Effects of the computer-assisted rehabilitation environment on patient rehabilitation: a systematic review and...

Computer-assisted rehabilitation environment (CAREN) integrates virtual reality, motion capture systems, and real-time feedback mechanisms to enhance patient rehabilitation results. This study aimed to determine the potential benefit of CAREN in increasing balance, cognition, and mental health in patients with neurological and musculoskeletal disorders.

Systematic searches were carried out across PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), and Web of Science databases for relevant studies published up to November 2025. The review comprised randomized, non-randomized controlled trials and single-arm studies evaluating the rehabilitative outcomes of CAREN treatment compared with standard therapy or no intervention in patients. The primary outcomes comprised balance function, cognitive functions, and mental health status; the secondary outcome was the incidence of adverse events. The quality of studies included in the review was evaluated using the Newcastle-Ottawa Scale, and the pooled effect size was computed using standardized mean differences (SMDs) or mean differences (MDs) for continuous outcomes. Statistical analysis was performed using Stata 18.0.

The database search yielded 3,553 records, of which 15 studies were included, and 9 had sufficient data for meta-analysis. CAREN training significantly improved balance, as indicated by higher Berg Balance Scale scores (SMD = 1.12; 95% CI = 0.08 to 2.16; p = 0.03; I ² = 92.64%), and cognitive function, as shown by increased Montreal Cognitive Assessment scores (MD = 0.44; 95% CI = 0.11 to 0.76; p = 0.01; I ² = 0.00%). Changes in fear of falling, assessed with the Falls Efficacy Scale-International (MD = -0.05; 95% CI = -0.36 to 0.27; p = 0.76; I ² = 0.00%), and depression, evaluated with the Beck Depression Inventory or Hamilton Depression Rating Scale (MD = -0.20; 95% CI = -0.62 to 0.22; p = 0.35; I ² = 70.64%), were non-significant. Additionally, adverse events were rare, with no serious cases reported.

CAREN training appears to improve balance and cognitive function, while its effects on mental health are relatively limited. However, these findings should be interpreted with caution.

PROSPERO, identifier (CRD420251172390).