Gamification and Virtual Reality in Stroke and Vestibular Rehabilitation

Stroke and other disorders resulting in vestibular dysfunction are a leading cause of balance impairment and functional disability in adults, both in the United States and worldwide. In the United States, roughly 795,000 people a year experience a stroke, the majority of which are 65 and older (Martin et al., 2025). In that demographic, stroke reduces mobility in more than half of survivors, and much of this mobility loss attributable to balance deficits (Feigin et al., 2025). Globally, there are roughly 93.8 million patients who have suffered a stroke, with an annual global incidence rate of approximately 11.9 million. Conservatively, roughly 20% of those who have suffered a stroke report balance impairment, but individual studies report rates as high as 83% (CDC). Benign paroxysmal positional vertigo is estimated to impact roughly 2.4% of the population over the course of our lifetimes. Among adults over 60, the prevalence rises to about 3.5%, and cumulative lifetime incidence by 80 years old is roughly 10% (Lindell et al., 2024). Conventional rehabilitation programs have persistently faced challenges with patient engagement and adherence (Shahhar et al., 2022). Gamification and VR-based rehabilitation leverage principles of motor learning, neuroplasticity, and intrinsic motivation to address these limitations.