The Intervention Effect of Serious Games on Upper Limb Motor Function and Activities of Daily Living in Stroke...

To systematically evaluate the intervention effect of serious games on upper limb motor function and activities of daily living in patients with stroke.

Systematic review and meta-analysis.

Patients with motor dysfunction in the upper limb following a stroke.

The Cochrane Library, PubMed, Embase, Web of Science, China National Knowledge Infrastructure Wanfang Data, Chinese Scientific and Technical Periodicals Database (VIP), and Chinese Biomedical Literature Database (CBM) were searched. The search targeted randomized controlled trials evaluating the effects of serious games on upper limb motor function and activities of daily living in patients with stroke. The search period spanned from the inception of each database to May 2025. Two researchers independently screened the literature, extracted data, and assessed the risk of bias of the included studies in accordance with the predefined inclusion and exclusion criteria. Data analysis was conducted with Stata 17.0 software and evidence quality was evaluated via the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Twenty-five studies were included. Meta-analysis results demonstrated that, compared with conventional rehabilitation alone, serious games combined with conventional rehabilitation significantly improved upper limb motor function (mean difference: 7.64; 95% CI, 6.19-9.09; I² = 64.7%; P < .001) and activities of daily living (standardized mean difference: 1.20; 95% CI, 0.86-1.54; I² = 81.3%; P < .001) in patients with stroke, with statistically significant differences.

This study demonstrates that serious games combined with conventional rehabilitation exercises can improve upper limb motor function and activities of daily living in patients with stroke. However, the evidence was of low quality, limited by the risk of bias and heterogeneity. Subgroup analysis revealed that a protocol with a duration of ≥4 weeks, a frequency of ≥5 sessions/week, and a single session of ≤30 minutes was more advantageous, although the between-group differences did not reach statistical significance, and the optimal protocol remains to be determined. It is recommended to initiate the intervention as early as possible in the acute/subacute stage, while its effectiveness in the chronic stage requires further validation through high-quality studies. Future research should involve large-sample randomized controlled trials to define the optimal protocol and evaluate its long-term efficacy, safety, and cost-effectiveness.