The Improvement Effects of Virtual Reality-Assisted Exercise Training on Motor and Psychiatric Symptoms in Patients With Parkinson’s Disease: A Meta-Analysis of Randomized Controlled Trials

Abstract

Background: This study aimed to systematically evaluate the combined improvement effects of virtual reality (VR)-assisted exercise training on motor function and psychiatric symptoms in patients with Parkinson’s disease (PD), and to provide more scientific evidence-based support for precise clinical rehabilitation. Methods: This study searched China National Knowledge Infrastructure (CNKI), Wanfang, China Science and Technology Journal Database (VIP Database), PubMed, Web of Science and Scopus for randomized controlled trials (RCTs) examining VR interventions in patients with idiopathic PD covering the period from database inception to 1 March 2026. Two investigators independently performed literature screening and data extraction. Methodological quality was assessed using the Cochrane Risk of Bias Tool 2.0. Meta-analysis was conducted using Review Manager 5.4 and R 4.6.0 software. Results: A total of 37 RCTs involving 1749 patients with PD were included. Meta-analysis results showed that, compared with conventional rehabilitation training, VR-assisted training significantly improved motor outcomes, as reflected by the Berg Balance Scale (BBS; mean difference (MD) = 3.96), Timed Up and Go Test (TUGT; MD = –2.48), and Unified Parkinson’s disease Rating Scale Part III (UPDRS-III; MD = –2.94). Regarding psychiatric symptoms, VR training significantly enhanced specific cognitive function (Montreal Cognitive Assessment (MoCA); MD = 1.94), alleviated subjective depressive mood (Beck Depression Inventory (BDI); MD = –1.75), and improved activity-specific balance confidence (Activities-specific Balance Confidence Scale (ABC); MD = 12.03). However, no statistically significant between-group differences were found in global cognition (Mini-Mental State Examination (MMSE)) and observer-rated depression (Hamilton Depression Rating Scale (HAMD)). Conclusions: VR-assisted exercise training effectively improves comprehensive motor function, specific cognition and depressive mood in patients with PD. Therapeutic efficacy may be influenced by the immersion level of equipment and intervention duration. VR confers short-term improvements, but its long-term effects remain unknown. It may serve as a promising adjunctive therapy; however, routine clinical recommendation requires further evidence from extended follow-up studies. High-quality RCTs with prolonged follow-up periods are still warranted to clarify the long-term effects of VR interventions with varying immersion levels.