{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T08:13:09Z","timestamp":1791101589993,"version":"4.1.0"},"reference-count":45,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T00:00:00Z","timestamp":1754352000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Importance<\/jats:title>\n                  <jats:p>Virtual reality (VR) is increasingly used in patients after stroke upper limb rehabilitation, but the comparative effectiveness of VR-Only versus hybrid VR combined with conventional therapy (CT) remains unclear.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>The objective of this review was to systematically review and meta-analyze the effectiveness of 2 distinct VR intervention approaches for patients undergoing hemiparetic upper limb rehabilitation after stroke: VR-Only versus CT, and hybrid interventions combining VR with CT versus CT alone.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Data Sources<\/jats:title>\n                  <jats:p>A PROSPERO protocol (CRD 42022349259) for a comprehensive search was conducted across 7 databases, focusing on studies published in English and Spanish.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Study Selection<\/jats:title>\n                  <jats:p>Randomized controlled trials (RCTs) comparing VR-Only or hybrid VR interventions to CT were included.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Data Extraction and Synthesis<\/jats:title>\n                  <jats:p>Study characteristics, participant demographics, intervention specifics, and outcome measures were extracted. The risk of bias was assessed using the Risk of Bias 2 (RoB 2) tool. Meta-analyses used a random-effects model to estimate standardized mean differences (SMDs) with 95% confidence intervals.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main Outcome(s) and Measure(s)<\/jats:title>\n                  <jats:p>Primary outcomes included motor function, motor capacity, hand dexterity, and functional capacity, measured by validated instruments such as the Fugl-Meyer Assessment and Box and Block Test.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Twenty-seven RCTs (1156 participants) were included. Hybrid VR\u2009+\u2009CT interventions significantly improved motor function (SMD\u2009=\u20090.44) and manual dexterity (SMD\u2009=\u20090.33) compared to CT alone. VR-Only interventions showed positive trends but were not statistically significant. Hybrid interventions maintained benefits at follow-up (SMD\u2009=\u20090.63, 95% CI\u2009=\u20090.11\u20131.15). Optimal improvements were observed with hybrid sessions of 31 to 59\u00a0minutes daily.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Hybrid VR\u2009+\u2009CT interventions are more effective than CT alone, improving motor function and manual dexterity after stroke, with sustained benefits over time. VR-Only interventions showed less consistent effects.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Relevance<\/jats:title>\n                  <jats:p>These results suggest that integrating VR into CT enhances rehabilitation outcomes of stroke survivors. Future research should focus on optimizing hybrid protocols and exploring long-term outcomes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ptj\/pzaf103","type":"journal-article","created":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T11:14:34Z","timestamp":1755602074000},"source":"Crossref","is-referenced-by-count":8,"title":["Use of Virtual Reality in Upper Extremity Rehabilitation of Adults After Stroke and Its Effect on Functionality: Systematic Review and Meta-Analysis"],"prefix":"10.1093","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0449-5015","authenticated-orcid":false,"given":"Yordanis","family":"Enr\u00edquez-Canto","sequence":"first","affiliation":[{"name":"Facultad de Ciencias de la Salud, Universidad Cat\u00f3lica Sedes Sapientiae , Lima, Lima Region ,","place":["Peru"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael","family":"Pizarro-Mena","sequence":"additional","affiliation":[{"name":"Facultad de Ciencias de la Rehabilitaci\u00f3n y Calidad de Vida, Universidad San Sebasti\u00e1n, Sede Los Leones , Santiago, Regi\u00f3n Metropolitana de Santiago ,","place":["Chile"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Ludue\u00f1a-Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Escuela de Kinesiolog\u00eda, Facultad de Salud y Odontolog\u00eda, Universidad Diego Portales , Santiago, Regi\u00f3n Metropolitana de Santiago ,","place":["Chile"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1557-886X","authenticated-orcid":false,"given":"Katherine","family":"Alexandre-Vergara","sequence":"additional","affiliation":[{"name":"Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello , Santiago, Regi\u00f3n Metropolitana de Santiago ,","place":["Chile"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gloria","family":"Riveros-Basoalto","sequence":"additional","affiliation":[{"name":"Bibliotec\u00f3logo referencista, Vicerrector\u00eda Acad\u00e9mica, Universidad San Sebasti\u00e1n , Santiago, Regi\u00f3n Metropolitana de Santiago ,","place":["Chile"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Dresdner-Figueroa","sequence":"additional","affiliation":[{"name":"Bibliotec\u00f3logo referencista, Vicerrector\u00eda Acad\u00e9mica, Universidad San Sebasti\u00e1n , Santiago, Regi\u00f3n Metropolitana de Santiago ,","place":["Chile"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,8,19]]},"reference":[{"issue":"3","key":"2025092519015221700_ref1","doi-asserted-by":"publisher","DOI":"10.3390\/S23031712","article-title":"Immersive virtual reality in post-stroke rehabilitation: a systematic review","volume":"23","author":"Demeco","year":"2023","journal-title":"Sensors (Basel)"},{"issue":"1","key":"2025092519015221700_ref2","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1186\/S12984-018-0370-2","article-title":"What do randomized controlled trials say about virtual rehabilitation in stroke? 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