Computer-Mediated Therapies for Stroke Rehabilitation: A Systematic Review and Meta-Analysis

Objective: To evaluate the efficacy of different forms of virtual reality (VR) treatments as either immersive virtual reality (IVR) or non-immersive virtual reality (NIVR) in comparison to conventional therapy (CT) in improving physical and psychological status among stroke patients. Methods: The literature search was conducted on seven databases: ACM Digital Library, Medline (via PubMed), Cochrane, IEEE Xplore, Web of Science, Scopus, and science direct. The effect sizes of the main outcomes were calculated using Cohen's d. Pooled results were used to present an overall estimate of the treatment effect using a random-effects model. Results: A total of 22 randomized controlled trials were evaluated. 3 trials demonstrated that immersive virtual reality improved upper limb activity, function and activity of daily life in a way comparable to CT. 18 trials showed that NIVR had similar benefits to CT for upper limb activity and function, balance and mobility, activities of daily living and participation. A comparison between the different forms of VR showed that IVR may be more beneficial than NIVR for upper limb training and activities of daily life. Conclusions: This study found out that IVR therapies may be more effective than NIVR but not CT to improve upper limb activity, function, and daily life activities. However, there is no evidence of the durability of IVR treatment. More research involving studies with larger samples is needed to assess the long-term effects and promising benefits of immersive virtual reality technology.