Effects of Virtual Reality–Based Exercise on Balance in Patients With Stroke: A Systematic Review and Meta-analysis

The aim of the study is to quantify the effects of virtual reality–based exercise on balance after stroke. DESIGN: The PubMed, Embase, Cochrane Library, Cumulative Index of Nursing and Allied Health Literature, and Web of Science databases were searched until December 31, 2021. Independent investigators abstracted data, assessed the quality of the evidence, and rated the certainty of the evidence. The intergroup differences were determined by calculating mean difference and 95% confidence interval by RevMan 5.3 software. RESULTS: Fourteen randomized controlled trials involving 423 stroke patients were included. Patients who received virtual reality–based exercise illustrated marked improvements in the Berg Balance Scale (mean difference, 1.35; 95% confidence interval, 0.58 to 1.86; P < 0.00001; I(2) = 44%), Timed Up and Go test (mean difference, −0.81; 95% confidence interval, −1.18 to −0.44; P < 0.0001; I(2) = 0%), Functional Reach Test (mean difference, 3.06; 95% confidence interval, 1.31–4.80; P = 0.0006; I(2) = 0%), 10-Meters Walking Test (mean difference, −1.53; 95% confidence interval, −2.92 to −0.13; P = 0.03; I(2) = 33%), and Modified Barthel Index (mean difference, 5.26; 95% confidence interval, 1.70 to 8.82; P = 0.004; I(2) = 0%) compared with the control group. CONCLUSIONS: Existing low-evidence analyses showed that virtual reality–based exercise could effectively and safely improve balance in chronic stroke. Longer-term virtual reality–based exercise was more effective on functional ability of stroke.