these methods have Current conventional rehabilitation interventions for children with CP mainly include neurodevelopmental therapy (NDT, a widely used clinical approach in pediatric rehabilitation, t

The gap

Consensus across the literature

Supporting evidence — 3 representative gaps

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

  Keywords: rehabilitation systems stroke patients motor subacute months upper limb impairment therapy sessions platforms based immersive
• mHealth Interventions for Stroke Recovery: A Systematic Review and Meta-Analysis of Motor and Functional Improvements (2026) · doi

  non-English publications and potential underreporting of negative or References: independent exclusion include of therapist-led sessions, while others were entirely self- administered, contributing to heterogeneity (I² = [14,16,17] Few studies provided detailed 75.4%). adherence data or long-term outcome follow-up, leaving gaps in understanding sustained use and real- world effectiveness. This review contributes to the existing literature by focusing specifically on stroke- related motor and functional outcomes, addressing a narrower scope than broader digital health reviews. [15, 21] tools Clinically, the moderate effect size reported has meaningful can implications. mHealth complement conventional rehabilitation by providing structured, flexible, and often home-based support, which may improve therapy adherence. The ability to remotely monitor progress and personalize exercises makes these interventions practical in both urban and remote settings. [4,5,11] However, clear guidelines on dosage, progression, and therapist involvement are lacking and must be established to optimize their integration into physiotherapy practice. [14,24] null results, which may affect the comprehensiveness of included evidence. [20,25] The findings are in agreement with previous systematic reviews such as those by Cao et al. (2024) and Rintala et al. (2023), which reported moderate benefits of mHealth interventions on stroke recovery. [7, 9] While the effect sizes in our analysis align with those reported by Cao et al. (0.5–0.6), heterogeneity remains a consistent concern across studies. These results also echo meta-analytic findings in related domains, such as Zhou et al. (2023), which identified similar levels of variability in mHealth effects on blood pressure control.[26]

  Keywords: reported mhealth therapist heterogeneity adherence stroke related reviews moderate effect interventions english publications potential underreporting
• 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) · 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, constraint- induced 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). However, the current evidence base is limited and of variable quality, and most relevant studies focus on changes in motor improving upper in

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