Virtual Reality Therapy and Virtual Reality Mirror Therapy in Post-Stroke Rehabilitation: A Review

Stroke is a leading cause of long-term disability worldwide, often resulting in motor impairments that reduce independence and quality of life. While physical therapy remains the standard for post-stroke rehabilitation, many patients face significant barriers to accessing or completing treatment, particularly those with severe impairments or limited resources. Virtual reality (VR)-based therapies, including virtual mirror therapy (VRMT), have emerged as potential alternatives to enhance rehabilitation access, engagement, and outcomes. This systematic review evaluates the comparative effectiveness of VRMT and other VR modalities in improving motor function in post-stroke patients. A comprehensive search of peer-reviewed literature from 2015 to 2025 was conducted across databases, including PubMed, Scopus, and Web of Science. Inclusion criteria required studies to use immersive or semi-immersive VR interventions with stroke populations, with at least one group receiving virtual mirror or reflection therapy. Outcomes were synthesized based on balance, gait, upper limb function, and user engagement. Across the selected studies, VRMT interventions showed particularly strong effects in improving dynamic balance and gait, especially in individuals with limited voluntary motor control. Compared to general VR platforms, VRMT appeared more effective in targeting sensorimotor integration through body-schema-based visual feedback. Other VR modalities, including gamified and cognitive training programs, demonstrated strengths in upper limb use and cognitive outcomes, though with greater variability in motor gains. These findings support the inclusion of VRMT as a promising adjunct or alternative to conventional therapy, particularly for patients with severe motor impairments. Further research is warranted to tailor VR-based rehabilitation for diverse clinical populations.