Effectiveness of Virtual Reality-Based Telerehabilitation for Stroke Patients in Pakistan: A Randomized Controlled Trial

Etisam Wahid; Shahzad Ahmad; Soom Khalil; Muhammad Sanan Khan; Naima Bibi; Nimrah Humayoon

doi:10.55735/n0ys8906

Authors

Etisam Wahid University of Veterinary and Animal Sciences, Swat, Pakistan https://orcid.org/0009-0009-0227-3735
Shahzad Ahmad University of Veterinary and Animal Sciences, Swat, Pakistan https://orcid.org/0009-0001-6319-7934
Soom Khalil Mufti Mehmood Memorial Teaching Hospital, Dera Ismail Khan, Pakistan https://orcid.org/0009-0000-9785-4712
Muhammad Sanan Khan Anatomy Health Club, Islamabad, Pakistan https://orcid.org/0009-0002-3520-6474
Naima Bibi Institute of Health Sciences, Peshawar, Pakistan
Nimrah Humayoon University of Veterinary and Animal Sciences, Swat, Pakistan https://orcid.org/0009-0009-8164-7327

DOI:

https://doi.org/10.55735/n0ys8906

Keywords:

Digital health , Neurorehabilitation , Stroke recovery , Virtual reality , Telerehabilitation

Abstract

Background: Stroke is a leading cause of long-term disability in Pakistan, with many patients unable to access timely rehabilitation due to geographical and financial constraints. Conventional rehabilitation, while effective, is often limited to urban centers. Virtual reality-based telerehabilitation offers an innovative solution, providing structured, interactive therapy remotely and improving accessibility for underserved populations. Objective: To evaluate the effectiveness of a virtual reality-based telerehabilitation program in improving motor function, balance, and daily living activities among post-stroke patients in Pakistan. Methodology: A randomized controlled trial was conducted among adults with subacute and chronic stroke. Participants were allocated into two groups: the intervention group received virtual reality-based telerehabilitation through smartphone-compatible headsets with remote therapist monitoring, while the control group underwent conventional physiotherapy. The intervention consisted of 30 to 45-minute sessions, three times a week, for eight weeks. Functional outcomes were measured using the Fugl-Meyer Assessment for upper limb function, Berg Balance Scale, and Barthel Index for daily living activities. Assessments were performed at baseline, post-intervention, and three-month follow-up. Between-group comparisons were made using independent sample t-tests. Within-group changes across the three time points were assessed using repeated measures ANOVA. Results: Preliminary analysis showed that virtual reality-based telerehabilitation produced comparable or superior improvements in upper limb function, balance, and independence in activities of daily living compared to standard therapy. Participants reported higher engagement and satisfaction, with no major adverse events. Conclusion: Virtual reality-based telerehabilitation is an effective and accessible rehabilitation strategy for stroke survivors in Pakistan. By leveraging affordable technology, it can address rehabilitation gaps, reduce hospital burden, and improve patient outcomes, especially in rural and resource-limited settings. Wider implementation and larger-scale studies are recommended to support national rehabilitation programs.

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