Virtual reality and VR-like technologies for the assessment and rehabilitation of concussion-related vestibular and oculomotor dysfunction: a systematic review

BACKGROUND: Vestibular and oculomotor dysfunction after concussion may cause persistent dizziness, imbalance, visual motion sensitivity, and functional limitation. Virtual reality (VR) and technologies are used for assessment and rehabilitation, but applications, devices, and outcomes remain heterogeneous. This review evaluated VR and VR-like technologies for concussion-related vestibular and oculomotor dysfunction. METHODS: Following PRISMA 2020 and PROSPERO registration, CENTRAL, MEDLINE, PsycINFO, PubMed, and Scopus were searched from inception to 21 March 2026. Of 1,197 records, 997 remained after deduplication; 55 full texts were assessed and 10 studies included. Two reviewers independently screened studies and extracted data. Owing to heterogeneity, findings were synthesized narratively. RESULTS: One study evaluated VR-based rehabilitation and nine examined assessment, validation, or symptom provocation. Rehabilitation outcomes improved across conventional, VR-based, and hybrid therapy groups, without consistent superiority of VR. Assessment studies suggested that standardized visual-motion environments may reveal postural, sensory-integration, or symptom-provocation responses not evident during static testing. However, findings varied by technology, recovery stage, task, and outcome. Eye-tracking showed poor diagnostic discrimination, and visual perturbation did not consistently demonstrate concussion-related impairment. CONCLUSION: VR may be a useful adjunct for standardized, repeatable, ecologically relevant assessment and rehabilitation, but evidence does not support stand-alone use or superiority over conventional therapy.