Virtual Reality, a Neuroergonomic and Neurorehabilitation Tool for Promoting Neuroplasticity in Stroke Survivors: A Systematic Review with Meta-analysis

Virtual Reality (VR) is an emerging neuroergonomics tool for stroke rehabilitation. It can be employed to promote post-stroke recovery during rehabilitation as a result of its neuroplasticity enhancing effects. This study systematically reviewed and meta-synthesised evidence on the effectiveness of virtual reality on selected markers of neuroplasticity among stroke survivors (SSv). The databases searched were PEDro, CINHAL, the Cochrane Library, and PUBMed using combinations of Medical subject heading (MeSH) terms and keywords in the titles, abstracts and text for the population, intervention and major outcome (PICO format). The studies included were randomized clinical trials that compared the effects VR among adult SSv. The PEDro scale was used for quality appraisal of the included studies. Forest plot (RevMan version 5.3) was used for the metasynthesis of the results, level of significance was set at α = 0.05. A total of 6 studies were included in the meta-analysis (involving 441 stroke survivors). The pooled effects on the improvement in motor function (SMD = −1.05; CI = −1.53, −0.56, Z = 4.22, p < 0.0001, I2 = 93%) and balance performance (SMD = −3.06; CI = −3.80, −2.32, Z = 8.11, p < 0.0001, I2 = 94%) was significantly in the favour of VR. There is evidence that virtual reality is an effective neuroergonomics modality for encouraging neuroplasticity through its effects on the motor function, balance and muscle strength of stroke survivors.