Table 1.
Presents the primary attributes of the research interventions
| Study | Group interventions | VR groups | No. participant | The average age of participants in years/SD | Frequency | Session duration (min/h) | Intervention duration (week) | Outcome measure | Measuring instrument | Results |
|---|---|---|---|---|---|---|---|---|---|---|
| Saposnik et al. 51 | Control group: Recreational activities intervention group: Conventional treatment + virtual rehabilitation along with Nintendo Wii | Commercial games based on Nintendo Wii | Total participants=121 Control group:62 Instrumental group:59 | 62 (12.0) 62 (13.0) | 5 | 60 min | 2 | 1. Motor function 2. Quality of life 3. Kinematics parameters |
1. WMFT, Box, and Block Test, SIS, dynamometer. 2. SIS, MBI, FIM, and Modified Rankin Scale 3. Kinematic analysis with RPSS |
Following the intervention, no statistically significant change was seen between the groups. |
| Kong et al. 52 | Control group: Conventional treatment IG: virtual rehabilitation with Nintendo Wii |
Commercial games created on Nintendo Wii | Participants=68 Control group:35 Intervention group:33 |
55.8 (11.5) 58.1 (9.1) | 4 | 60 | 3 | 1. Motor function 2. Quality of life |
1. FMA-UE, ARAT. 2. FIM, SIS |
Following the intervention, no statistically significant change was seen between the groups. |
| Choi et al. 53 | Control group: Conventional treatment Intervention group: virtual rehabilitation-based Mobile games | Mobile games using a smartphone and a Tablet or computer | Participants=24 Control group:12 Intervention group:12 |
72.1 (9.9) 61.0 (15.2) | 5 | 30 | 2 | 1. Motor function 2. Quality of life 3. Depression |
1. FMA-UE, Brunnstro¨m, MMT 2. MBI, EQ-5D 3. BDI |
There was a noticeable statistical difference between the FMA-UE, Brunnstro¨m, and MMT groups. |
| Brunner et al. 54 | Control group: Conventional treatment Intervention group; Conventional treatment + virtual rehabilitation system + bionic gloves (YouGrabber |
Games based on interacting with virtual environments and objects | N=102 CG:52 IG:50 | 62.0 (—) 62.0 (—) | 4 | 60 | 4 | 1. Motor function 2. Quality of life |
1. ARAT, Box, and Block Test 2. FIM |
Following the intervention, no statistically significant change was seen between the groups. |
| Shin et al. 55 | CG: Conventional treatment Intervention group; virtual rehabilitation with biofeedback bionic gloves (SmartGlove) |
Games based on interacting with virtual environments and objects | N=33 CG:14 IG:19 | 59.8 (13.0) 57.2 (10.3) | 3 | 30 | 4 | 1. Motor function 2. Quality of life |
1. FMA-UE, JTT, PPT (Purdue pegboard test) 2. SIS |
There was a discernible difference between the Fugl-Meyer Assessment for the Upper Extremities, SIS and JTT groups. |
| Taveggia et al. 56 | Control group: Conventional treatment Intervention group: Conventional treatment and virtual rehabilitation system with an exoskeleton (Armeo Spring) | Games based on performing virtual tasks in virtual environments | N=54 CG:27 IG:27 | 68.0 (13.0) 73.0 (10.0) | 5 | 30 | 6 | 1. Motricity 2.Spasticity 3. Pain 4. Quality of life |
1. MI 2. Ashworth 3. FIM 4. VAS |
Each measure showed a statistically significant difference between the two groups. |
| Rubio et al.,57 | Conventional treatment+ virtual rehabilitation system | Games based on interacting with virtual environments and objects | 10 | 59.50 (±11.43) years | 2 | 60 | 8 | 1. Motor function | 1. Action Research Arm Test (ARAT) 2. BBT 3. SF-36 |
There was a statistically significant variation in the UL motor function (BBT, ARAT, grip strength, and upper extremity muscle strength) in patients. |
| Mekbib et al.,58 | Conventional treatment Intervention group: virtual rehabilitation system | VR-based limb mirroring therapy | 21 | 57.13 (±4.45) | 4 | 60 | 2 | UE | Resting-state fMRI and FMA for UL | Exercises involving bilateral and unilateral limb mirroring in a fully immersive virtual setting have the potential to improve motor performance and cortical reorganization. |
| Sheehy et al.,59 | Conventional treatment occupational therapy rehabilitative exercise | Games based on interacting with virtual environments, arm and trunk movement | 69 | 64.7 (±16.2) | 5 | 30–45 min | 2 | UE | Jintronix software and a Kinect 2 three-dimensional motion-tracking camera | As sitting balance results were comparable for both groups, this study does not support the use of VRT-provided sitting balance exercises for the rehabilitation of sitting balance following a stroke. Though this is only the second study to look into virtual reality therapy (VRT) for sitting balance and post-stroke upper extremity function for sitting balance, more research employing more difficult exercises and more intense treatment is needed before definitive findings can be drawn. |
| Subramanian et al. 60 | CG: Similar real therapy Intervention group:: 3D immersive VR (CAREN) | Games based on interacting with virtual environments and object | N= 25 CG:13 IG:12 | 60.0 (11.0) 62.0 (9.7) | 3 | — | 4 | 1. Motor function 2. Arm use. 3. Kinematcs parameters |
1. Fugl-Meyer Assessment for the Upper Extremities, WMFT, RPSS (Reaching Performance Scale for Stroke) 2. MAL–AS 3. Kinematic 3D analysis |
No statistically significant difference was found between groups in kinematics, arm motor impairment, activity level, and arm us. |
| Cho & Jung,61 | Control group: Conventional treatment Intervention group: immersive VR (IREX) |
Games based on interacting with virtual environments and objects | N= 29 CG:14 IG:15 | 63.7 (8.8) 64.0 (7.1) | 5 | 60 | 4 | 1. Motor function 2. Visual perception and processing time |
1. WMFT 2. MVPT (Motor-free Visual Perception Test) |
No statistically significant difference was found between groups on WMFT. A statistically significant difference was found in MVPT between groups. |
| Kwon et al. 62 | Control group: Conventional therapy IG: Conventional therapy + Immersive VR (IREX) | Games based on interacting with virtual environments and objects | N= 26 CG:13 IG:13 | 57.9 (12.3) 57.1 (15.4) | 5 | 30 | 4 | 1. Motor function 2. Quality of life |
1. Fugl-Meyer Assessment for the Upper Extremities, MFT (Manual Function Test) 2. MBI |
Following the intervention, no statistically significant change was seen between the groups. |
| Sin et al. 63 | Control group: Conventional treatment Intervention group: Conventional therapy + semi-immersive VR with Xbox Kinect |
Commercial games based on Xbox Kinect | N= 35 CG:17 IG:18 | 75.5 (5.5) 71.7 (9.4) | 3 | 30 | 6 | 1. Motor function 2. Manual dexterity |
1. Active ROM, Fugl-Meyer Assessment for the Upper Extremities, 2. Box, and Block Test |
A statistically significant difference was found between active ROM, FMA-UE and BBT groups. |
| Rand et al. 64 | Control group: Conventional treatment Intervention group: Semi-immersive and non-immersive VR with Xbox Kinect, PlayStation 2&3 |
Commercial games based on Xbox Kinect, Sony Play Station 2 EyeToy, Sony Play Station 3 Move, and SeeMe VR system | N= 29 CG:14 IG:15 | 62.5 (—) 57.0 (—) | 2 | 60 | 12 | 1. Motor function | 1. Number of movements, acceleration, and movement intensity | A statistically significant difference was found between groups in the number of intentional movements |
| Thielbar et al. 65 | Control group: Intensive treatment IG: Intensive therapy with mechatronic VR (AVK) |
Games based on interacting with a virtual Keypad | N= 14 CG:7 IG:7 | 59.0 (7.0) 54.0 (7.0) | 3 | — | 6 | 1. Motor function | 1. JTT, ARAT, Fugl-Meyer Assessment for the Upper Extremities, finger function | A statistically significant difference was found between the FMA-UE, JTT, and finger function groups. |
| Zheng et al. 66 | CG: RTMS treatment + immersive VR IG: L-F RTMS treatment + immersive VR | Games based on interacting with virtual environments and objects | N= 108 CG:53 IG:55 | 66.2 (13.1) 65.4 (13.5) | 6 | — | 4 | 1. Motor function 2. Quality of life |
1. Fugl-Meyer Assessment for the Upper Extremities, WMFT 2. Modified Barthel Index 3. SF-36 |
A statistically significant difference was found between the FMA-UE, WMFT, and MBI groups. |
| Kiper et al. 67 | CG: Conventional treatment Intervention group: Conventional treatment + VR feedback gloves |
Games based on interacting with virtual environments and object | N= 44 CG:21 IG:23 | 65.5 (14.2) 63.1 (9.5) | 5 | 60 | 4 | 1. Motor function 2. Quality of life 3. Kinematic parameters |
1. Fugl-Meyer Assessment for the Upper Extremities 2. FIM 3. Kinematic 3D analysis |
There was a discernible variation between the groups in terms of FMA-UE, FIM, and kinematics characteristics. |
| Feng et al. 68 | Conventional treatment and physiotherapy +virtual rehabilitation | Games based on interacting with virtual environments and objects | N= 28 | IG: 67.47 ± 4.79 CG: 66.93 ± 4.64 |
5 | 45 min | 12 | Motor function | 1. BBS 2.FGA 3.TUGT |
The study’s findings suggest that, in comparison to traditional physical treatment, 12 weeks of VR rehabilitation improved the balance and gait of patients receiving physical therapy.. |
| Shin et al. 69 | Control group: Conventional treatment Intervention group: Conventional treatment and virtual rehabilitation system | Games based on interacting with virtual environments and objects | N= 32 CG:16 IG:16 | 54.6 (13.4) 53.3 (11.8) | 5 | 60 | 4 | 1. Quality of life 2.Depression 3. Motor function |
1. HRQOL and SF-36 2. Hamilton 3. Fugl-Meyer Assessment for the Upper Extremities |
Following the intervention, no statistically significant change was seen between the groups. |
| Lee et al. 70 | Control group: Conventional treatment Intervention group: Conventional treatment and virtual rehabilitation system | Games based on interacting with virtual environments and objects | N= 18 CG:8 IG:10 | 73.1 (8.9) 69.2 (5.5 | 3 | 30 | 6 | 1. Motor function | 1. JTHFT, BBT, GPT (Grooved pegboard test), dynamometer | There was a statistically significant variation in the UL motor function (JTHFT, BBT, GPT, grip strength, and upper extremity muscle strength) between the groups. |
BBS, Berg Balance Scale; BBT, Box and Block Test; CG, control group; FGA, Functional Gait Assessment; FIM, Functional Independence Measure; FMA-UE, Fugl-Meyer Assessment for Upper Extremity; GPT, Grooved Pegboard Test; HRQOL, Health-Related Quality of Life; IG, intervention group; JTHFT, Jebsen-Taylor Hand Function Test; JTT: Jebsen-Taylor Hand Function Test; MBI, Modified Barthel Index; MMT, Manual Muscle Testing; RPSS, Reaching Performance Scale for Stroke; RTMS, repetitive transcranial magnetic stimulation; SIS, Stroke Impact Scale; TUGT, Timed Up and Go Test; UL, upper limb; VAS, Visual Analog Scale; VR, virtual reality; WMFT, Wolf Motor Function Test.