Non-immersive virtual reality combined with conventional therapy improves upper limb function and activities of daily livingVirtual reality helps stroke patients regain arm movement and function

Frontiers in Medicine Published July 1, 2026 DOI ↗ Editorial oversight: Dr. Ji-eun Park, MD · Brain, Mind & Pain

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Key Takeaway

Consider NIVR as a promising adjunct to conventional therapy for improving upper limb motor function in stroke patients.

This meta-analysis synthesized data from 12 studies involving 498 stroke patients to evaluate the efficacy of non-immersive virtual reality (NIVR) combined with conventional therapy compared to conventional therapy alone. The analysis focused on upper limb motor function and activities of daily living (ADL).

Key findings indicate that NIVR as an adjunct significantly improved upper limb motor function, with mean differences of 5.40 for FMA-UE (95% CI 1.58, 9.22) and 4.57 for BBT (95% CI 0.35, 8.79). Significant improvements were also noted in activities of daily living measured by the FIM (MD = 5.99; 95% CI 2.27, 9.71). While the pooled BI/MBI analysis showed a marginally significant improvement (MD = 5.47; p = 0.04), specific subgroup analyses for both BI and MBI did not reach statistical significance.

The authors note several limitations, including dose imbalances in 3 of 12 studies, limited database search scope, and heterogeneity in scale administration. Additionally, the study had limited statistical power for subgroup analyses. Clinical application should be interpreted with caution due to these factors; findings require confirmation through more robust, dose-matched trials.

How this fits prior evidence

This meta-analysis addresses a gap in rehabilitative modalities by evaluating non-immersive virtual reality as an adjunct to conventional therapy. While prior evidence highlights the role of tailored behavioral interventions and specific technologies like TMS for motor outcomes, this study specifically focuses on the integration of NIVR to improve upper limb function and ADL scores following stroke.

Recovering after a stroke is a long journey, especially when it comes to regaining the use of one's arms. For many patients, the goal is simple but vital: being able to perform everyday activities like eating or dressing independently. New research looks at how adding non-immersive virtual reality (NIVR) to standard physical therapy changes these outcomes.

A review of 12 clinical trials involving nearly 500 stroke patients found that those who used virtual reality alongside traditional therapy showed significant improvements in upper limb motor function and daily activities. Specifically, the data showed better scores in tests measuring arm movement and overall independence compared to those receiving standard care alone.

While these results are promising, researchers suggest some caution. Because different studies used different amounts of virtual reality training, the evidence is not yet perfectly clear. More research with consistent treatment amounts is needed to confirm exactly how much this technology can help patients regain their independence.

What this means for you:

Adding virtual reality to standard therapy may improve arm movement and daily tasks for stroke survivors.

Common questions

How does virtual reality help after a stroke?

When added to traditional therapy, non-immersive virtual reality (NIVR) was linked to better upper limb motor function. This means patients showed improved movement in their arms and performed better on tests measuring their ability to complete daily activities.

Is this treatment safe for stroke survivors?

The study did not report any specific side effects, serious safety concerns, or reasons why patients had to stop the treatment. However, because some studies used different amounts of virtual reality, you should talk to your doctor about how it fits into a personal care plan.

How much better is it than standard therapy alone?

Patients using both methods showed significant improvements in arm movement and daily tasks compared to those receiving only standard therapy. However, some specific measurements for daily activities were only marginally significant because of differences in how the studies were conducted.

Study Details

Study typeMeta analysis

EvidenceLevel 1

PublishedJun 2026

View Original Abstract ↓

BackgroundStroke is a leading cause of disability, with upper limb dysfunction affecting the majority of survivors. Non-immersive virtual reality (NIVR) has emerged as an accessible and engaging adjunctive therapy that may address the limitations of conventional rehabilitation and promote motor recovery.MethodsThis systematic review and meta-analysis, conducted in accordance with PRISMA guidelines, included 12 randomized controlled trials (RCTs) involving 498 stroke patients. The included studies compared NIVR combined with conventional therapy versus conventional therapy alone. Primary outcome measures were upper limb motor function, assessed using the Fugl-Meyer Assessment for Upper Extremity (FMA-UE) and the Box and Block Test (BBT), and activities of daily living (ADL), assessed using the Barthel Index (BI), Modified Barthel Index (MBI), and Functional Independence Measure (FIM). Dose matching was reported in nine of the 12 studies; three studies provided extra therapy time to NIVR groups. The search was limited to PubMed, Web of Science, and Scopus, potentially missing studies from other databases (e.g., CENTRAL, Embase, CINAHL) and trial registries.ResultsNIVR was associated with significantly improved upper limb motor function [FMA-UE: MD = 5.40, 95% CI (1.58, 9.22); BBT: MD = 4.57, 95% CI (0.35, 8.79)] and FIM scores [MD = 5.99, 95% CI (2.27, 9.71)]. Pooled BI/MBI analysis showed a marginal effect that reached statistical significance [MD = 5.47, 95% CI (0.30, 10.63), p = 0.04]. However, this finding should be interpreted with caution, as neither the BI subgroup analysis [3 studies, MD = 3.88, 95% CI (−1.64, 9.41), p = 0.17] nor the MBI subgroup analysis [5 studies, MD = 5.94, 95% CI (−1.75, 13.64), p = 0.13] individually reached statistical significance. This discrepancy likely reflects limited statistical power in subgroup analyses and heterogeneity in scale administration across studies, rather than a robust treatment effect.ConclusionNIVR as an adjunct is associated with better upper limb function and global ADL. However, dose imbalance in 3/12 studies and limited database search (PubMed, Web of Science, Scopus) warrant cautious interpretation. Findings need confirmation via dose-matched, broader-search trials.

Non-immersive virtual reality combined with conventional therapy improves upper limb function and activities of daily livingVirtual reality helps stroke patients regain arm movement and function

How this fits prior evidence

Common questions

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Non-immersive virtual reality combined with conventional therapy improves upper limb function and activities of daily livingVirtual reality helps stroke patients regain arm movement and function

How this fits prior evidence

Common questions

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