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.

Abstract

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. The search strategy was conducted in 5 databases (PubMed, Scopus, Web of Science, Embase, and Cochrane Library databases) from inception to December 2023. Randomized controlled trials (RCTs) comparing the effectiveness of standard rehabilitation and VR-based rehabilitation for stroke patients. Data from the included articles were extracted independently by 2 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, sex distribution (the proportion of males), VR type, duration of rehabilitation, comparison, intervention, and assessment of outcome. A total of 29 studies involving 1561 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<.0001)], depression symptoms [SMD=-0.94 (95% CI [-1.46, -0.42], P<.001)], and improved quality of life [SMD=0.94 (95% CI [0.42, 1.45], P<.001)] of stroke patients. Subgroup analysis showed that immersive VR was particularly effective in reducing anxiety and depression symptoms compared to nonimmersive 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. 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 6 weeks in duration, particularly among European patients.