The effect of virtual reality-based rehabilitation on mental health and quality of life of stroke patients: a systematic review and meta-analysis of randomized controlled trials.

Objective: The aim of this study was to conduct a meta-analysis to investigate the effect of virtual reality (VR)-based rehabilitation on the mental health and quality of life of stroke patients.

Data sources: The search strategy was conducted in five databases (PubMed, Scopus, Web of Science, Embase, and Cochrane Library databases) from inception to December 2023.

Study selection: Randomized controlled trials (RCTs) comparing the effectiveness of standard rehabilitation and VR-based rehabilitation for stroke patients.

Data extraction: Data from the included articles were extracted independently by two authors, with any disagreements resolved through consultation with a third author. The extracted data included the first author's name, country/region, publication year, sample size, mean/median age of participants, gender distribution (the proportion of males), VR type, duration of rehabilitation, comparison, intervention, and assessment of outcome.

Data synthesis: A total of 29 studies involving 1,561 stroke patients were included. The results showed that compared with standard rehabilitation, VR-based rehabilitation remarkably reduced anxiety symptoms [SMD=-0.97 (95% CI [-1.84, -0.09], P <0.0001)], depression symptoms [SMD=-0.94 (95% CI [-1.46, -0.42], P <0.001)], and improved quality of life [SMD=0.94 (95% CI [0.42, 1.45], P <0.001)] of stroke patients. Subgroup analysis showed that immersive VR was particularly effective in reducing anxiety and depression symptoms compared to non-immersive VR. The longer the duration of VR intervention, exceeding 6 weeks, the more significant the effect of improving anxiety and depression symptoms. Meanwhile, VR-based rehabilitation significantly improved the psychological state and quality of life of European patients.

Conclusions: VR-based rehabilitation significantly reduces anxiety and depression symptoms and enhances the quality of life in stroke patients compared to standard rehabilitation. The most notable improvements were observed with immersive VR-based rehabilitation programs over six weeks in duration, particularly among European patients.