. 2022 Jun 20;24(6):e24111. doi: 10.2196/24111

Table 2.

Meta-analyses and assessments of heterogeneity, publication bias, and quality of evidence.

Outcomes		Tools or methods used to assess the outcomes	Number of trials analyzed and number of participants involved	Standardized mean difference (95% CI)	Between-group difference, P value	Heterogeneity				Egger test, P value		Quality of evidence
						Cochrane Q test	P value	I² (%)
Impairments in upper extremity functions and structures
	(1) Upper extremity motor function	Fugl-Meyer Assessment-Upper Extremity	28 [9,31-33,35-37,40-46,48,50-58, 60,63,65]; N_VR^a _group=526, N_{control group}=509	0.45 (0.21 to 0.68)	<.001	83.72	<.001	68	.33		Moderate^b
	(1) Upper extremity motor function (after one outlier removed^c)	Fugl-Meyer Assessment-Upper Extremity	27 [9,31-33,35-37,40-46,48,50-58, 60,63,65]; N_{VR group}=502, N_{control group}=487	0.35 (0.19 to 0.50)	<.001	35.23	.11	26	.84		High
	(2) Grip strength	Dynamometer	6 [10,36,37,41,65,67]; N_{VR group}=157, N_{control group}=155	−0.002 (−0.30 to 0.30)	.99	7.41	.19	32	.23		Moderate^d
	(3) Spasticity	Ashworth Scale or modified Ashworth Scale	6 [35,43,47,52,55]; N_{VR group}=109, N_{control group}=111	0.09 (−0.28 to 0.47)	.63	8.68	.12	42	.35		Moderate^d
	(4) Range of motion	Goniometer	4 [52,54,60]; N_{VR group}=56, N_{control group}=56	1.01 (0.50 to 1.52)	<.001	4.65	.20	35	.99		Low^d
	(5) Stroke recovery stage	Brunnstrom stages of stroke recovery for upper extremity	2 [35,62]; N_{VR group}=28, N_{control group}=29	0.26 (−0.26 to 0.79)	.32	0.27	.61	0	N/A^e		Low^d
	(6) Muscle strength	Manual Muscle Testing	3 [47,52]; N_{VR group}=33, N_{control group}=33	0.79 (0.28 to 1.30)	.002	2.03	.36	1	.73		Low^d
	(6) Muscle strength	Motricity Index	2 [35,38]; N_{VR group}=27, N_{control group}=29	0.09 (−0.43 to 0.62)	.73	0.88	.35	0	N/A		Low^d
Activity limitations
	(7) Independence in day-to-day activities	Functional Independence Measure	13 [8-10,31,42-44,47,52,56,59,62]; N_{VR group}=406, N_{control group}=395	0.23 (0.06 to 0.40)	.01	16.01	.19	25	.03		High
	(7) Independence in day-to-day activities	Barthel Index or modified Barthel Index	11 [10,34,36,37,41,46,48,54,57,65,67]; N_{VR group}=224, N_{control group}=221	0.20 (−0.16 to 0.55)	.28	30.54	.001	67	.59		Moderate^b
	(7) Independence in day-to-day activities	Modified Rankin Scale	2 [52]; N_{VR group}=26, N_{control group}=26	0.57 (0.01 to 1.12)	.046	0.55	.46	0	N/A		Low^d
	(8) Hand dexterity	Box and Block Test	13 [8,10,31,32,35,37,41,48,51,53,60,62,64]; N_{VR group}=297, N_{control group}=286	0.26 (−0.08 to 0.60)	.13	42.63	<.001	72	.33		Moderate^b
	(9) Arm and hand motor ability	Action Research Arm Test	6 [8,30,38,44,45,64]; N_{VR group}=238, N_{control group}=238	−0.03 (−0.21 to 0.15)	.76	2.08	.84	0	.22		High
	(9) Arm and hand motor ability	Wolf Motor Function Test task completion time	9 [10,40,50,51,54,61,62,66,68]; N_{VR group}=174, N_{control group}=170	0.15 (−0.06 to 0.37)	.16	7.19	.52	0	.28		Moderate^d
	(9) Arm and hand motor ability	Wolf Motor Function Test task performance score	7 [39,40,50,54,62,66,68]; N_{VR group}=93, N_{control group}=91	0.36 (−0.07 to 0.79)	.10	11.97	.06	50	.28		Low^d,f
	(9) Arm and hand motor ability	Manual Function Test	4 [37,46,48,49]; N_{VR group}=51, N_{control group}=51	0.20 (−0.37 to 0.78)	.49	6.28	.10	52	.70		Low^d,f
	(10) Hand motor ability	Jebsen Hand Function Test	4 [36,41,58,65]; N_{VR group}=70, N_{control group}=67	0.90 (−0.42 to 2.22)	.18	36.25	<.001	92	.65		Very low^b,d
Participation restrictions in life situations
	(11) Quality of life	Stroke Impact Scale total score	3 [30,53,54]; N_{VR group}=138, N_{control group}=140	0.13 (−0.41 to 0.66)	.65	4.26	.12	53	.12		Very low^d,f
	(11) Quality of life	Stroke Impact Scale hand function score	2 [10,44]; N_{VR group}=104, N_{control group}=105	−0.04 (−0.31 to 0.23)	.78	0.89	.35	0	N/A		Low^d
	(12) Upper extremity use in daily life	Motor Activity Log quality of movement score	6 [40,50,51,53,61,64]; N_{VR group}=71, N_{control group}=68	0.50 (−0.05 to 1.05)	.08	11.78	.04	58	.31		Low^d,f
	(12) Upper extremity use in daily life	Motor Activity Log amount of use score	5 [40,50,53,61,64]; N_{VR group}=50, N_{control group}=48	0.27 (−0.13 to 0.67)	.18	3.36	.50	0	.91		Moderate^d

^aVR: virtual reality.

^bDowngraded owing to a high level of heterogeneity.

^cShin et al [58] was removed.

^dDowngraded owing to an inadequate sample size.

^eN/A: not applicable.

^fDowngraded owing to a moderate level of heterogeneity.