Virtual reality-based rehabilitation in neurologicalphysiotherapy: current evidence and clinical outcomes

Abstract

Virtual reality (VR)-based rehabilitation is an emerging technology-assisted approach in neurological physiotherapy that provides interactive, engaging, and progressively challenging environments for individuals with neurological disorders. Stroke, Parkinson’s disease, multiple sclerosis, cerebral palsy, traumatic brain injury, and other neurological conditions commonly cause impairments in strength, balance, gait, coordination, motor control, cognition, and activities of daily living. Although conventional physiotherapy remains fundamental to neurological rehabilitation, maintaining intensive and repetitive practice over prolonged periods can be challenging because of fatigue, limited motivation, and restricted access to specialized services. VR can complement conventional rehabilitation by providing task-specific exercises, immediate visual and auditory feedback, adjustable difficulty, multisensory stimulation, and objective performance monitoring. Its applications include upper-limb rehabilitation, balance training, gait retraining, cognitive-motor exercises, postural control, and functional activity practice. VR may also improve patient engagement and support homebased and remotely supervised rehabilitation. However, clinical effectiveness can vary according to neurological condition, patient characteristics, intervention duration, technology type, immersion level, and treatment intensity. Safety, accessibility, cost, cybersickness, digital literacy, and appropriate patient selection must also be considered. Overall, VR represents a promising adjunct to neurological physiotherapy that can enhance repetitive, meaningful, and patient-centered rehabilitation while preserving the essential role of physiotherapists in assessment, clinical reasoning, treatment planning, supervision, progression, and functional recovery