Related Experiment Video
Updated: May 25, 2026

Mobile Game-based Virtual Reality Program for Upper Extremity Stroke Rehabilitation
Published on: March 8, 2018
Home-based virtual reality for upper limb stroke rehabilitation: supervised vs. unsupervised approaches - a
MohammadElias Karimi1, Milad Aminzadeh2
1Department of Physiotherapy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Purpose:
To evaluate the effectiveness of home-based virtual reality (VR) for upper limb recovery in stroke survivors, specifically distinguishing between supervised and unsupervised approaches.
Materials And Methods:
We searched PubMed, Scopus, and Web of Science for randomized controlled trials (RCTs). Risk of bias was assessed using RoB 2, and certainty of evidence via GRADE. A narrative synthesis included all eligible studies (n = 7), while a meta-analysis focused on a homogeneous subgroup (n = 2) comparing unsupervised home-based VR to unsupervised active controls.
Results:
Seven RCTs (n = 414) were reviewed. The meta-analysis of unsupervised trials (n = 291) showed no significant difference between home-based VR and active control groups (SMD = -0.06; 95% CI: -0.29 to 0.17; p = 0.62; I2 = 0%). Conversely, narrative synthesis indicated that interventions incorporating active remote supervision consistently yielded positive outcomes. The overall certainty of evidence was "Very Low."
Conclusions:
Unsupervised home-based VR does not appear superior to conventional home exercise. though it serves as a comparable alternative when direct supervision is limited. However, interventions involving therapist supervision show promise. The "human factor" of supervision may be more critical than the technology itself, highlighting the need for future trials to clearly define supervision levels.

