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Virtual Reality Rehabilitation Tied to Better Mobility and Quality of Life in Multiple SclerosisVirtual Reality May Help Adults With MS Walk and Balance Better

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Key Takeaway
VR rehabilitation may improve gait, mobility, balance, and quality of life in MS, but evidence certainty is low to very low.

This meta-analysis pooled data from randomized trials of virtual reality-based rehabilitation in adults with multiple sclerosis, covering 781 randomized participants, of whom 702 contributed outcome data.

VR rehabilitation was associated with large improvements in gait speed (Hedges' g = 0.99; 95% CI 0.39 to 1.58) and functional mobility on the Timed Up and Go test (g = 1.00; 95% CI 0.47 to 1.54). Balance on the Berg Balance Scale also improved, with a moderate effect (g = 0.59; 95% CI 0.14 to 1.03).

Health-related quality of life improved on both instruments used: MSQOL-54 (g = 0.87; 95% CI 0.01 to 1.73) and MusiQoL (g = 1.19; 95% CI 0.60 to 1.78). Upper limb outcomes could not be pooled and were summarized narratively because instruments and reporting differed across trials.

Heterogeneity ranged from moderate to considerable (I² 51.8% to 86.0%). Certainty of evidence was low for functional mobility and balance and very low for gait speed and both quality-of-life measures, so these estimates should be read as preliminary. Adverse events, discontinuations, and funding sources were not reported.

For clinicians, VR-based rehabilitation is a plausible adjunct for walking, mobility, balance, and quality of life in MS, but the current evidence base does not yet support firm claims about magnitude or durability of benefit.

How this fits prior evidence

This meta-analysis addresses a gap in rehabilitative interventions for multiple sclerosis. While prior evidence suggests that resistance training may raise peripheral BDNF in MS, the evidence for that specific intervention is of low certainty. This study provides evidence for VR-based rehabilitation as a potential tool to improve physical mobility and quality of life, though the evidence quality remains low to very low.

If you live with multiple sclerosis, everyday movement can feel like a fight. Walking to the kitchen, keeping your balance, staying steady on your feet. A new analysis of 781 adults with MS suggests virtual reality rehab might help with exactly those things.

The researchers pooled data from randomized trials and found improvements in walking speed, functional mobility (how well you move through daily tasks), balance, and quality of life. The effects looked sizable on paper. But here is the honest part: the certainty of that evidence ranged from low to very low, and the trials varied a lot in how they were run.

Upper limb outcomes could not be combined because the studies measured them differently, so those results were described rather than pooled. The analysis also did not report safety information, so we do not know from this work whether VR rehab carries any risks or side effects.

What does this mean for you? VR rehab might be worth asking your doctor or care team about, especially if walking and balance are goals. But treat these numbers as a promising early signal, not proof. The researchers themselves say the estimates should be considered preliminary.

What this means for you:
VR rehab may help walking, balance, and quality of life in MS, but the evidence is still early and uncertain.

Common questions

Does virtual reality rehab help with multiple sclerosis?

A new analysis of 781 adults with MS found that VR-based rehab may improve walking speed, functional mobility, balance, and quality of life. But the researchers rated the certainty of this evidence as low to very low, so these results are preliminary. Talk with your doctor about whether VR rehab fits your situation.

How much does VR rehab improve walking speed in MS?

The analysis reported a large effect on walking speed, measured by the 10-meter walk test, with an effect size of 0.99. However, the certainty of that evidence was very low, and the trials varied considerably. That means the true benefit could be smaller or larger. Ask your care team what this might mean for you.

Is VR rehab safe for people with MS?

This analysis did not report safety information, including adverse events, serious adverse events, or how many people stopped treatment. So we cannot say from this work whether VR rehab carries any risks. If you are considering it, discuss safety with your doctor or physical therapist first.

Who was included in this analysis of VR rehab for MS?

The analysis included 781 randomized participants, all adults with multiple sclerosis. Of those, 702 provided outcome data. The studies looked at walking speed, functional mobility, balance, quality of life, and upper limb function. Upper limb results could not be pooled because the trials measured them differently.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedNov 2026
View Original Abstract ↓
BACKGROUND: Impairments in gait, balance and upper limb function are among the most disabling consequences of multiple sclerosis (MS), and virtual reality (VR) has been proposed as a means of delivering repetitive, task-oriented and feedback-driven rehabilitation. Previous syntheses have been confined to single devices, to balance outcomes, or to mixed neurological populations, and none has examined physical function and health-related quality of life jointly across the full range of VR modalities used in MS. METHODS: We searched seven electronic databases from inception to July 30, 2026, for randomized controlled trials of structured VR-based rehabilitation in adults with MS (PROSPERO CRD420261332329). Two reviewers independently screened records, extracted data, appraised risk of bias with RoB 2 and rated certainty of evidence with GRADE. Standardized mean differences (Hedges' g) were pooled using random-effects models, and heterogeneity was quantified with the I² statistic. RESULTS: Nineteen trials were included, comprising 781 randomized participants, of whom 702 (89.9%) contributed outcome data. VR was associated with improvements in gait speed (10MWT: g = 0.99, 95% CI 0.39 to 1.58; I² = 51.8%), functional mobility (TUG: g = 1.00, 95% CI 0.47 to 1.54; I² = 52.4%), balance (BBS: g = 0.59, 95% CI 0.14 to 1.03; I² = 57.7%) and health-related quality of life (MSQOL-54: g = 0.87, 95% CI 0.01 to 1.73; I² = 86.0%; MusiQoL: g = 1.19, 95% CI 0.60 to 1.78; I² = 57.5%). Upper limb outcomes, assessed in eight trials, were synthesized narratively because of differences in instruments and reporting. Certainty of evidence was low for functional mobility and balance, and very low for gait speed, MSQOL-54, and MusiQoL. CONCLUSIONS: VR-based rehabilitation may improve gait speed, functional mobility, balance and quality of life in adults with MS. Given the low to very low certainty of the evidence and the moderate to considerable heterogeneity across trials, these estimates should be regarded as preliminary and interpreted by outcome rather than as a general effect of VR. Adequately powered trials with clearly defined VR modalities, standardized dosing, active dose-matched comparators and longer follow-up are required.
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