Virtual Reality-Based Upper-Limb Rehabilitation after Stroke: Effects on Upper-Limb Function, Self-Hygiene Performance and Activities of Daily Living - A Literature Review

Abstract

Stroke frequently results in persistent upper-limb dysfunction, which can limit self-care, activities of daily living (ADL), functional independence, and quality of life. Virtual reality (VR)-based rehabilitation has emerged as a promising approach for providing repetitive, task-oriented, interactive, and engaging upper-limb training. However, although previous studies have reported improvements in motor and functional outcomes, evidence specifically addressing self-care and self-hygiene remains limited. This review aimed to synthesize the available evidence regarding the effectiveness of VR-based upper-limb rehabilitation on upper-limb function, self-care and self-hygiene performance, ADL, functional independence, and quality of life among stroke survivors. A structured literature search was conducted using PubMed/MEDLINE, Scopus, Web of Science, ScienceDirect, and IEEE Xplore, supplemented by screening reference lists of relevant publications. Following the predefined screening process, 1,900 records were identified, 650 duplicates were removed, and 100 full-text articles were assessed for eligibility. After full-text screening, 11 studies were included in the qualitative synthesis. The reviewed evidence indicated that VR-based rehabilitation may improve upper-limb motor function, hand function, ADL performance, and quality of life, particularly when used alongside conventional rehabilitation. However, direct evidence regarding self-care and self-hygiene outcomes was comparatively limited. Considerable heterogeneity in VR technologies, intervention protocols, treatment duration, participant characteristics, and outcome measures was observed across studies. Overall, VR appears to be a promising adjunct to conventional stroke rehabilitation, but further high-quality research focusing on meaningful activity-level outcomes, particularly self-hygiene and functional independence, is warranted.