Assessment of the effectiveness and safety of virtual reality-based telerehabilitation in improving motor function, balance and gait in patients with Parkinson’s disease: a protocol for systematic review and meta-analysis

INTRODUCTION: Virtual reality-based telerehabilitation (VR-TR) combines gamified exercises with remote supervision for people with Parkinson's disease (PD). Its effectiveness and safety in PD remain uncertain. This protocol outlines methods to evaluate the effects of VR-TR on functional and clinical outcomes. METHODS AND ANALYSIS: Randomised controlled trials and quasi-experimental studies will be identified in PubMed (National Library of Medicine), Scopus (Elsevier), Cochrane CENTRAL (Cochrane Library) and PEDro (Physiotherapy Evidence Database) from inception to June 2026, with additional searches of grey literature and trial registries. Eligible participants are adults with idiopathic PD. Interventions include immersive or non-immersive VR-TR with remote supervision, compared with conventional physiotherapy, usual care or other active non-VR interventions. Primary outcomes are balance, gait and global motor function; secondary outcomes are quality of life and adverse events. Two reviewers will independently screen, extract data and assess risk of bias. Where possible, meta-analyses will be conducted using RevMan V.5.4, and the certainty of evidence will be appraised with Grading of Recommendations Assessment, Development and Evaluation. ETHICS AND DISSEMINATION: This study does not involve human participants and uses data from published studies; therefore, ethics approval is not required. However, as per institutional requirements, ethical clearance was obtained from the Institutional Ethics Committee of Datta Meghe Institute of Higher Education and Research (DMIHER) (Ref. No.: DMIHER(DU)/IEC/2025/204). Findings will be published in peer-reviewed journals and presented at conferences. PROSPERO REGISTRATION NUMBER: CRD420251009423.