{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T08:12:30Z","timestamp":1791101550293,"version":"4.1.0"},"reference-count":63,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T00:00:00Z","timestamp":1764720000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Stroke is a common neurological disorder that often results in motor dysfunction, significantly impairing patients\u2019 quality of life and increasing the economic burden on healthcare systems. Virtual reality (VR) technology has emerged as an innovative approach in stroke rehabilitation. This meta-analysis aimed to comprehensively evaluate the effects of VR-based interventions on motor function, daily function, and balance in stroke patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We systematically searched PubMed, Embase, the Cochrane Library, Web of Science, and China National Knowledge Infrastructure (CNKI) databases from inception to October 2025 for randomized controlled trials (RCTs) investigating VR technology in stroke rehabilitation. Study quality was assessed using the Cochrane Risk of Bias 2.0 tool. Data synthesis involved pooling effect sizes, conducting subgroup analyses, and assessing publication bias using Stata 17.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 27 RCTs involving 877 stroke patients were included in the meta-analysis. VR technology demonstrated statistically significant improvements across multiple functional domains: lower limb motor function (Cohen\u2019s d = 0.41, 95% CI [0.25\u20130.57],\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.001), upper limb motor function (Cohen\u2019s d = 0.25, 95% CI [0.03\u20130.48],\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.03), daily function (Cohen\u2019s d = 0.24, 95% CI [0.07\u20130.42],\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.01), and balance (Cohen\u2019s d = 0.31, 95% CI [0.09\u20130.52],\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). The effects ranged from small to moderate across domains, with lower limb function showing the most substantial improvement. Sensitivity analyses confirmed the robustness of these findings, and subgroup analyses revealed that factors such as training cycle influenced treatment effects.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>VR technology demonstrates significant potential as an effective complementary intervention for improving motor function, daily function, and balance in stroke patients. The small to moderate effect sizes across domains support its integration into conventional rehabilitation protocols. Future research should focus on optimizing VR parameters, investigating different VR technology types, and evaluating long-term sustainability to further establish its efficacy in stroke rehabilitation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.7717\/peerj.20402","type":"journal-article","created":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T08:22:56Z","timestamp":1764750176000},"page":"e20402","source":"Crossref","is-referenced-by-count":2,"title":["Virtual reality technology for upper and lower limb motor function, daily function, and balance in stroke patients: a meta-analysis of randomized controlled trials"],"prefix":"10.7717","volume":"13","author":[{"given":"Weixiao","family":"Zhang","sequence":"first","affiliation":[{"name":"Business School, University of Technology Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanshan","family":"Lyu","sequence":"additional","affiliation":[{"name":"School of Physical Education, China University of Mining Technology, Xuzhou, Jiangsu Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuwen","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Physical Education, Yangzhou University, Yangzhou, Jiangsu Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4443","published-online":{"date-parts":[[2025,12,3]]},"reference":[{"key":"10.7717\/peerj.20402\/ref-1","doi-asserted-by":"publisher","first-page":"446","DOI":"10.1177\/15394492231158375","article-title":"Telehealth-guided virtual reality for recovery of upper extremity function following stroke","volume":"43","author":"Adams","year":"2023","journal-title":"OTJR"},{"issue":"24","key":"10.7717\/peerj.20402\/ref-2","doi-asserted-by":"publisher","first-page":"5144","DOI":"10.3390\/ijerph16245144","article-title":"Virtual reality games as an adjunct in improving upper limb function and general health among stroke survivors","volume":"16","author":"Ahmad","year":"2019","journal-title":"International Journal of Environmental Research and Public Health"},{"key":"10.7717\/peerj.20402\/ref-3","doi-asserted-by":"publisher","first-page":"2402","DOI":"10.1080\/09593985.2021.1941458","article-title":"Effectiveness of virtual reality-based rehabilitation versus conventional therapy on upper limb motor function of chronic stroke patients: a systematic review and meta-analysis of randomized controlled trials","volume":"38","author":"Al-Whaibi","year":"2022","journal-title":"Physiotherapy Theory and Practice"},{"key":"10.7717\/peerj.20402\/ref-4","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1053\/jscd.2002.127106","article-title":"Effectiveness of a postdischarge care management model for stroke and transient ischemic attack: a randomized trial","volume":"11","author":"Allen","year":"2002","journal-title":"Journal of Stroke and Cerebrovascular Diseases"},{"key":"10.7717\/peerj.20402\/ref-5","doi-asserted-by":"publisher","first-page":"2060","DOI":"10.1109\/tnsre.2024.3405852","article-title":"Effectiveness of immersive virtual reality-based hand rehabilitation games for improving hand motor functions in subacute stroke patients","volume":"32","author":"Amin","year":"2024","journal-title":"IEEE Transactions on Neural Systems and Rehabilitation Engineering"},{"key":"10.7717\/peerj.20402\/ref-6","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1186\/s12984-025-01564-5","article-title":"Effects of home-based virtual reality upper extremity rehabilitation in persons with chronic stroke: a randomized controlled trial","volume":"22","author":"Ase","year":"2025","journal-title":"Journal of NeuroEngineering and Rehabilitation"},{"key":"10.7717\/peerj.20402\/ref-7","doi-asserted-by":"publisher","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":"A\u015fk\u0131n","year":"2018","journal-title":"Somatosensory & Motor Research"},{"key":"10.7717\/peerj.20402\/ref-8","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1016\/j.clineuro.2009.12.015","article-title":"Falls and gait disorders in geriatric neurology","volume":"112","author":"Axer","year":"2010","journal-title":"Clinical Neurology and Neurosurgery"},{"key":"10.7717\/peerj.20402\/ref-9","doi-asserted-by":"publisher","first-page":"102152","DOI":"10.1016\/j.eclinm.2023.102220","article-title":"Effectiveness and safety of virtual reality rehabilitation after stroke: an overview of systematic reviews","volume":"64","author":"Bargeri","year":"2023","journal-title":"EClinicalMedicine"},{"key":"10.7717\/peerj.20402\/ref-10","doi-asserted-by":"publisher","first-page":"1061","DOI":"10.3389\/fneur.2019.01061","article-title":"Embodiment and presence in virtual reality after stroke. 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