Patient-centered insights into virtual reality rehabilitation for stroke: a systematic review and qualitative meta-synthesis

Background Virtual reality rehabilitation (VRR) is an emerging technology that offers new possibilities for stroke recovery. Understanding stroke survivors' experiences and expectations is essential for optimizing its application. Objective This systematic review synthesizes qualitative evidence on stroke survivors' experiences with and participation in VRR to identify benefits, challenges, and areas for improvement. Methods This systematic review follows the meta-aggregation method guided by ENTREQ and PRISMA and uses the Critical Appraisal Skills Programme (CASP) to assess the quality of included studies. We searched eight English and Chinese databases for qualitative or mixed-method studies on stroke survivors' experiences with VRR, published by May 31, 2024. Selected studies were independently reviewed, and data were synthesized into core themes. Results Fourteen studies were included, involving a total of 133 participants aged 13 to 85 years. The analysis identified four key themes: (1) perceived self-benefits, including physical and psychological improvements; (2) facilitators, such as user engagement and supportive environments; (3) barriers, including technical and personal limitations; and (4) expectations. The quality of the included studies was assessed using the CASP tool, with scores ranging from 26 to 30, indicating moderate to high quality across the studies. Conclusion VRR has the potential to enhance stroke rehabilitation outcomes, but its success depends on addressing individual and systemic challenges. Personalized interventions and multidisciplinary efforts are needed to develop user-friendly, adaptable VRR systems that fully leverage the advantages of this technology.