Associations between factors such as exercise habits or gaming behavior and the effects of arm for movement condition

The gap

Evidence profile

Sourced from the recommendations and limitations and future work of the source papers, classified as general, drawn from work published between 2024 and 2026, spanning 5 journals. Those papers have been cited 39 times in total.

Supporting evidence — 5 representative gaps

• What is The Effectiveness of Virtual Reality Interventions On Upper Limb Motor Function Recovery In Stroke Survivors? : A Comprehensive Systematic Review (2026) · The Indonesian Journal of General Medicine · doi

  For clinical practice: • Implement VR rehabilitation primarily for subacute stroke patients (1-6 months post-stroke) with moderate-to-severe upper limb impairment • Use VR as an adjunct to, not replacement for, conventional occupational and physical therapy • Deliver interventions for >15 total hours over >4 weeks with >4 sessions weekly • Select VR platforms based on rehabilitation goals: immersive systems for gross motor recovery, non-immersive systems for fine motor dexterity • Prioritize purpose-built rehabilitation systems incorporating motor learning principles over commercial gaming systems • Monitor for transient simulator sickness, particularly during initial sessions For policy and healthcare systems: • Allocate VR resources preferentially to subacute rehabilitation settings • Develop reimbursement pathways for VR as an adjunctive rehabilitation service © The Indonesian Journal of General Medicine 79  Research Article Volume 38, Issue No.01 . 2026 ISSN : 3048-104X • Invest in home-based VR telerehabilitation infrastructure to improve access and enable higher therapy doses • Establish standardized outcome measurement protocols across VR rehabilitation programs For future research: • Conduct large, multicenter RCTs with sample sizes >100 per group to provide definitive evidence • Develop and validate VR-specific outcome measures sensitive to clinically meaningful change • Include long-term follow-up (>6 months) to assess durability of treatment effects • Examine optimal dosing parameters through factorial design trials • Investigate mechanisms of VR-induced neuroplasticity using neuroimaging and neurophysiological measures • Study VR effectiveness in under-represented populations including patients with cognitive impairment, aphasia, and visuospatial neglect • Conduct economic analyses of VR implementation costs versus benefits • Compare different VR platforms directly in head-to-head RCTs • Examine the added value of novel features such as haptic feedback, functional electrical stimulation integration, and artificial intelligence-driven adaptive difficulty REFERENCES 1. Laver KE, Lange B, George S, et al (2025) Virtual reality for stroke rehabilitation. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD008349.pub5 © The Indonesian Journal of General Medicine 80  Research Article Volume 38, Issue No.01 . 2026 ISSN : 3048-104X 2. Soleimani M, Ghazisaeedi M, Heydari S (2024) The efficacy of virtual reality for upper limb rehabilitation in stroke patients: a systematic review and meta-analysis. BMC Medical Informatics and Decisio

  generalrecommendations
  Keywords: rehabilitation systems stroke patients motor subacute months upper limb impairment therapy sessions platforms based immersive
• Acute psychological and physiological benefits of exercising with virtual reality (2024) · PLoS ONE · cited 30× · doi

  This may lead to higher levels of enjoyment and effort in the VR condition and future research should investigate the use of VR over longer training periods, considering how these effects compare over time with diminishing novelty. Future research should focus on these populations, where it is possible positive impacts could be greater for those who do not engage in exercise at all. Whilst these results are promising, they should be considered in light of the limitations of this study and its design. Therefore, our findings may not be applicable to the wider general population or older aged adults.

  generallimitations
  Keywords: future lead higher levels enjoyment effort condition investigate longer training periods considering effects compare time
• Effects of age and arm movement condition on dynamic balance performance during virtual height exposure (2025) · Frontiers in Sports and Active Living · doi

  Future studies should focus on associations between factors such as exercise habits or gaming behavior and the effects of arm for movement condition during virtual height exposure, instance, by comparing extreme groups (e. There are a few limitations of the present study, which need to be addressed. Another limitation of this study is the use of an incongruent support surface. As we did not control for these measures, they may have contributed to the partially high variability.

  generallimitations
  Keywords: future focus associations factors exercise habits gaming behavior effects movement condition virtual height exposure instance
• Balance performance of healthy young individuals in real versus matched virtual environments: a systematic scoping review (2024) · Frontiers in Human Neuroscience · cited 9× · doi

  The present systematic scoping review revealed several issues that should be addressed in future studies. First and most importantly there is an urgent need for studies on the influence of HMD-driven VR on balance performance in healthy children and adolescents. Previous studies (Balogun et al., 1994; Gouleme et al., 2014, 2018) on the development of postural control have shown age-related differences between children’s, adolescents’ and young adults’ balance performances. Children, for example rely more heavily on visual input to control their posture and thus maintain their balance (Hirabayashi and Iwasaki, 1995; Steindl et al., 2006). Therefore, the effects of VR on balance performance may be stronger in children than young adults. Two parameters potentially affecting balance performance in VR are an individuals’ perceived presence when immersed in the virtual environment (Asslander and Streuber, 2020) as well as virtual reality sickness (e.g., dizziness, nausea; Chang et  al., 2020). However, presence was only assessed in two (Asslander and Streuber, 2020; Boroomand-Tehrani et al., 2020) of the included studies. Similarly, only two studies (Peterson et al., 2018; Asslander and Streuber, 2020) recorded proxies of virtual reality sickness. Future studies should analyze how these psycho-physical variables are associated with balance performance in healthy young individuals when viewing a virtual environment through a HMD. The findings presented in this review are limited to immediate effects of VR matched to the real environment on balance performance. However, there is evidence that the time spent in VR affects balance performance in VR (Ketterer et al., 2022) as well as in the real environment once the HMD is taken off (Akizuki et  al., 2005). This relationship should be investigated in future studies as it is particularly important with respect to VR-assisted balance training. Additionally, it might also be interesting to investigate long-term (training/de-training) effects of VR on balance performance as well as the effects different virtual environments. In this regard, one could suppose that balance may be affected more strongly when the virtual environment does not correspond to the real environment. All of the HMDs used in the included studies were cable-bound and connected to a PC. This may have affected balance performance as well as perceived presence as the cords would probably move, especially in dynamic conditions, which participants presumably sensed. The latest generation of consumer-oriented HMDs (e.g., Meta Quest 3, HTC VIVE Focus 3) are standalone devices, which should provide users with an even more realistic experience when immersed in virtual reality. Consequently, future studies should investigate their effects on balance performance in healthy young populations. Lastly, previous research (Esteves et al., 2022; Deodato et al., 2023) has also shown that unilateral injuries may not only affect balance performance of the injured but also of the actually healthy limb, perhaps due to a general reorganization of balance control. Future studies could investigate whether VR provides benefits for research within this topic, as it could for instance be used as a training tool.

  generalfuture work
  Keywords: balance performance virtual environment future effects healthy children young well training control presence asslander streuber
• Cerebral cortical activation and functional connectivity characteristics of children with unilateral cerebral palsy during a single-session virtual reality throwing motor task: a functional near-infrared spectroscopy study (2026) · Frontiers in Rehabilitation Sciences · doi

  these methods have Current conventional rehabilitation interventions for children with CP mainly include neurodevelopmental therapy (NDT, a widely used clinical approach in pediatric rehabilitation, though current evidence-based guidelines do not support its efficacy as a standalone intervention), hand function training, constraintinduced movement therapy, and physical agent modalities (PAMs, referring to adjunctive physical treatments including electrotherapy, thermotherapy, and ultrasound therapy) (11). However, such as high repetitiveness, high training intensity, easy fatigue, and poor compliance in children (12). In recent years, virtual reality (VR) technology, with its advantages of immersion, interactivity, and imagination, can construct a multi-sensory integrated training environment, significantly enhancing children’s motivation to participate in training. Studies have confirmed that positive emotional feedback in VR games can further strengthen neural stimulation (13), making it an effective alternative for upper limb function rehabilitation in CP (14, 15). Existing systematic reviews suggest that long-term VR rehabilitation training has limb motor shown potential benefits function and promoting motor recovery in children with CP, compared with traditional non-VR rehabilitation methods (16, 17).

  generallimitationsevidence 5/5
  Keywords: rehabilitation training children current therapy function motor evidence physical high upper limb conventional interventions mainly

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