Prospects for the Application of Virtual Reality Technologies in the Early Rehabilitation of Stroke Patients
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Keywords

Acute ischemic stroke
Virtual reality
Early rehabilitation
Neuroplasticity
Intensive care unit

DOI

10.26689/ijgpn.v3iSpecial.14212

Submitted : 2026-02-10
Accepted : 2026-02-25
Published : 2026-03-12

Abstract

Among contemporary technological advancements, virtual reality (VR) emerges as a potent and promising modality for addressing primary rehabilitation goals. Empirical evidence confirms that VR-based rehabilitation can generate realistic perceptual experiences and corresponding patient responses, thereby enhancing the efficacy of cognitive and motor rehabilitation in a cost-efficient manner. However, the success of this rehabilitation paradigm is predominantly contingent upon the specific technologies and clinical protocols implemented by practitioners. This article examines the current pertinent issue of implementing virtual reality technologies for patients with acute ischemic stroke during the early rehabilitation phase. The authors focus specifically on the neurophysiological correlates of VR application and the associated mechanisms of cerebral neuroplasticity. We delineate the characteristic features and contemporary approaches to VR implementation, while proposing a novel conceptual framework for deploying advanced VR technologies in the intensive care unit setting.

References

Iosa M, Morone G, Fusco A, et al., 2012, Seven Capital Devices for the Future of Stroke Rehabilitation. Stroke Res Treat, 2012: 187965.

Morone G, Paolucci S, Mattia D, et al., 2016, The 3Ts of the New Millennium Neurorehabilitation Gym: Therapy, Technology, Translationality. Expert Rev Med Devices, 13(9): 785–787.

Laver KE, Lange B, George S, et al., 2017, Virtual Reality for Stroke Rehabilitation. Cochrane Database Syst Rev, 11(11): CD008349.

Kleim JA, Jones TA, 2008, Principles of Experience-Dependent Neural Plasticity: Implications for Rehabilitation After Brain Damage. J Speech Lang Hear Res, 51(1): S225–S239.

Kim YM, Yun GJ, Song YJ, et al., 2011, The Effect of Virtual Reality Training on Unilateral Spatial Neglect in Stroke Patients. Ann Rehabilitation Med, 35(3): 309–315.

De Luca R, Buono VL, Leo A, et al., 2017, Use of Virtual Reality in Improving Poststroke Neglect: Promising Neuropsychological and Neurophysiological Findings from a Case Study. Appl Neuropsychol Adult, 26(1): 96–100.

Calabr JR, Naro A, Russo M, et al., 2017, The Role of Virtual Reality in Improving Motor Performance as Revealed by EEG: A Randomized Clinical Trial. J Neuroeng Rehabil, 14(1): 53.

Wang L, Zhang H, Ai H, et al., 2024, Effects of Virtual Reality Rehabilitation After Spinal Cord Injury: A Systematic Review and Meta-Analysis. J Neuroeng Rehabil, 21(1): 191.

Sofroniew NJ, Vlasov YA, Hires SA, et al., 2015, Neural Coding in Barrel Cortex During Whisker-Guided Locomotion. Elife, (4): e12559.

Bagce HF, Saleh S, Adamovich S, et al., 2012, Visuomotor Gain Distortion Alters Online Motor Performance and Enhances Primary Motor Cortex Excitability in Patients with Stroke. Neuromodulation, 15(4): 361Y366.

Billinghurst M, Weghorst S, 1995, The Use of Sketch Maps to Measure Cognitive Maps of Virtual Environments, Proceedings Virtual Reality Annual International Symposium ‘95, Research Triangle Park, NC, USA, 40–47.

Witmer BG, Singer MJ, 1998, Measuring Presence in Virtual Environments: A Presence Questionnaire. Teleoperators and Virtual Environments, 7(3): 225–240.

Slater M, Usoh M, 1993, Representations Systems, Perceptual Position, and Presence in Virtual Environments. Teleoperators and Virtual Environments, 2(3): 221–233.

Ceradini M, Losanno E, Micera S, et al., 2024, Immersive VR for Upper-Extremity Rehabilitation in Patients with Neurological Disorders: A Scoping Review. J Neuroeng Rehabil, 21(1): 75.

Macchitella L, Spaccavento S, Arigliani M, et al., 2023, A Narrative Review of the Use of a Cutting-Edge Virtual Reality Rehabilitation Technology in Neurological and Neuropsychological Rehabilitation. NeuroRehabil, 53(4): 439–457.

Obrero-Gaitán E, Chau-Cubero CY, Lomas-Vega R, et al., 2024, Effectiveness of Virtual Reality-Based Therapy in Pulmonary Rehabilitation of Chronic Obstructive Pulmonary Disease: A Systematic Review with Meta-Analysis. Heart Lung, 65: 1–10.

Takei K, Morita S, Watanabe Y, 2024, Acceptability of Physical Therapy Combined with Nintendo Ring Fit Adventure Exergame for Geriatric Hospitalized Patients. Games Health J, 13(1): 33–39.

Drazich BF, McPherson R, Gorman EF, et al., 2023, In Too Deep? A Systematic Literature Review of Fully-Immersive Virtual Reality and Cybersickness Among Older Adults. J Am Geriatr Soc, 71(12): 3906–3915.

Hara M, Murakawa Y, Wagatsuma T, et al., 2024, Feasibility of Somatocognitive Coordination Therapy Using Virtual Reality for Patients with Advanced Severe Parkinson’s Disease. J Parkinsons Dis, 14(4): 895–898.

Bailey RB, 2022, Highlighting Hybridization: A Case Report of Virtual Reality Augmented Interventions to Improve Chronic Post-Stroke Recovery. Medicine (Baltimore), 101(25): e29357.

Liu Y, Lin R, Tian X, et al., 2024, Effects of VR Task-Oriented Training Combined with rTMS on Balance Function and Brain Plasticity in Stroke Patients: A Randomized Controlled Trial Study Protocol. Trials, 25(1): 702.

Heinrich C, Morkisch N, Langlotz T, et al., 2022, Feasibility and Psychophysical Effects of Immersive Virtual Reality-Based Mirror Therapy. J Neuroeng Rehabil, 19(1): 107.

Kamm CP, Blättler R, Kueng R, et al., 2023, Feasibility and Usability of a New Home-Based Immersive Virtual Reality Headset-Based Dexterity Training in Multiple Sclerosis. Mult Scler Relat Disord, 71: 104525.

Gebreheat G, Antonopoulos N, Porter-Armstrong A, 2024, Application of Immersive Virtual Reality Mirror Therapy for Upper Limb Rehabilitation After Stroke: A Scoping Review. Neurol Sci, 45(9): 4173–4184.

Demeco A, Zola L, Frizziero A, et al., 2023, Immersive Virtual Reality in Poststroke Rehabilitation: A Systematic Review. Sensors (Basel), 23(3): 1712.

Mekbib DB, Zhao Z, Wang J, et al., 2020, Proactive Motor Functional Recovery Following Immersive Virtual Reality-Based Limb Mirroring Therapy in Patients with Subacute Stroke. Neurotherapeutics, 17(4): 1919–1930.

De Luca R, Leonardi S, Maresca G, et al., 2023, Virtual Reality as a New Tool for the Rehabilitation of Post-Stroke Patients with Chronic Aphasia: An Exploratory Study. Aphasiology, 37(2): 249–259.

Bu X, Ng PH, Tong Y, et al., 2022, A Mobile-Based Virtual Reality Speech Rehabilitation App for Patients with Aphasia After Stroke: Development and Pilot Usability Study. JMIR Serious Games, 10(2): e30196.