Advances in Virtual Reality-Based Physical Rehabilitation for Neurodegenerative Diseases: A Systematic Review
Source abstract
Abstract
Background: Neurodegenerative diseases cause both progressive motor and cognitive impairments for which no curative treatments exist. Virtual reality (VR)-based rehabilitation has emerged as a promising strategy to enhance physical rehabilitation by offering immersive, engaging, and personalized environments. Methods: A systematic review was conducted following the PRISMA guidelines, examining studies published between 2020 and 2025 in the Web of Science and Scopus. Twelve studies met the inclusion criteria, focusing on VR-based physical rehabilitation in individuals with neurodegenerative diseases. Results: Most studies reported significant improvements in balance, gait, postural control, and motor function. Some studies also found benefits in processing speed, executive function, emotional well-being, and activities of daily living. Across different levels of immersion, VR interventions showed high usability and were well tolerated, even among older adults. However, methodological limitations, such as small sample sizes, a lack of control groups, and short intervention durations, were prevalent. Conclusions: VR has demonstrated to be an effective and well-tolerated tool for the rehabilitation of individuals with neurodegenerative diseases such as Parkinson’s disease and multiple sclerosis. However, the confirmation of its clinical efficacy and long-term impact necessitates the execution of randomized controlled trials with larger samples and extended follow-up periods.
Source: crossref · Quality: baseline
Research context
OpenAlex topics: Stroke Rehabilitation and Recovery · Cerebral Palsy and Movement Disorders · Botulinum Toxin and Related Neurological Disorders
SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.
Affiliations
Department of Psychology, Faculty of Psychology, University of Oviedo, Plaza Feijoo s/n, 33003 Oviedo, Spain
Instituto de Neurociencias del Principado de Asturias (INEUROPA), University of Oviedo, Plaza Feijoo s/n, 33003 Oviedo, Spain
Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Av. del Hospital Universitario s/n, 33011 Oviedo, Spain
BioMedical Engineering Center (BME), Campus Viesques, University of Oviedo, C. Juan López-Peñalver s/n, 33203 Gijón, Spain
Funding
“Severo Ochoa” Program of the Consejería de Ciencia, Empresas, Formación y Empleo of the Government of Asturias
References (50)
Show source-provided references
1. Neurodegenerative Disorder10.22214/ijraset.2023.50032 ↗
2. Effectiveness of gamification for the rehabilitation of neurodegenerative disorders10.1016/j.chaos.2020.110192 ↗
3. Cognitive training and cognitive rehabilitation for persons with mild to moderate dementia of the Alzheimer’s or vascular type: A review10.1186/alzrt189 ↗
4. Evidence-based cognitive rehabilitation: Recommendations for clinical practice10.1053/apmr.2000.19240 ↗
5. Zuschnegg, J., Schoberer, D., Häussl, A., Lassacher, D., Lohrmann, C., and Eglseer, D. (2023). Effectiveness of computer-based interventions for community-dwelling people with cognitive decline: A systematic review with meta-analyses. BMC Geriatr., 23.10.1186/s12877-023-03941-y ↗
6. Virtual reality and disability: Emergence and challenge10.1080/09638280110111315 ↗
7. Virtual reality in neurorehabilitation
8. Mancuso, V., Sarcinella, E.D., Bruni, F., Arlati, S., Di Santo, S.G., Cavallo, M., Cipresso, P., and Pedroli, E. (2024). Systematic review of memory assessment in virtual reality: Evaluating convergent and divergent validity with traditional neuropsychological measures. Front. Hum. Neurosci., 18.10.3389/fnhum.2024.1380575 ↗
9. A SWOT Analysis of the Field of Virtual Reality Rehabilitation and Therapy10.1162/1054746053967094 ↗
10. Quan, W., Liu, S., Cao, M., and Zhao, J. (2024). A Comprehensive Review of Virtual Reality Technology for Cognitive Rehabilitation in Patients with Neurological Conditions. Appl. Sci., 14.10.3390/app14146285 ↗
11. Høeg, E.R., Povlsen, T.M., Bruun-Pedersen, J., Lange, B., Nilsson, N.C., Haugaard, K., Faber, S.M., Hansen, S.W., Kimby, C.K., and Serafin, S. (2021). System Immersion in Virtual Reality-Based Rehabilitation of Motor Function in Older Adults: A Systematic Review and Meta-Analysis. Front. Virtual Real., 2.10.3389/frvir.2021.647993 ↗
12. Clinical Efficacy of Virtual Reality Cave Automatic Virtual Environments (CAVE) for Chronic Musculoskeletal Pain in Older Adults: A Randomized Controlled Trial10.1016/j.jamda.2024.105344 ↗
13. Kim, W.S., Cho, S., Ku, J., Kim, Y., Lee, K., Hwang, H.J., and Paik, N.J. (2020). Clinical Application of Virtual Reality for Upper Limb Motor Rehabilitation in Stroke: Review of Technologies and Clinical Evidence. J. Clin. Med., 9.10.3390/jcm9103369 ↗
14. Evidence-Based Cognitive Rehabilitation: Systematic Review of the Literature From 2009 Through 201410.1016/j.apmr.2019.02.011 ↗
15. Cyber sickness in low-immersive, semi-immersive, and fully immersive virtual reality10.1007/s10055-021-00507-4 ↗
16. Kourtesis, P., Collina, S., Doumas, L.A.A., and MacPherson, S.E. (2019). Validation of the Virtual Reality Neuroscience Questionnaire: Maximum Duration of Immersive Virtual Reality Sessions Without the Presence of Pertinent Adverse Symptomatology. Front. Hum. Neurosci., 13.10.3389/fnhum.2019.00417 ↗
17. Buele, J., and Palacios-Navarro, G. (2023). Cognitive-motor interventions based on virtual reality and instrumental activities of daily living (iADL): An overview. Front. Aging Neurosci., 15.10.3389/fnagi.2023.1191729 ↗
18. Maggio, M.G., De Bartolo, D., Calabrò, R.S., Ciancarelli, I., Cerasa, A., Tonin, P., Di Iulio, F., Paolucci, S., Antonucci, G., and Morone, G. (2023). Computer-assisted cognitive rehabilitation in neurological patients: State-of-art and future perspectives. Front. Neurol., 14.10.3389/fneur.2023.1255319 ↗
19. Advances in immersive virtual reality interventions for mental disorders: A new reality?10.1016/j.copsyc.2021.02.004 ↗
20. Technology-Assisted Cognitive Motor Dual-Task Rehabilitation in Chronic Age-Related Conditions: Systematic Review10.2196/44484 ↗
21. Bergó, E., Lombardi, G., Pambuku, A., Della Puppa, A., Bellu, L., D’Avella, D., and Zagonel, V. (2016). Cognitive Rehabilitation in Patients with Gliomas and Other Brain Tumors: State of the Art. Biomed. Res. Int., 2016.10.1155/2016/3041824 ↗
22. Georgiev, D., Georgieva, I., Gong, Z., Nanjappan, V., and Georgiev, G. (2021). Virtual Reality for Neurorehabilitation and Cognitive Enhancement. Brain Sci., 11.10.3390/brainsci11020221 ↗
23. Bonanno, M., De Pasquale, P., De Marchis, C., Lombardo Facciale, A., Paladina, G., Fonti, B., Quartarone, A., and Calabrò, R.S. (2024). Might patients with cerebellar ataxia benefit from the Computer Assisted Rehabilitation ENvironment (CAREN)? A pilot study focusing on gait and balance. Front. Bioeng. Biotechnol., 12.10.3389/fbioe.2024.1385280 ↗
24. Comparison of the Effects of an Exergame-Based Program with Conventional Physiotherapy Protocol Based on Core Areas of the European Guideline on Postural Control, Functional Mobility, and Quality of Life in Patients with Parkinson’s Disease: Randomized Clinical Trial10.1089/g4h.2022.0039 ↗
25. Global estimates of the need for rehabilitation based on the Global Burden of Disease study 2019: A systematic analysis for the Global Burden of Disease Study 201910.1016/S0140-6736(20)32340-0 ↗
26. Janeh, O., and Steinicke, F. (2021). A Review of the Potential of Virtual Walking Techniques for Gait Rehabilitation. Front. Hum. Neurosci., 15.10.3389/fnhum.2021.717291 ↗
27. Agostini, F., Conti, M., Morone, G., Iudicelli, G., Fisicaro, A., Savina, A., Mangone, M., and Paoloni, M. (2025). The Role of Virtual Reality in Postural Rehabilitation for Patients with Parkinson’s Disease: A Scoping Review. Brain Sci., 15.10.3390/brainsci15010023 ↗
28. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews10.1186/s13643-021-01626-4 ↗
29. Kashif, M., Ahmad, A., Bandpei, M.A.M., Gilani, S.A., Hanif, A., and Iram, H. (2022). Combined effects of virtual reality techniques and motor imagery on balance, motor function and activities of daily living in patients with Parkinson’s disease: A randomized controlled trial. BMC Geriatr., 22.10.1186/s12877-022-03035-1 ↗
30. Kashif, M., Albalwi, A.A., Zulfiqar, A., Bashir, K., Alharbi, A.A., and Zaidi, S. (2024). Effects of virtual reality versus motor imagery versus routine physical therapy in patients with parkinson’s disease: A randomized controlled trial. BMC Geriatr., 24.10.1186/s12877-024-04845-1 ↗
31. Evaluation of Quality of Life After Use the Virtual Reality in Patients with Neurodegenerative Disease10.1055/s-0044-1785681 ↗
32. Patients’ perspective and usability of innovation technology in a new rehabilitation pathway: An exploratory study in patients with multiple sclerosis10.1016/j.msard.2020.102312 ↗
33. Mazzari, L., Zambon, E., Tonzar, S., Martini, M., Sabot, R., Galmonte, A., and Manganotti, P. (2025). Exergaming-Based Rehabilitation for Lateral Trunk Flexion in Parkinson’s Disease: A Pilot Study. Appl. Sci., 15.10.3390/app15041745 ↗
34. Formica, C., Bonanno, L., Latella, D., Ferrera, M.C., Maresca, G., Logiudice, A.L., Sorbera, C., Brigandì, A., Di Lorenzo, G., and Marino, S. (2023). The effect of Computer Assisted Rehabilitation Environment (CAREN) in cognitive impairment and coping strategies in Parkinson’s disease: A preliminary study. Sci. Rep., 13.10.1038/s41598-023-29299-0 ↗
35. Parkinson’s disease and virtual reality rehabilitation: Cognitive reserve influences the walking and balance outcome10.1007/s10072-021-05123-3 ↗
36. Pullia, M., Ciatto, L., Andronaco, G., Donato, C., Aliotta, R.E., Quartarone, A., De Cola, M.C., Bonanno, M., Calabrò, R.S., and Cellini, R. (2023). Treadmill Training Plus SemiImmersive Virtual Reality in Parkinson’s Disease: Results from a Pilot Study. Brain Sci., 13.10.3390/brainsci13091312 ↗
37. Honzíková, L., Dąbrowská, M., Skřinařová, I., Mullerová, K., Čecháčková, R., Augste, E., Trdá, J., Baníková, Š., Filip, M., and Školoudík, D. (2025). Immersive Virtual Reality as Computer-Assisted Cognitive–Motor Dual-Task Training in Patients with Parkinson’s Disease. Medicina, 61.10.3390/medicina61020248 ↗
38. Rodríguez-Fuentes, G., Ferreiro-Gómez, E., Campo-Prieto, P., and Cancela-Carral, J.M. (2024). Exergames and Immersive Virtual Reality as a Novel Therapy Approach in Multiple Sclerosis: Randomised Feasibility Study. J. Clin. Med., 13.10.3390/jcm13195845 ↗
39. Sánchez-Herrera-Baeza, P., Cano-De-La-Cuerda, R., Oña-Simbaña, E.D., Palacios-Ceña, D., Pérez-Corrales, J., Cuenca-Zaldivar, J.N., Gueita-Rodriguez, J., De Quirós, C.B., Jardón-Huete, A., and Cuesta-Gomez, A. (2020). The Impact of a Novel Immersive Virtual Reality Technology Associated with Serious Games in Parkinson’s Disease Patients on Upper Limb Rehabilitation: A Mixed Methods Intervention Study. Sensors, 20.10.3390/s20082168 ↗
40. Schuch, C.P., Balbinot, G., Bonilla, M.N., Machado, A.G., and De Oliveira, A.A. (2020). Feasibility of a Short-Term Virtual Reality Balance Intervention to Improve Mobility Smoothness in Parkinson’s Disease. Front. Virtual Real., 1.10.3389/frvir.2020.00007 ↗
41. Aromataris, E., and Munn, Z. (2020). Chapter 7: Systematic Reviews of Etiology and Risk. JBI Manual for Evidence Synthesis, JBI.10.46658/JBIRM-17-01 ↗
42. The Revised JBI Critical Appraisal Tool for the Assessment of Risk of Bias in Quasi-Experimental Studies10.11124/JBIES-23-00268 ↗
43. The Revised JBI Critical Appraisal Tool for the Assessment of Risk of Bias for Randomized Controlled Trials10.11124/JBIES-22-00430 ↗
44. Qualitative research synthesis: Methodological guidance for systematic reviewers utilizing meta-aggregation10.1097/XEB.0000000000000062 ↗
45. Experience of the use and presence of cyber disease in inmmersive virtual reality exposure in urban community-dwelling older adults10.1016/j.regg.2025.101634 ↗
46. Spatial Memory Deficits in Parkinson’s Disease: Neural Mechanisms and Assessment10.62347/CKGV8650 ↗
47. Xiao, Y., Yang, T., and Shang, H. (2023). The Impact of Motor-Cognitive Dual-Task Training on Physical and Cognitive Functions in Parkinson’s Disease. Brain Sci., 13.10.3390/brainsci13030437 ↗
48. Aging-induced degradation in tracking performance in three-dimensional movement10.1080/18824889.2024.2359183 ↗
49. Memory enhancement by multidomain group cognitive training in patients with Parkinson’s disease and mild cognitive impairment: Long-term effects of a multicenter randomized controlled trial10.1007/s00415-021-10568-9 ↗
50. Long-term effects of cognitive training in Parkinson’s disease: A randomized, controlled trial