Abstract TP316: Impact of Virtual Reality Upper Limb Rehabilitation on Daily Functioning and Quality of Life in Stroke Survivors: A Comprehensive Meta-Analysis

Background: Stroke is a leading cause of long-term disability, often resulting in motor impairments that significantly affect daily activities and quality of life (QoL). Traditional rehabilitation methods, although beneficial, can be limited by factors such as cost, accessibility, and patient engagement. Virtual reality (VR)-based rehabilitation has emerged as a promising alternative, offering an interactive and immersive environment to enhance motor function recovery, particularly for upper limb impairments. VR integrates repetitive task training with real-time feedback, which may foster neuroplasticity. This systematic review and meta-analysis aims to evaluate the effectiveness of VR-based upper limb training on activity of daily living (ADL) and QoL in stroke survivors. Methods: A systematic search was conducted on SCOPUS, Embase, PubMed, and CENTRAL up to August 2025 for Randomized Controlled Trials (RCTs). The risk of bias was assessed using ROBS 2.0. Result: A total of 61 RCTs were included after screening 932 studies. Overall, VR interventions significantly improved ADL Mean 0.34, SMD (95% CI 0.28 to 0.42 ) and QoL Mean 0.39, SMD (95% CI 0.35 to 0.68 ) compared to conventional therapy. IVR demonstrated superior outcomes for ADL compared to NIVR (IVR ADL Mean 0.32 SMD (95% CI 0.14 to 0.62 ), NIVR ADL Mean 0.41, SMD (95% CI 0.35 to 0.47 ). Subacute stroke survivors exhibited the most significant gains in ADL Mean = 0.52, SMD (95% CI 0.45 to 0.57 ) compared to chronic Mean 0.35, SMD (95% CI 0.32 to 0.38 ) or acute patients Mean 0.38 SMD (95% CI 0.28 to 0.38 ) Conclusion: Virtual reality-based upper limb rehabilitation significantly improves activity of daily living (ADL) and quality of life (QoL) in stroke survivors, with IVR showing superior outcomes over NIVR. Subacute stroke patients experience the greatest benefits in ADL recovery compared to chronic and acute patients. Risk of Bias was low.