Table 1 Clinical information and outcome measures of studies on VAMR and traditional therapy

Ahmad et al. 2019 [30]

EG: 18

57

Chronic

1.5 h of standard physiotherapy exercise with 30 min VR training (once a week for 8 weeks)

2 h of standard physiotherapy exercise (once a week for 8 weeks)

FMA-UE/WMFT/IMI/IADL/SIS

CG: 18

62.94

Aşkın et al. 2018 [31]

EG: 18

53.27 ± 11.19

Chronic

20 sessions of physical therapy + 20 sessions of Kinect-based VR training

20 sessions of physical therapy

FMA-UE/BBT/BRS/MAS/MI/AROM

CG: 20

56.55 ± 9.85

Assis et al. 2016 [28]

EG: 3

50.5

Chronic

EG sensory-motor training in using NeuroR system (4 weeks)

Having a relaxation session, instructed by the physiotherapist (4 weeks)

FMA-UE

CG: 3

59.5

Bergmann et al. 2017 [32]

EG: 10

62 ± 11

Subacute

VR-augmented robot-assisted gait training (RAGT) 12 sessions (4 weeks, 3 sessions per week)

Standard RAGT 12 sessions (4 weeks, 3 sessions per week)

IMI/FAC/MRC

CG: 10

65 ± 8

Brunner et al. 2017 [33]

EG: 62

62

Subacute

60 min VR training (30 days, 4–5 sessions per week)

60 min standard conventional therapy program (30 days, 4–5 sessions per week)

ARAT/BBT/FIM/PGIC

CG: 58

62

Byl et al.2013 [34]

EG: 10

65.2 ± 5.4

Chronic

Perform repetitive movements while playing task-specific games (Twice a week for 6 weeks)

Repetitive task exercises involve stretching, and grasping (Twice a week for 6 weeks)

FMA-UE/WMFT/BBT

CG: 5

54.2 ± 20.5

Calabrò et al. 2017 [35]

EG: 12

60 ± 4

Chronic

Lokomat with VR (RAGT + VR)

Lokomat without VR (RAGT-VR)

RMI/POMA/MAS/HRS/VAS

CG: 12

63 ± 6

Cameirão et al. 2011 [17]

EG: 10

56.8

Acute

Perform the Spheroids tasks (Hitting, Grasping, and Placing) (Once a week for 3 weeks)

Perform pure extended occupational therapy (Once a week for 3 weeks)

FMA-UE/MBI/MRC/MI

CG: 9

52.9

Chen et al. 2015 [36]

EG: 8

58.2 ± 12.1

Chronic

30 min play bowling and ladder climbing games by XaviX®Port system (3 sessions per week for 8 weeks)

30 min in use of Curamotion exerciser and the climbing board and bar (3 sessions per week for 8 weeks)

FMA-UE/FIM/BBT/ROM

CG: 8

48.5 ± 16.4

Cho et al. 2012 [37]

EG: 15

64.0 ± 7.1

N/A

VR training (60 min sessions, 5 times a week, for 4 weeks)

Traditional rehabilitation (30 min sessions, 3 times a week, for 4 weeks)

WMFT/MVPT

CG: 14

63.7 ± 8.8

Choi et al. 2016 [38]

EG: 12

61.0 ± 15.2

N/A

30 min occupational therapy + 30 min MoU-Rehab (5 days per week for 2 weeks, 1 h per day)

1 h occupational therapy (5 days per week for 2 weeks, 1 h per day)

FMA-UE/B-stage/MMT/MBI/EQ-5D/BDI

CG: 12

72.1 ± 9.9

Duff et al. 2013 [14]

EG: 11

69.27 ± 7.85

Chronic

Adaptive mixed reality rehabilitation (AMRR) system (3 times a week for 4 weeks)

1-h upper-extremity therapy (3 times a week for 4 weeks)

FMA-UE/WMFT/MAL/SIS

CG: 10

67.7 ± 7.85

El-Kafy et al. 2021 [39]

EG: 18

53.32 ± 5.13

Chronic

2 h muscle exercises, ADL tasks, and VR training program using Armeo Spring (3 times a week for 3 months)

2 h conventional functional training program (3 times a week for 3 months)

ARAT/WMFT/HGS

CG: 19

54.46 ± 4.27

Faria et al. 2018 [40]

EG: 12

57.1 ± 11.0

Chronic

Underwent training with the Reh@Task (for 1 month)

Conventional occupational therapy (for 1 month)

MoCA

CG: 12

68.9 ± 9.8

Ho et al. 2019 [41]

EG: 100

67.97 ± 11.38

Acute

40 min conventional therapy + 20 min VR program (7 times for 1 week)

1 h conventional therapy only (7 times for 1 week)

mRS/NIHSS

CG: 100

67.68 ± 11.13

Hung et al. 2019 [42]

EG: 17

56.58

Chronic

30 min Kinect2scratch with 3–4 games per training session (2/3 sessions per week, total 24 sessions)

30 min conventional therapy (2/3 sessions per week, total of 24 sessions)

FMA-UE/WMFT/MAL

CG: 16

61.38

Ikbali Afsar et al. 2018 [43]

EG: 19

69.42 ± 8.55

Subacute

VR training using Xbox Kinect + conventional therapy (5 days per week, for 4 weeks)

Conventional rehabilitation program (5 days per week, for 4 weeks)

FMA-UE/BBT/FIM

CG: 16

63.44 ± 15.73

In et al. 2012 [44]

EG: 11

63.45 ± 11.78

Chronic

30 min VR reflection therapy (5 days a week for 4 weeks)

30 min conventional therapy (5 days a week for 4 weeks)

FMA-UE/BBT/MAS/MFT

CG: 8

64.50 ± 11.69

Johnson et al. 2020 [45]

EG: 28

64.7 ± 13.9

Chronic

45 min Jintronix Rehabilitation System (2 times a week for 8 weeks)

Usual care (2 times a week for 8 weeks)

FMA-UE/ARAT/BBT/MAS

CG: 30

59.3 ± 15.6

Kalron et al. 2016 [46]

EG: 15

47.3 ± 9.6

N/A

30 min Computer Assisted Rehabilitation Environment (CAREN) Integrated Reality System with D-flow software (6 weeks, 2 sessions per week)

10 min stretching exercises + 20 min intervention (6 weeks, 2 sessions per week)

FRT/BBT/FSST

CG: 15

43.9 ± 10.6

Kim et al. 2018 [47]

EG: 11

VR: 54.7 ± 17.3

Subacute

30 min occupational therapy + 30 min daily VR (5 days per week for 10 weekdays)

30 min occupational therapy (5 days per week for 10 weekdays)

FMA-UE/B-stage/BBT/K-MBI

CG: 8

CG:53.5 ± 16.0

Kiper et al. 2011 [48]

EG: 40

All: 64 ± 16.4

Chronic

1 h traditional neuromotor rehabilitation treatment + 1 h reinforced feedback in virtual environment therapy (5 days a week for 4 weeks)

2 h traditional neuromotor rehabilitation treatment (5 days a week for 4 weeks)

FMA-UE/FIM/ASS

CG: 40

Kiper et al. 2014 [49]

EG: 23

63.1 ± 9.5

Chronic

1 h VR treatment + 1 h conventional treatment (5 days per week for 4 weeks)

2 h of conventional training (5 days per week for 4 weeks)

FMA-UE/FIM

CG: 21

65.5 ± 14.2

Kottink et al. 2014 [50]

EG: 8

N/A

Chronic

30 min VR rehabilitation game (Once per week for 6 weeks)

30 min conventional training (Once per week for 6 weeks)

FMA-UE

CG: 10

Lee et al. 2014 [51]

EG: 12

58.33 ± 10.17

N/A

30 min virtual reality reflection equipment (Asymmetric training on hand) + 1 h standard rehabilitation training (4 weeks)

30 min symmetric training on hand + 1 h standard rehabilitation training (4 weeks)

FMA-UE/BBT/MAS/ROM

CG: 12

65.42 ± 9.77

Lee et al. 2016 [52]

EG: 13

66.46 ± 7.26

Chronic

30 min VR rehabilitation program (3 times per week for 8 weeks)

30 min conventional training sessions (3 times per week for 8 weeks)

FMA-UE/MFT/BBT/MBI/ SF-12

CG: 13

69.92 ± 7.18

Lee et al. 2018 [53]

EG: 15

VR: 61.80 ± 6.80

Subacute

VR canoe paddling training (30 min each day, 3 times per week, for 5 weeks)

Conventional rehabilitation program (30 min each day, 3 times per week, for 5 weeks)

mFRT// MFT

CG: 15

CG: 61.33 ± 8.44

Levin et al. 2012 [54]

EG: 6

58.1 ± 14.6

Chronic

VR therapy (goal-directed reaching tasks) (4 clinical evaluations + 9 intervention sessions)

Occupational therapy (4 clinical evaluations + 9 intervention sessions)

FMA-UE/BBT/WMFT/CSI

CG: 6

59.8 ± 15.1

Lin et al. 2018 [55]

EG: 5

45.0 ± 11.2

N/A

35 min VR game with a motion tracking device (12 sessions, 3 sessions per week)

35 min traditional rehabilitation (12 sessions, 3 sessions per week)

FMA-UE

CG: 5

52.2 ± 7.7

Lin et al. 2020 [56]

EG: 38

VR: 64.5 ± 13.5

Acute

3–6 days early rehabilitation + 5 days VR Training

3–6 days early rehabilitation

MBI/PASS/HADS

CG: 107

CG: 66.9 ± 13.3

ÖGÜN et al. 2019 [57]

EG: 33

61.48 ± 10.92

Chronic

60 min of the upper extremity immersive VR rehabilitation program

45 min of conventional therapy and 15 min of a sham VR program

ARAT/FMA-UE/FIM/PASS

CG: 32

59.75 ± 8.07

Oh et al. 2019 [58]

EG: 17

57.4 ± 12.2

Chronic

VR combined real instrument training (6 weeks)

Conventional occupational therapy (6 weeks)

MMT/mAS/FMA-UE/K-MMSE/K-MoCA/BBT

CG: 14

52.6 ± 10.7

Park et al. 2016 [59]

EG: 15

61.6 ± 5.34

Chronic

30 min game-based VR movement therapy using the Wii (5 days a week for 4 weeks)

30 min conventional therapy (5 days a week for 4 weeks)

FMA-UE/BBT/MAL-QOM

CG: 15

62.0 ± 4.29

Park et al. 2019 [60]

EG: 12

53.5 ± 13

Subacute

30 min using Smart Board (20 sessions, 5 days per week, 4 weeks)

30 min using conventional occupational therapy (20 sessions, 5 days per week, 4 weeks)

FMA-UE/WMFT/AROM/MBI

CG: 13

51.5 ± 16.7

Pedreira da Fonseca, 2017 [61]

EG: 15

53.8 ± 6.3

Chronic

Use Nintendo Wii for VR therapy in 45 min + 15 min conventional therapy

1 h conventional therapy

DGI

CG: 15

50.9 ± 10.9

Piron et al. 2010 [62]

EG: 27

59 ± 8

N/A

Perform motor tasks with real objects by using 3D magnetic receiver to record movement (5 days per week for 4 weeks)

Perform specific exercises for the arm (5 days per week for 4 weeks)

FMA-UE/FIM

CG: 23

62 ± 10

Prange et al. 2015 [63]

EG: 35

60.3 ± 9.7

Subacute

30 min arm support training by using ArmeoBoom (Once per week for 6 weeks)

30 min standardized sets of arm exercises + OT (Once per week for 6 weeks)

FMA-UE/SULCS

CG: 33

58 ± 11.4

Saposnik et al. 2010 [64]

EG: 11

55

Chronic

Use the Nintendo Wii game console to play “Wii Sports” (20 h in 2 weeks)

Leisure activities, including cards, bingo and building blocks (20 h in 2 weeks)

WMFT/BBT/SIS

CG: 113

67

Saposnik et al. 2016 [65]

EG: 71

62 ± 13

Acute

Non-immersive virtual reality using the Nintendo Wii (2 weeks)

Simple recreational activities (2 weeks)

WMFT/BBT/MBI/FIM/SIS

CG: 70

62 ± 12

Shin et al. 2013 [66]

EG: 9

46.6 ± 5.8

N/A

RehabMaster™

Conventional occupational therapy

FMA-UE/MBI

CG: 7

52 ± 11.9

Shin et al. 2014 [67]

EG: 9

52.0 ± 11.9

N/A

Conventional occupational therapy + 20 min of RehabMaster training (10 sessions in 2 weeks)

Conventional occupational therapy (10 sessions in 2 weeks)

FMA-UE/MBI

CG: 7

46.6 ± 55.8

Shin et al. 2015 [68]

EG:16

53.37 ± 11.8

Chronic

30 min conventional therapy + 30 min of game-based VR rehabilitation with the RehabMasterTM system (5 days a week for 4 weeks)

30 min of conventional therapy + additional 30 min therapy (5 days a week for 4 weeks)

FMA-UE/HDRS

CG: 16

54.67 ± 13.4

Shin et al. 2016 [69]

EG: 24

57.2 ± 10.3

N/A

Smart glove intervention (4 weeks with 20 sessions for 30 min per day)

Conventional therapy (4 weeks with 20 sessions for 30 min per day)

FMA-UE/JTT

CG: 22

59.8 ± 13

Sin et al. 2013 [70]

EG: 18

71.78 ± 9.42

Chronic

Xbox Kinect with 30 min + conventional OT for 30 min (3 times a week for 6 weeks)

1 h conventional occupational therapy (3 times a week for 6 weeks)

FMA-UE/BBT/AROM

CG: 17

75.59 ± 5.55

Subramanian et al. 2013 [71]

EG: 16

62 ± 9.7

Chronic

3D virtual environment (CAREN system) simulated a supermarket scene (3 times a week for 4 weeks)

Point to the target in the physical environment (3 times a week for 4 weeks)

FMA-UE/WMFT/MAL-AS

CG: 16

60 ± 11

Thielbar et al. 2020 [72]

EG: 9

59.7 ± 10.5

Chronic

Virtual Environment for Rehabilitative Gaming Exercises system (3 evaluation sessions)

Conventional therapy (3 evaluation sessions)

FMA-UE

CG: 9

59.8 ± 4.8

Tramontano et al. 2018 [73]

EG: 13

63.1 ± 8.5

Subacute

20 min vestibular rehabilitation (12 sessions, 3 times per week for 4 weeks)

20 min conventional rehabilitation training (12 sessions, 3 times per week for 4 weeks)

MBT/FAC/BBS/RMI/T-total/T-balance

CG: 12

65.1 ± 15.5

Turolla et al. 2013 [29]

EG: 263

60.2 ± 14.3

N/A

1 h of upper limb conventional therapy and 1 h of VR therapy (4 weeks)

2 h conventional treatment (4 weeks)

FMA-UE/FIM

CG: 113

65.4 ± 12.5

Viana et al. 2014 [74]

EG: 10

56.0 ± 10.2

Subacute

1 h VR exercises for the UL + 13 min transcranial direct current stimulation (primary motor cortex) (5 weeks)

1 h transcranial direct current stimulation (primary motor cortex) (5 weeks)

FMA-UE/WMFT/MAS/SSQOL

CG: 10

55.0 ± 12.2

Yin et al. 2014 [75]

EG: 11

62

N/A

Nine 30 min upper extremity VR therapy + 30 min conventional therapy (5 weekdays for 2 weeks)

1 h conventional therapy (5 weekdays for 2 weeks)

FMA-UE/ARAT/MAL/FIM

CG: 12

56