Virtual reality technology for upper and lower limb motor function, daily function, and balance in stroke patients: a meta-analysis of randomized controlled trials

Background Stroke is a common neurological disorder that often results in motor dysfunction, significantly impairing patients’ quality of life and increasing the economic burden on healthcare systems. Virtual reality (VR) technology has emerged as an innovative approach in stroke rehabilitation. This meta-analysis aimed to comprehensively evaluate the effects of VR-based interventions on motor function, daily function, and balance in stroke patients. Methods We systematically searched PubMed, Embase, the Cochrane Library, Web of Science, and China National Knowledge Infrastructure (CNKI) databases from inception to October 2025 for randomized controlled trials (RCTs) investigating VR technology in stroke rehabilitation. Study quality was assessed using the Cochrane Risk of Bias 2.0 tool. Data synthesis involved pooling effect sizes, conducting subgroup analyses, and assessing publication bias using Stata 17. Results A total of 27 RCTs involving 877 stroke patients were included in the meta-analysis. VR technology demonstrated statistically significant improvements across multiple functional domains: lower limb motor function (Cohen’s d = 0.41, 95% CI 0.25–0.57, P < 0.001), upper limb motor function (Cohen’s d = 0.25, 95% CI 0.03–0.48, P = 0.03), daily function (Cohen’s d = 0.24, 95% CI 0.07–0.42, P = 0.01), and balance (Cohen’s d = 0.31, 95% CI 0.09–0.52, P < 0.001). The effects ranged from small to moderate across domains, with lower limb function showing the most substantial improvement. Sensitivity analyses confirmed the robustness of these findings, and subgroup analyses revealed that factors such as training cycle influenced treatment effects. Conclusion VR technology demonstrates significant potential as an effective complementary intervention for improving motor function, daily function, and balance in stroke patients. The small to moderate effect sizes across domains support its integration into conventional rehabilitation protocols. Future research should focus on optimizing VR parameters, investigating different VR technology types, and evaluating long-term sustainability to further establish its efficacy in stroke rehabilitation.