Comparative Effectiveness of Virtual Reality and Mirror Therapy on Upper Extremity Motor Recovery After Stroke: A Systematic Review and Meta-analysis.
Kevin Axel Chandra, Felicia Jahja, Jenny Lauvita et al.
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In 30 seconds
This systematic review and meta-analysis pooled randomized controlled trials directly comparing virtual reality (VR) with mirror therapy (MT) for upper-extremity recovery in adult stroke survivors. Across seven outcomes, there were no statistically significant differences between interventions in Fugl-Meyer Assessment scores or Box and Block Test performance. VR showed a small statistical advantage on the Manual Function Test (mean difference 1.26; 95% CI, 0.03-2.48; P=.04), but the authors considered its clinical relevance limited. Overall, the findings indicate comparable motor recovery with VR and MT.
Key findings
- No significant difference was found in Fugl-Meyer upper-extremity total score: MD=1.08; 95% CI, -1.16 to 3.33.
- VR favored MT on the Manual Function Test (MD=1.26; 95% CI, 0.03-2.48; P=.04), but the absolute difference was small relative to the scale range.
- No significant difference was found on the Box and Block Test (MD=0.71; 95% CI, -0.37 to 1.79).
- Heterogeneity across pooled outcomes was negligible (I²=0%).
Why it matters
The comparison suggests that both VR and MT can be considered rehabilitation approaches with broadly similar effects on upper-extremity motor outcomes after stroke. The isolated statistical advantage for VR in manual function was small and may not translate into a meaningful clinical difference. Distinguishing statistical from clinical importance helps avoid overstating comparative benefits when selecting or evaluating rehabilitation interventions.
What to keep in mind
The review calls for further adequately powered randomized trials to determine whether specific patient subgroups benefit more from VR.