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

Abstract

ObjectiveThe 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 SourcesThe search strategy was conducted in five databases (PubMed, Scopus, Web of Science, Embase, and Cochrane Library databases) from inception to December 2023. Study SelectionRandomized controlled trials (RCTs) comparing the effectiveness of standard rehabilitation and VR-based rehabilitation for stroke patients. Data ExtractionData 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 SynthesisA 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. ConclusionsVR-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.