Virtual Reality Rehabilitation-Related Complications in Neurological Disorders: A Scoping Review
TL;DR
Cybersickness, characterized by nausea, dizziness, headache, blurred vision, eye strain, fatigue, and disorientation, was the most frequently reported complication and disorder-specific adverse events included postural instability and fatigue in multiple sclerosis, falls and visual hallucinations in Parkinson's disease, and photosensitive seizure risk in epilepsy.
Abstract
Virtual reality (VR) has emerged as an innovative tool in neurorehabilitation, providing immersive and interactive environments that enhance motor, cognitive, and functional recovery in individuals with neurological disorders. Despite its therapeutic benefits, VR may induce adverse effects, including cybersickness, balance disturbances, and disorder-specific complications, which may limit its clinical application. This scoping review aimed to map the existing evidence on VR-related complications in neurological disorders and summarize the reported adverse events, assessment methods, and safety strategies. A scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. A comprehensive literature search was performed in PubMed, Google Scholar, and SciSpace for studies published between January 2016 and March 2026. Eligible studies included immersive or non-immersive VR interventions in neurological populations that reported adverse events or safety outcomes. Data were extracted using a standardized form and synthesized using a descriptive narrative approach. The search identified 121 records, of which 13 studies met the inclusion criteria. The included studies involved individuals with multiple sclerosis, Parkinson's disease, stroke, traumatic and acquired brain injury, spinal cord injury, cerebral palsy, hereditary ataxia, dementia, and epilepsy. Cybersickness, characterized by nausea, dizziness, headache, blurred vision, eye strain, fatigue, and disorientation, was the most frequently reported complication. Disorder-specific adverse events included postural instability and fatigue in multiple sclerosis, falls and visual hallucinations in Parkinson's disease, oculomotor disturbances following brain injury, and photosensitive seizure risk in epilepsy. Most adverse events were mild, transient, and effectively managed through supervised rehabilitation, shorter VR sessions, standardized monitoring, and individualized treatment protocols. Virtual reality is generally a safe and feasible adjunct to neurorehabilitation when appropriate safety measures are implemented. Nevertheless, disorder-specific risks require careful patient selection, clinical monitoring, and individualized intervention strategies. Future research should prioritize long-term safety evaluation, standardized adverse-event reporting, and the development of evidence-based clinical guidelines to support the safe integration of VR into neurological rehabilitation.