{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T06:17:58Z","timestamp":1792649878476,"version":"4.5.0"},"reference-count":125,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2020,10,21]],"date-time":"2020-10-21T00:00:00Z","timestamp":1603238400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Trade Industry and Energy (Korea), Ministry of Science and Information and Communications Technology (Korea), and the Ministry of Health and Welfare (Korea) under the Technology Development Program for AI-Bio-Robot-Medicine Convergence","award":["20001650"],"award-info":[{"award-number":["20001650"]}]},{"name":"Seoul National University Bundang Hospital (SNUBH) Research Fund","award":["02-2016-032"],"award-info":[{"award-number":["02-2016-032"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Neurorehabilitation for stroke is important for upper limb motor recovery. Conventional rehabilitation such as occupational therapy has been used, but novel technologies are expected to open new opportunities for better recovery. Virtual reality (VR) is a technology with a set of informatics that provides interactive environments to patients. VR can enhance neuroplasticity and recovery after a stroke by providing more intensive, repetitive, and engaging training due to several advantages, including: (1) tasks with various difficulty levels for rehabilitation, (2) augmented real-time feedback, (3) more immersive and engaging experiences, (4) more standardized rehabilitation, and (5) safe simulation of real-world activities of daily living. In this comprehensive narrative review of the application of VR in motor rehabilitation after stroke, mainly for the upper limbs, we cover: (1) the technologies used in VR rehabilitation, including sensors; (2) the clinical application of and evidence for VR in stroke rehabilitation; and (3) considerations for VR application in stroke rehabilitation. Meta-analyses for upper limb VR rehabilitation after stroke were identified by an online search of Ovid-MEDLINE, Ovid-EMBASE, the Cochrane Library, and KoreaMed. We expect that this review will provide insights into successful clinical applications or trials of VR for motor rehabilitation after stroke.<\/jats:p>","DOI":"10.3390\/jcm9103369","type":"journal-article","created":{"date-parts":[[2020,10,22]],"date-time":"2020-10-22T20:51:00Z","timestamp":1603399860000},"page":"3369","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":216,"title":["Clinical Application of Virtual Reality for Upper Limb Motor Rehabilitation in Stroke: Review of Technologies and Clinical Evidence"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1199-5707","authenticated-orcid":false,"given":"Won-Seok","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do 13620, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2421-5116","authenticated-orcid":false,"given":"Sungmin","family":"Cho","sequence":"additional","affiliation":[{"name":"Delvine Inc., Seoul 08788, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9610-0078","authenticated-orcid":false,"given":"Jeonghun","family":"Ku","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, College of Medicine, Keimyung University, Daegu 42601, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuhee","family":"Kim","sequence":"additional","affiliation":[{"name":"Ybrain Research Institute, Seongnam-si, Gyeonggi-do 13449, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiwon","family":"Lee","sequence":"additional","affiliation":[{"name":"Ybrain Research Institute, Seongnam-si, Gyeonggi-do 13449, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1183-1219","authenticated-orcid":false,"given":"Han-Jeong","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Electronics and Information, Korea University, Sejong 30019, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5193-8678","authenticated-orcid":false,"given":"Nam-Jong","family":"Paik","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do 13620, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,10,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1016\/S1474-4422(19)30034-1","article-title":"Global, regional, and national burden of stroke, 1990\u20132016: A systematic analysis for the Global Burden of Disease Study 2016","volume":"18","author":"Collaborators","year":"2019","journal-title":"Lancet Neurol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.1016\/S0072-9752(08)94063-X","article-title":"The future of stroke prevention by risk factor modification","volume":"94","author":"Gorelick","year":"2009","journal-title":"Handb. Clin. Neurol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2361","DOI":"10.1161\/STR.0b013e31829734f2","article-title":"Forecasting the future of stroke in the United States: A policy statement from the American Heart Association and American Stroke Association","volume":"44","author":"Ovbiagele","year":"2013","journal-title":"Stroke"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1161\/01.STR.32.6.1279","article-title":"Estimates of the prevalence of acute stroke impairments and disability in a multiethnic population","volume":"32","author":"Lawrence","year":"2001","journal-title":"Stroke"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1016\/j.jht.2011.01.002","article-title":"Upper extremity function in stroke subjects: Relationships between the international classification of functioning, disability, and health domains","volume":"24","author":"Michaelsen","year":"2011","journal-title":"J. Hand Ther."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1093\/ageing\/afv060","article-title":"Health-related quality of life is associated with stroke deficits in older adults","volume":"44","author":"Min","year":"2015","journal-title":"Age Ageing"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Kwon, S., Park, J.H., Kim, W.S., Han, K., Lee, Y., and Paik, N.J. (2018). Health-related quality of life and related factors in stroke survivors: Data from Korea National Health and Nutrition Examination Survey (KNHANES) 2008 to 2014. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0195713"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e98","DOI":"10.1161\/STR.0000000000000098","article-title":"Guidelines for Adult Stroke Rehabilitation and Recovery: A Guideline for Healthcare Professionals from the American Heart Association\/American Stroke Association","volume":"47","author":"Winstein","year":"2016","journal-title":"Stroke"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2053","DOI":"10.1161\/STROKEAHA.114.004695","article-title":"Is more better? Using metadata to explore dose-response relationships in stroke rehabilitation","volume":"45","author":"Lohse","year":"2014","journal-title":"Stroke"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1177\/0888439003259415","article-title":"Treatment interventions for the paretic upper limb of stroke survivors: A critical review","volume":"17","author":"Barreca","year":"2003","journal-title":"Neurorehabil. Neural Repair"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"415","DOI":"10.2522\/ptj.20130579","article-title":"Emergence of virtual reality as a tool for upper limb rehabilitation: Incorporation of motor control and motor learning principles","volume":"95","author":"Levin","year":"2015","journal-title":"Phys. Ther."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"S225","DOI":"10.1044\/1092-4388(2008\/018)","article-title":"Principles of experience-dependent neural plasticity: Implications for rehabilitation after brain damage","volume":"51","author":"Kleim","year":"2008","journal-title":"J. Speech Lang. Hear. Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1093\/ptj\/82.9.898","article-title":"Virtual reality-augmented rehabilitation for patients following stroke","volume":"82","author":"Merians","year":"2002","journal-title":"Phys. Ther."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1007\/s00371-009-0387-4","article-title":"Optimising engagement for stroke rehabilitation using serious games","volume":"25","author":"Burke","year":"2009","journal-title":"Vis. Comput."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1162\/PRES_a_00078","article-title":"Virtual rehabilitation environment using principles of intrinsic motivation and game design","volume":"21","author":"Mihelj","year":"2012","journal-title":"Presence Teleoperators Virtual Environ."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e11173","DOI":"10.1097\/MD.0000000000011173","article-title":"A low cost kinect-based virtual rehabilitation system for inpatient rehabilitation of the upper limb in patients with subacute stroke: A randomized, double-blind, sham-controlled pilot trial","volume":"97","author":"Kim","year":"2018","journal-title":"Medicine"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1109\/TNSRE.2007.891388","article-title":"Telerehabilitation using a virtual environment improves upper extremity function in patients with stroke","volume":"15","author":"Holden","year":"2007","journal-title":"IEEE Trans. Neural Syst. Rehabil Eng."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Kim, W.S., Cho, S., Baek, D., Bang, H., and Paik, N.J. (2016). Upper Extremity Functional Evaluation by Fugl-Meyer Assessment Scoring Using Depth-Sensing Camera in Hemiplegic Stroke Patients. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0158640"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1162\/pres.1997.6.6.603","article-title":"A Framework for Immersive Virtual Environments (FIVE): Speculations on the Role of Presence in Virtual Environments","volume":"6","author":"Slater","year":"1997","journal-title":"Presence Teleoperators Virtual Environ."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"3549","DOI":"10.1098\/rstb.2009.0138","article-title":"Place illusion and plausibility can lead to realistic behaviour in immersive virtual environments","volume":"364","author":"Slater","year":"2009","journal-title":"Philos. Trans. R. Soc. Lond. B Biol. Sci."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1162\/PRES_a_00263","article-title":"When Does Virtual Embodiment Change Our Minds?","volume":"25","author":"Bailey","year":"2016","journal-title":"Presence Teleoperators Virtual Environ."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2509","DOI":"10.3389\/fpsyg.2019.02509","article-title":"Immersive Versus Non-immersive Experience: Exploring the Feasibility of Memory Assessment through 360 degrees Technology","volume":"10","author":"Ventura","year":"2019","journal-title":"Front. Psychol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1145\/271283.271303","article-title":"The ImmersaDesk and infinity wall projection-based virtual reality displays","volume":"31","author":"Czernuszenko","year":"1997","journal-title":"ACM Siggraph Comput. Graph."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1145\/129888.129892","article-title":"The CAVE: Audio visual experience automatic virtual environment","volume":"35","author":"Sandin","year":"1992","journal-title":"Commun. ACM"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1016\/j.ijpsycho.2011.12.003","article-title":"Cortical correlate of spatial presence in 2D and 3D interactive virtual reality: An EEG study","volume":"83","author":"Kober","year":"2012","journal-title":"Int. J. Psychophysiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1080\/15213260701283079","article-title":"A Process Model of the Formation of Spatial Presence Experiences","volume":"9","author":"Wirth","year":"2007","journal-title":"Media Psychol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"6586","DOI":"10.3390\/s150306586","article-title":"Tracking systems for virtual rehabilitation: Objective performance vs. subjective experience. A practical scenario","volume":"15","author":"Naranjo","year":"2015","journal-title":"Sensors"},{"key":"ref_28","unstructured":"Abedin-Nasab, M.H. (2020). Center for Advanced Surgical and Interventional Technology Multimodal Haptic Feedback for Robotic Surgery. Handbook of Robotic and Image-Guided Surgery, Elsevier."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"462","DOI":"10.3109\/17483107.2015.1027293","article-title":"Upper limb rehabilitation after spinal cord injury: A treatment based on a data glove and an immersive virtual reality environment","volume":"11","author":"Aznar","year":"2016","journal-title":"Disabil. Rehabil. Assist. Technol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"798","DOI":"10.1177\/0269215511434575","article-title":"Virtual reality in the rehabilitation of the arm after hemiplegic stroke: A randomized controlled pilot study","volume":"26","author":"Crosbie","year":"2012","journal-title":"Clin. Rehabil."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1016\/j.clinph.2019.02.013","article-title":"Does hand robotic rehabilitation improve motor function by rebalancing interhemispheric connectivity after chronic stroke? Encouraging data from a randomised-clinical-trial","volume":"130","author":"Accorinti","year":"2019","journal-title":"Clin. Neurophysiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1016\/j.apmr.2018.01.023","article-title":"Virtual Reality for Upper Limb Rehabilitation in Subacute and Chronic Stroke: A Randomized Controlled Trial","volume":"99","author":"Kiper","year":"2018","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1109\/MCG.2015.2","article-title":"Upper-Limb Function Assessment Using VBBTs for Stroke Patients","volume":"36","author":"Cho","year":"2016","journal-title":"IEEE Comput. Graph. Appl."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1080\/08990220.2018.1444599","article-title":"Effects of Kinect-based virtual reality game training on upper extremity motor recovery in chronic stroke","volume":"35","author":"Askin","year":"2018","journal-title":"Somatosens. Mot. Res."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"854","DOI":"10.3389\/fpsyg.2018.00854","article-title":"Combined Cognitive-Motor Rehabilitation in Virtual Reality Improves Motor Outcomes in Chronic Stroke\u2014A Pilot Study","volume":"9","author":"Faria","year":"2018","journal-title":"Front. Psychol."},{"key":"ref_36","first-page":"2590","article-title":"Game-Based Virtual Reality Canoe Paddling Training to Improve Postural Balance and Upper Extremity Function: A Preliminary Randomized Controlled Study of 30 Patients with Subacute Stroke","volume":"24","author":"Lee","year":"2018","journal-title":"Med. Sci. Monit. Int. Med. J. Exp. Clin. Res."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1109\/TNSRE.2013.2293673","article-title":"Gesture therapy: An upper limb virtual reality-based motor rehabilitation platform","volume":"22","author":"Sucar","year":"2014","journal-title":"IEEE Trans. Neural Syst. Rehabil. Eng."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e15","DOI":"10.2196\/games.6773","article-title":"Domiciliary VR-Based Therapy for Functional Recovery and Cortical Reorganization: Randomized Controlled Trial in Participants at the Chronic Stage Post Stroke","volume":"5","author":"Ballester","year":"2017","journal-title":"JMIR Serious Games"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"55","DOI":"10.3109\/17483107.2011.562959","article-title":"Bilateral upper limb trainer with virtual reality for post-stroke rehabilitation: Case series report","volume":"7","author":"Sampson","year":"2012","journal-title":"Disabil. Rehabil. Assist. Technol."},{"key":"ref_40","unstructured":"Xin, W., Duan, F., Yong, Y., Tan, J.T.C., and Xiaomin, C. (July, January 29). Design of A Multi-functional System Based on Virtual Reality for Stroke Rehabilitation. Proceedings of the 11th World Congress on Intelligent Control and Automation, Shenyang, China."},{"key":"ref_41","first-page":"129","article-title":"Integrating haptic-tactile feedback into a video-capture-based virtual environment for rehabilitation","volume":"9","author":"Feintuch","year":"2006","journal-title":"Cyberpsychol. Behav. Impact Internetmultimedia Virtual Real. Behav. Soc."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1109\/4233.826858","article-title":"A virtual-reality-based telerehabilitation system with force feedback","volume":"4","author":"Popescu","year":"2000","journal-title":"IEEE Trans. Inf. Technol. Biomed. A Publ. IEEE Eng. Med. Biol. Soc."},{"key":"ref_43","unstructured":"Prisco, G.M., Avizzano, C.A., Calcara, M., Ciancio, S., Pinna, S., and Bergamasco, M. (1998, January 20). A virtual environment with haptic feedback for the treatment of motor dexterity disabilities. Proceedings of the 1998 IEEE International Conference on Robotics and Automation (Cat. No.98CH36146), Leuven, Belgium."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1876","DOI":"10.1109\/TIM.2008.919878","article-title":"Haptic Virtual Rehabilitation Exercises for Poststroke Diagnosis","volume":"57","author":"Alamri","year":"2008","journal-title":"IEEE Trans. Instrum. Meas."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Kayyali, R., Shirmohammadi, S., Saddik, A.E., and Lemaire, E. (2007, January 12\u201314). Daily-Life Exercises for Haptic Motor Rehabilitation. Proceedings of the 2007 IEEE International Workshop on Haptic, Audio and Visual Environments and Games, Ottawa, ON, Canada.","DOI":"10.1109\/HAVE.2007.4371599"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1186\/1743-0003-6-28","article-title":"Design of a complex virtual reality simulation to train finger motion for persons with hemiparesis: A proof of concept study","volume":"6","author":"Adamovich","year":"2009","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1682\/JRRD.2010.07.0128","article-title":"Effect of position feedback during task-oriented upper-limb training after stroke: Five-case pilot study","volume":"48","author":"Molier","year":"2011","journal-title":"J. Rehabil. Res. Dev."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1109\/7333.948460","article-title":"Virtual reality-enhanced stroke rehabilitation","volume":"9","author":"Jack","year":"2001","journal-title":"IEEE Trans. Neural Syst. Rehabil. Eng."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1080\/17518420902773117","article-title":"Virtual reality-based paediatric interactive therapy system (PITS) for improvement of arm and hand function in children with motor impairment\u2014A pilot study","volume":"12","author":"Wille","year":"2009","journal-title":"Dev. Neurorehabilit."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Connelly, L., Stoykov, M.E., Jia, Y., Toro, M.L., Kenyon, R.V., and Kamper, D.G. (2009, January 3\u20136). Use of a pneumatic glove for hand rehabilitation following stroke. Proceedings of the 2009 Annual International Conference of the IEEE Engineering in Medicine and Biology Society, Minneapolis, MN, USA.","DOI":"10.1109\/IEMBS.2009.5335400"},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Huang, X., Naghdy, F., Naghdy, G., and Du, H. (2017, January 17\u201320). Clinical effectiveness of combined virtual reality and robot assisted fine hand motion rehabilitation in subacute stroke patients. Proceedings of the 2017 International Conference on Rehabilitation Robotics (ICORR), London, UK.","DOI":"10.1109\/ICORR.2017.8009299"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Pignolo, L., Dolce, G., Basta, G., Lucca, L.F., Serra, S., and Sannita, W.G. (2012, January 24\u201327). Upper limb rehabilitation after stroke: ARAMIS a \u201crobo-mechatronic\u201d innovative approach and prototype. Proceedings of the 2012 4th IEEE RAS & EMBS International Conference on Biomedical Robotics and Biomechatronics (BioRob), Rome, Italy.","DOI":"10.1109\/BioRob.2012.6290868"},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Andaluz, V.H., Salazar, P.J., Silva, S.M., Escudero, V.M., and Bustamante, D.C. (2016, January 19\u201321). Rehabilitation of upper limb with force feedback. Proceedings of the 2016 IEEE International Conference on Automatica (ICA-ACCA), Curico, Chile.","DOI":"10.1109\/ICA-ACCA.2016.7778419"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1109\/3516.951363","article-title":"Upper limb motion analysis using haptic interface","volume":"6","author":"Bardorfer","year":"2001","journal-title":"IEEE\/ASME Trans. Mechatron."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1247","DOI":"10.1016\/j.apmr.2003.09.020","article-title":"Virtual reality and haptics as a training device for movement rehabilitation after stroke: A single-case","volume":"85","author":"Broeren","year":"2004","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1109\/TNSRE.2009.2028830","article-title":"Incorporating Haptic Effects Into Three-Dimensional Virtual Environments to Train the Hemiparetic Upper Extremity","volume":"17","author":"Adamovich","year":"2009","journal-title":"IEEE Trans. Neural Syst. Rehabil. Eng."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1186\/1743-0003-8-27","article-title":"Robotically facilitated virtual rehabilitation of arm transport integrated with finger movement in persons with hemiparesis","volume":"8","author":"Merians","year":"2011","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Nagaraj, S.B., and Constantinescu, D. (2009, January 16\u201318). Effect of Haptic Force Feedback on Upper Limb. Proceedings of the 2009 Second International Conference on Emerging Trends in Engineering & Technology, Nagpur, India.","DOI":"10.1109\/ICETET.2009.85"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1080\/17483107.2016.1218554","article-title":"Rehabilitation of activities of daily living in virtual environments with intuitive user interface and force feedback","volume":"12","author":"Chiang","year":"2017","journal-title":"Disabil. Rehabil. Assist. Technol."},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Sadihov, D., Migge, B., Gassert, R., and Kim, Y. (2013, January 14\u201317). Prototype of a VR upper-limb rehabilitation system enhanced with motion-based tactile feedback. Proceedings of the 2013 World Haptics Conference (WHC), Daejeon, Korea.","DOI":"10.1109\/WHC.2013.6548450"},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Kapur, P., Premakumar, S., Jax, S.A., Buxbaum, L.J., Dawson, A.M., and Kuchenbecker, K.J. (2009, January 18\u201320). Vibrotactile feedback system for intuitive upper-limb rehabilitation. Proceedings of the World Haptics 2009\u2014Third Joint EuroHaptics Conference and Symposium on Haptic Interfaces for Virtual Environment and Teleoperator Systems, Salt Lake City, UT, USA.","DOI":"10.1109\/WHC.2009.4810918"},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Ram\u00edrez-Fern\u00e1ndez, C., Mor\u00e1n, A.L., and Garc\u00eda-Canseco, E. (2015, January 20\u201323). Haptic feedback in motor hand virtual therapy increases precision and generates less mental workload. Proceedings of the 2015 9th International Conference on Pervasive Computing Technologies for Healthcare (PervasiveHealth), Istanbul, Turkey.","DOI":"10.4108\/icst.pervasivehealth.2015.260242"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1186\/s12984-018-0370-2","article-title":"What do randomized controlled trials say about virtual rehabilitation in stroke? A systematic literature review and meta-analysis of upper-limb and cognitive outcomes","volume":"15","author":"Aminov","year":"2018","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Lohse, K.R., Hilderman, C.G., Cheung, K.L., Tatla, S., and Van der Loos, H.F. (2014). Virtual reality therapy for adults post-stroke: A systematic review and meta-analysis exploring virtual environments and commercial games in therapy. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0093318"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1080\/02699052.2020.1725126","article-title":"Virtual reality therapy for upper limb rehabilitation in patients with stroke: A meta-analysis of randomized clinical trials","volume":"34","author":"Mekbib","year":"2020","journal-title":"Brain Inj."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1016\/j.apmr.2019.10.195","article-title":"Effectiveness of Virtual Reality- and Gaming-Based Interventions for Upper Extremity Rehabilitation Poststroke: A Meta-analysis","volume":"101","author":"Karamians","year":"2020","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"7595639","DOI":"10.1155\/2019\/7595639","article-title":"The Effects of Virtual Reality Training on Function in Chronic Stroke Patients: A Systematic Review and Meta-Analysis","volume":"2019","author":"Lee","year":"2019","journal-title":"BioMed Res. Int."},{"key":"ref_68","first-page":"Cd008349","article-title":"Virtual reality for stroke rehabilitation","volume":"11","author":"Laver","year":"2017","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"j4008","DOI":"10.1136\/bmj.j4008","article-title":"AMSTAR 2: A critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both","volume":"358","author":"Shea","year":"2017","journal-title":"BMJ"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1693","DOI":"10.1016\/j.apmr.2008.02.022","article-title":"Estimating minimal clinically important differences of upper-extremity measures early after stroke","volume":"89","author":"Lang","year":"2008","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"181","DOI":"10.2340\/16501977-0674","article-title":"Systematic review of outcome measures used in the evaluation of robot-assisted upper limb exercise in stroke","volume":"43","author":"Sivan","year":"2011","journal-title":"J. Rehabil. Med."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1139\/y90-044","article-title":"Motion sickness: A synthesis and evaluation of the sensory conflict theory","volume":"68","author":"Oman","year":"1990","journal-title":"Can. J. Physiol. Pharm."},{"key":"ref_73","unstructured":"Qualcomm Developer Network (2020, October 20). Reducing Cybersickness in Virtual Reality: What is Cybersickness and how it can be Reduced or Prevented when Developing Virtual Reality Experiences. Available online: https:\/\/developer.qualcomm.com\/ebook\/reducing-cybersickness-virtual-reality."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/1743-0003-1-11","article-title":"Reaching in reality and virtual reality: A comparison of movement kinematics in healthy subjects and in adults with hemiparesis","volume":"1","author":"Viau","year":"2004","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"300","DOI":"10.3389\/fneur.2018.00300","article-title":"Upper Limb Kinematics in Stroke and Healthy Controls Using Target-to-Target Task in Virtual Reality","volume":"9","author":"Hussain","year":"2018","journal-title":"Front. Neurol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1016\/j.actpsy.2011.05.015","article-title":"Comparison of grasping movements made by healthy subjects in a 3-dimensional immersive virtual versus physical environment","volume":"138","author":"Magdalon","year":"2011","journal-title":"Acta Psychol."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1109\/TNSRE.2014.2387412","article-title":"Quality of Grasping and the Role of Haptics in a 3-D Immersive Virtual Reality Environment in Individuals With Stroke","volume":"23","author":"Levin","year":"2015","journal-title":"IEEE Trans. Neural Syst. Rehabil. Eng."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1089\/109493103769710505","article-title":"The effect of two types of virtual reality on voluntary center of pressure displacement","volume":"6","author":"Lott","year":"2003","journal-title":"Cyberpsychology Behav."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"1383","DOI":"10.1161\/STROKEAHA.111.000559","article-title":"Method for enhancing real-world use of a more affected arm in chronic stroke: Transfer package of constraint-induced movement therapy","volume":"44","author":"Taub","year":"2013","journal-title":"Stroke"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1186\/1743-0003-11-111","article-title":"Training modalities in robot-mediated upper limb rehabilitation in stroke: A framework for classification based on a systematic review","volume":"11","author":"Basteris","year":"2014","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1186\/s12984-019-0587-8","article-title":"Learning and transfer of complex motor skills in virtual reality: A perspective review","volume":"16","author":"Levac","year":"2019","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1080\/001401300184378","article-title":"Training in virtual environments: Transfer to real world tasks and equivalence to real task training","volume":"43","author":"Rose","year":"2000","journal-title":"Ergonomics"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"2430","DOI":"10.1016\/j.ridd.2014.06.006","article-title":"Transfer of motor learning from virtual to natural environments in individuals with cerebral palsy","volume":"35","author":"Massetti","year":"2014","journal-title":"Res. Dev. Disabil."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1089\/g4h.2016.0088","article-title":"Achievement of Virtual and Real Objects Using a Short-Term Motor Learning Protocol in People with Duchenne Muscular Dystrophy: A Crossover Randomized Controlled Trial","volume":"7","author":"Massetti","year":"2018","journal-title":"Games Health J."},{"key":"ref_85","doi-asserted-by":"crossref","unstructured":"Anglin, J., Saldana, D., Schmiesing, A., and Liew, S.-L. (2017, January 18\u201322). Transfer of a skilled motor learning task between virtual and conventional environments. Proceedings of the 2017 IEEE Virtual Reality (VR), Los Angeles, CA, USA.","DOI":"10.1109\/VR.2017.7892346"},{"key":"ref_86","doi-asserted-by":"crossref","unstructured":"Levac, D.E., and Jovanovic, B.B. (2017, January 19\u201322). Is children\u2019s motor learning of a postural reaching task enhanced by practice in a virtual environment?. Proceedings of the 2017 International Conference on Virtual Rehabilitation (ICVR), Montreal, QC, Canada.","DOI":"10.1109\/ICVR.2017.8007489"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.1002\/bjs.10528","article-title":"Impact of simulated three-dimensional perception on precision of depth judgements, technical performance and perceived workload in laparoscopy","volume":"104","author":"Sakata","year":"2017","journal-title":"Br. J. Surg."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1007\/978-3-030-37639-0_4","article-title":"Virtual Reality Design for Stroke Rehabilitation","volume":"1235","author":"Charles","year":"2020","journal-title":"Adv. Exp. Med. Biol."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1145\/2947617","article-title":"An empirical evaluation of visuo-haptic feedback on physical reaching behaviors during 3D interaction in real and immersive virtual environments","volume":"13","author":"Ebrahimi","year":"2016","journal-title":"ACM Trans. Appl. Percept. TAP"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"8289","DOI":"10.1523\/JNEUROSCI.4455-13.2014","article-title":"Learning redundant motor tasks with and without overlapping dimensions: Facilitation and interference effects","volume":"34","author":"Ranganathan","year":"2014","journal-title":"J. Neurosci."},{"key":"ref_91","doi-asserted-by":"crossref","unstructured":"Deterding, S., Dixon, D., Khaled, R., and Nacke, L. (2011, January 28\u201330). From game design elements to gamefulness: Defining \u201cgamification\u201d. Proceedings of the 15th International Academic MindTrek Conference: Envisioning Future Media Environments, Tampere, Finland.","DOI":"10.1145\/2181037.2181040"},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"855","DOI":"10.3109\/02699052.2016.1144146","article-title":"Virtual reality gaming in the rehabilitation of the upper extremities post-stroke","volume":"30","author":"Yates","year":"2016","journal-title":"Brain Inj."},{"key":"ref_93","doi-asserted-by":"crossref","unstructured":"Mubin, O., Alnajjar, F., Al Mahmud, A., Jishtu, N., and Alsinglawi, B. (2020). Exploring serious games for stroke rehabilitation: A scoping review. Disabil. Rehabil. Assist. Technol., 1\u20137.","DOI":"10.1080\/17483107.2020.1768309"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1186\/1743-0003-11-32","article-title":"A task-specific interactive game-based virtual reality rehabilitation system for patients with stroke: A usability test and two clinical experiments","volume":"11","author":"Shin","year":"2014","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1007\/s11257-015-9154-6","article-title":"Adaptation in serious games for upper-limb rehabilitation: An approach to improve training outcomes","volume":"25","author":"Hocine","year":"2015","journal-title":"User Modeling User-Adapt. Interact."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1089\/g4h.2016.0089","article-title":"Virtual Reality and Active Videogame-Based Practice, Learning Needs, and Preferences: A Cross-Canada Survey of Physical Therapists and Occupational Therapists","volume":"6","author":"Levac","year":"2017","journal-title":"Games Health J."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"1237","DOI":"10.1016\/j.pmrj.2018.07.004","article-title":"Barriers, Facilitators and Interventions to Support Virtual Reality Implementation in Rehabilitation: A Scoping Review","volume":"10","author":"Glegg","year":"2018","journal-title":"PM&R"},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1161\/01.STR.31.1.223","article-title":"Brain plasticity and stroke rehabilitation. The Willis lecture","volume":"31","author":"Johansson","year":"2000","journal-title":"Stroke"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1146\/annurev.neuro.27.070203.144216","article-title":"The plastic human brain cortex","volume":"28","author":"Amedi","year":"2005","journal-title":"Annu. Rev. Neurosci."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1038\/nrn1970","article-title":"Enriched environments, experience-dependent plasticity and disorders of the nervous system","volume":"7","author":"Nithianantharajah","year":"2006","journal-title":"Nat. Rev. Neurosci."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1002\/acn3.544","article-title":"Brain-computer interfaces for post-stroke motor rehabilitation: A meta-analysis","volume":"5","author":"Cervera","year":"2018","journal-title":"Ann. Clin. Transl. Neurol."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.rehab.2014.09.016","article-title":"Brain computer interfaces for neurorehabilitation\u2014Its current status as a rehabilitation strategy post-stroke","volume":"58","author":"Ward","year":"2015","journal-title":"Ann. Phys. Rehabil. Med."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1002\/ana.24390","article-title":"Brain-computer interface boosts motor imagery practice during stroke recovery","volume":"77","author":"Pichiorri","year":"2015","journal-title":"Ann. Neurol."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"210","DOI":"10.3389\/fnhum.2019.00210","article-title":"Effects of a Brain-Computer Interface With Virtual Reality (VR) Neurofeedback: A Pilot Study in Chronic Stroke Patients","volume":"13","author":"Vourvopoulos","year":"2019","journal-title":"Front. Hum. Neurosci."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"1844","DOI":"10.1001\/archneur.61.12.1844","article-title":"Mechanisms underlying recovery of motor function after stroke","volume":"61","author":"Ward","year":"2004","journal-title":"Arch. Neurol."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"1641","DOI":"10.1016\/j.clinph.2006.01.016","article-title":"Arm function after stroke: Neurophysiological correlates and recovery mechanisms assessed by transcranial magnetic stimulation","volume":"117","author":"Talelli","year":"2006","journal-title":"Clin. Neurophysiol."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1016\/S1474-4422(06)70525-7","article-title":"Non-invasive brain stimulation: A new strategy to improve neurorehabilitation after stroke?","volume":"5","author":"Hummel","year":"2006","journal-title":"Lancet Neurol."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1212\/01.wnl.0000173067.84247.36","article-title":"Therapeutic trial of repetitive transcranial magnetic stimulation after acute ischemic stroke","volume":"65","author":"Khedr","year":"2005","journal-title":"Neurology"},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1016\/j.clinph.2005.12.003","article-title":"Transcranial DC stimulation (tDCS): A tool for double-blind sham-controlled clinical studies in brain stimulation","volume":"117","author":"Gandiga","year":"2006","journal-title":"Clin. Neurophysiol."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1093\/brain\/awh369","article-title":"Effects of non-invasive cortical stimulation on skilled motor function in chronic stroke","volume":"128","author":"Hummel","year":"2005","journal-title":"Brain"},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"1802","DOI":"10.1212\/01.WNL.0000161839.38079.92","article-title":"A sham stimulation-controlled trial of rTMS of the unaffected hemisphere in stroke patients","volume":"64","author":"Mansur","year":"2005","journal-title":"Neurology"},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"856","DOI":"10.1177\/1545968320948610","article-title":"Low-frequency repetitive transcranial magnetic stimulation over contralesional motor cortex for motor recovery in subacute ischemic stroke: A randomized sham-controlled trial","volume":"34","author":"Kim","year":"2020","journal-title":"Neurorehabil. Neural Repair"},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"1551","DOI":"10.1097\/01.wnr.0000177010.44602.5e","article-title":"Transcranial direct current stimulation of the unaffected hemisphere in stroke patients","volume":"16","author":"Fregni","year":"2005","journal-title":"Neuroreport"},{"key":"ref_114","doi-asserted-by":"crossref","unstructured":"Vines, B.W., Cerruti, C., and Schlaug, G. (2008). Dual-hemisphere tDCS facilitates greater improvements for healthy subjects\u2019 non-dominant hand compared to uni-hemisphere stimulation. BMC Neurosci., 9.","DOI":"10.1186\/1471-2202-9-103"},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1002\/ana.20170","article-title":"Influence of somatosensory input on motor function in patients with chronic stroke","volume":"56","author":"Floel","year":"2004","journal-title":"Ann. Neurol."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1161\/01.STR.0000195130.16843.ac","article-title":"Effects of somatosensory stimulation on use-dependent plasticity in chronic stroke","volume":"37","author":"Sawaki","year":"2006","journal-title":"Stroke"},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"2008","DOI":"10.1016\/j.clinph.2009.08.016","article-title":"Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research","volume":"120","author":"Rossi","year":"2009","journal-title":"Clin. Neurophysiol."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/j.brs.2017.10.012","article-title":"Limited output transcranial electrical stimulation (LOTES-2017): Engineering principles, regulatory statutes, and industry standards for wellness, over-the-counter, or prescription devices with low risk","volume":"11","author":"Bikson","year":"2018","journal-title":"Brain Stimul."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1007\/s11596-015-1419-0","article-title":"Effect of combined low-frequency repetitive transcranial magnetic stimulation and virtual reality training on upper limb function in subacute stroke: A double-blind randomized controlled trail","volume":"35","author":"Zheng","year":"2015","journal-title":"J. Huazhong Univ. Sci. Technol. Med. Sci."},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"016009","DOI":"10.1088\/1741-2552\/aa8ce3","article-title":"Combined rTMS and virtual reality brain-computer interface training for motor recovery after stroke","volume":"15","author":"Johnson","year":"2018","journal-title":"J. Neural Eng."},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1016\/j.apmr.2013.10.027","article-title":"Combination transcranial direct current stimulation and virtual reality therapy for upper extremity training in patients with subacute stroke","volume":"95","author":"Lee","year":"2014","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"2306","DOI":"10.1016\/j.jstrokecerebrovasdis.2018.05.013","article-title":"Tele-Rehabilitation after Stroke: An Updated Systematic Review of the Literature","volume":"27","author":"Sarfo","year":"2018","journal-title":"J. Stroke Cereb. Dis"},{"key":"ref_123","first-page":"Cd010255","article-title":"Telerehabilitation services for stroke","volume":"1","author":"Laver","year":"2020","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"1016","DOI":"10.2340\/16501977-0459","article-title":"Exercises for paretic upper limb after stroke: A combined virtual-reality and telemedicine approach","volume":"41","author":"Piron","year":"2009","journal-title":"J. Rehabil. Med."},{"key":"ref_125","first-page":"455","article-title":"Mobile game-based virtual reality rehabilitation program for upper limb dysfunction after ischemic stroke","volume":"34","author":"Choi","year":"2016","journal-title":"Restor. Neurol. Neurosci."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/10\/3369\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:25:09Z","timestamp":1760178309000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/10\/3369"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,21]]},"references-count":125,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2020,10]]}},"alternative-id":["jcm9103369"],"URL":"https:\/\/doi.org\/10.3390\/jcm9103369","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,21]]}}}