 348-360.
4. Khan A, Podlasek A, Somaa F. Virtual reality in post-stroke neurorehabilitation - a systematic review and meta-analysis. Top Stroke Rehabil 2023; 30(1): 53-72.
5. Kim WS, Cho S, Ku J, Kim Y, Lee W, Hwang HJ, et al. Clinical Application of Virtual Reality for Upper Limb Motor Rehabilitation in Stroke: Review of Technologies and Clinical Evidence. J Clin Med. 2020; 9(10): 3369.
6. Sterne JAC, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: a revised tool for assessing risk of bias in randomized trials. Bmj 2019; 366: l4898.
7. Mekbib DB, Debeli DK, Zhang L, Fang S, Shao Y, Yang W, et al. A novel fully immersive virtual reality environment for upper extremity rehabilitation in patients with stroke. Ann N Y Acad Sci. 2021; 1493(1): 75-89.
8. Rodríguez-Hernández M, Polonio-López B, Corregidor-Sánchez AI, Martín-Conty JL, Mohedano-Moriano A, Criado-Álvarez JJ. Can specific virtual reality combined with conventional rehabilitation improve poststroke hand motor function? A randomized clinical trial. J Neuroeng Rehabil 2023; 20(1):3 8.
9. Amin F, Waris A, Syed S, Amjad I, Umar M, Iqbal J. Effectiveness of Immersive Virtual Reality-Based Hand Rehabilitation Games for Improving Hand Motor Functions in Subacute Stroke Patients. IEEE Trans Neural Syst Rehabil Eng. 2024; 32: 2060-2069.
10. Huang CY, Chiang WC, Yeh YC, Fan SC, Yang WH, Kuo HC, et al. Effects of virtual reality-based motor control training on inflammation, oxidative stress, neuroplasticity and upper limb motor function in patients with chronic stroke: a randomized controlled trial. BMC Neurol 2022; 22(1): 21.
11. Hegazy RM, Alkhateeb AM, Abdelmohsen AM. Impact of a virtual reality program on post-stroke upper limb function: a randomized controlled trial. Physiotherapy Quarterly 2022;30(4):81-
12. Huang Q, Jiang X, Jin Y, Wu B, Vigotsky AD, Fan L, et al. Immersive virtual reality-based rehabilitation for subacute stroke: a randomized controlled trial. J Neurol 2024; 271(3): 1256-1266.
13. Aguilera-Rubio Á, Alguacil-Diego IM, Mallo-López A, Jardón Huete A, Oña ED, Cuesta-Gómez A. Use of low-cost virtual reality in the treatment of the upper extremity in chronic stroke: a randomized clinical trial. J Neuroeng Rehabil 2024; 21(1): 12.
14. Hernandez A, Bubyr L, Archambault PS, Higgins J, Levin MF, Kairy D. Virtual Reality-Based Rehabilitation as a Feasible and Engaging Tool for the Management of Chronic Poststroke Upper-Extremity Function Recovery: Randomized Controlled Trial. JMIR Serious Games 2022;10(3):e37506.
15. Lee HS, Lim JH, Jeon BH, Song CS. Non-immersive Virtual Reality Rehabilitation Applied to a Task-oriented Approach for Stroke Patients: A Randomized Controlled Trial. Restor Neurol Neurosci 2020; 38(2): 165-172.
16. Wilson PH, Rogers JM, Vogel K, Steenbergen B, McGuckian TB, Duckworth J. Home-based (virtual) rehabilitation improves motor and cognitive function for stroke patients: a randomized controlled trial of the Elements (EDNA-22) system. J Neuroeng Rehabil 2021; 18(1): 165.
17. Rutkowski S, Kiper P, Cacciante L, Cieslik B, Mazurek J, Turolla A. Use of virtual reality-based training in different fields of rehabilitation: A systematic review and meta-analysis. J Rehabil Med. 2020; 52(11): jrm00121.
18. Patsaki I, Dimitriadi N, Despoti A, Tzoumi D, Leventakis N, Roussou G. The effectiveness of immersive virtual reality in physical recovery of stroke patients: A systematic review. Front Syst Neurosci 2022; 16: 880447.
19. Maier M, Rubio Ballester B, Duff A, Duarte Oller E, Verschure PFMJ. Effect of Specific Over Nonspecific VR-Based Rehabilitation on Poststroke Motor Recovery: A Systematic Meta-analysis. Neurorehabilitation and Neural Repair. 2019; 33(2): 112-129.
20. Hao J, He Z, Yu X, Remis A. Comparison of immersive and non-immersive virtual reality for upper extremity functional recovery in patients with stroke: a systematic review and network meta-analysis. Neurol Sci 2023;44(8):2679-2697