Effectiveness of Virtual Reality on Hand Function for Patients with Hemiplegia After Stroke: A Meta-Analysis of Randomized Controlled Trials

Background Hemiplegia resulting from a stroke frequently causes considerable difficulties in hand function. Virtual reality (VR) therapy has evolved as an innovative and engaging method to facilitate sensorimotor rehabilitation. Objective This meta-analysis assessed the efficacy of VR-based therapies on hand function in post-stroke hemiplegic patients. The study evaluated the impact of treatment duration, type of VR (immersive, semi-immersive, non-immersive), and stroke stage (subacute versus chronic) on outcomes. Methods A comprehensive search of six databases until September 2024 identified randomized controlled trials (RCTs) that compared VR therapy with conventional rehabilitation or sham control. The primary outcomes consisted of validated, hand-specific performance metrics, including the Fugl-Meyer upper extremity subscale, Action Research Arm Test, Box and Block Test, Jebsen-Taylor Hand Function Test and Box and Block Test. Results Twenty-five RCTs involving 844 participants were evaluated. VR therapy significantly enhanced hand function (SMD = 0.68; 95% CI: 0.41–0.95; p < 0.00001), while there was considerable heterogeneity (I 2 = 71%). Subgroup analysis indicated that semi-immersive VR had the most significant benefit (SMD = 1.03), whereas interventions with a cumulative training duration beyond 12 h, along with those administered to subacute patients, demonstrated greater effect size in hand function relative to shorter interventions (pooled SMD for >12 h = 0.94; 95% CI: 0.66–1.23). Conclusion This meta-analysis suggests that semi-immersive VR therapy improves hand function in post-stroke patients, especially when the total cumulative treatment duration exceeds 12 h. Future research should determine the principal treatment elements, establish uniform dosing methods, and evaluate long-term results, including activities of daily living and quality of life.