Advancing Neurorehabilitation Through Virtual Reality and Robotics: A Critical Narrative Review of Motor Recovery Technologies

Abstract

Background: Neurological disorders such as stroke, spinal cord injury, and Parkinson’s disease often lead to persistent motor deficits. Conventional rehabilitation is limited by insufficient therapy intensity and patient adherence. Virtual reality (VR) and robotics have been increasingly studied as adjunctive interventions to enhance motor recovery. Objective: To synthesize evidence from 2015–2025 on the effectiveness of VR and robotic technologies in motor neurorehabilitation, with attention to mechanisms, outcomes, limitations, and future directions. Methods: A narrative review was conducted using PubMed, Scopus, and Google Scholar. Eligible studies included randomized controlled trials, systematic reviews, and meta-analyses assessing VR and/or robotic interventions for motor recovery in patients with neurological motor impairments. Results: Across systematic reviews and meta-analyses, VR demonstrated small-to-moderate improvements in upper-limb function, particularly in stroke survivors, with immersive VR outperforming non-immersive systems (standardized mean differences ranging 0.3–0.5). Robotics improved activities of daily living and strength, especially in upper-limb rehabilitation, though effect sizes were modest when compared to dose-matched conventional therapy. Device comparisons showed end-effector robots favored for proximal arm recovery, while exoskeletons were more effective for distal hand function. Lower-limb robotics, including exoskeleton gait trainers, showed gains in gait speed and ambulation but with mixed evidence. Combined VR-robot interventions and brain–computer interface (BCI) systems showed preliminary additive effects, though evidence quality was low-to-moderate and most trials had <50 participants with short follow-up (<6 months). Conclusion: VR and robotics provide measurable but modest improvements in motor recovery and are best used as adjuncts to conventional therapy. Broader clinical adoption requires standardized protocols, inclusion of diverse populations, long-term outcome evaluation, and cost-effectiveness strategies.