XR serious games for phantom limb pain, neurofunctional recovery, and prosthetic adoption: a systematic review.
Muhannad Farhan, Saad Jawaid Khan, Kehinde Quasim Yusuf et al.
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In 30 seconds
This systematic review synthesized studies of extended-reality serious games for adults with limb amputation, examining phantom limb pain, rehabilitation, embodiment, and prosthesis adoption. Twenty-four studies met the inclusion criteria. The review found consistent reductions in phantom limb pain; AR-based phantom motor execution systems reported effect sizes of d = 0.9-1.3. Two randomised controlled trials found improved gait and balance with VR exergames. Other studies suggested benefits for object manipulation, motor control, and embodiment, while evidence connecting sensorimotor feedback to cortical adaptation remained exploratory.
Key findings
- Across included studies, XR interventions showed consistent phantom limb pain reduction; AR-based systems reported effect sizes of d = 0.9-1.3.
- VR exergames improved gait and balance in 2 RCTs.
- Immersive VR and EMG systems indicated improvements in object manipulation, performance time, and motor control.
- Evidence for cortical adaptation was exploratory, while usability and engagement outcomes were positive.
Why it matters
The findings suggest that XR serious games may address both pain and functional rehabilitation after amputation, with potential to support mobility, prosthesis control, and embodiment. However, the evidence for cortical mechanisms is not yet established, and limited research on real-world implementation and scalability means reported benefits should be interpreted as preliminary.
What to keep in mind
Real-world implementation and scalability remain under-researched; evidence linking XR-mediated sensorimotor feedback to cortical adaptation is exploratory.