Volume 16, Issue 4 (3-2026)
JAP 2026, 16(4): 1-14 |
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ashoury H. A Systematic Review of Virtual Reality Rehabilitation for Improving Functional Outcomes and Return to Sport After ACL Reconstruction Hossein Ashoury 1. JAP 2026; 16 (4) :1-14
URL: http://jap.iums.ac.ir/article-1-5803-en.html
URL: http://jap.iums.ac.ir/article-1-5803-en.html
Assistant Professor, Department of Physical Education and Sports Sciences, Payame Noor University, Tehran, Iran , hoosienashoury@yahoo.com
Abstract: (22 Views)
background and Aim: Return to sport (RTS) rates following anterior cruciate ligament reconstruction (ACLR) remain suboptimal, often due to persistent functional deficits and psychological barriers. Virtual reality (VR) offers a novel modality for enhancing neuromuscular control, cognitive engagement, and rehabilitation adherence. This research systematically evaluated data from randomized controlled trials (RCT) to determine the comparative effectiveness of VR exercises against traditional rehabilitation methods on an athlete's physical knee function, mental confidence, and successful return to sport after ACL reconstruction.
Methods: A systematic search was conducted in PubMed, Scopus, Web of Science, SPORTDiscus, and the Cochrane Central Register of Controlled Trials from 2015 to April 2024. Included studies were RCTs that compared VR-based rehabilitation to conventional physiotherapy in athletes following ACLR. Primary outcomes assessed were functional performance (e.g., hop tests, balance), patient-reported scores International Knee Documentation Committee (IKDC), and RTS rates. To assess the risk of bias, Cochrane RoB 2 was used and the quality of the articles was assessed by the Pedro scale.
Results: Six RCT involving 248 participants met the inclusion criteria. The VR interventions varied from fully immersive gaming to augmented reality biofeedback, with protocols ranging from 4 to 12 weeks. Meta-analysis was not feasible due to clinical heterogeneity. The findings consistently demonstrated that VR groups achieved significantly greater improvements in dynamic postural control (Star Excursion Balance Test), single-leg hop for distance, and IKDC scores compared to control groups. Two studies reported significantly higher RTS rates and greater psychological readiness to return to sport in the VR group at 6- and 9-month follow-ups.
Conclusion: VR-based rehabilitation appears to be a superior adjunct to conventional physiotherapy for improving functional performance, patient-reported outcomes, and potentially RTS rates after ACLR. Its benefits are likely mediated through enhanced neuromuscular control, proprioception, and cognitive engagement. Further high-quality RCT with standardized VR protocols and long-term follow-up are warranted to solidify these findings.
Methods: A systematic search was conducted in PubMed, Scopus, Web of Science, SPORTDiscus, and the Cochrane Central Register of Controlled Trials from 2015 to April 2024. Included studies were RCTs that compared VR-based rehabilitation to conventional physiotherapy in athletes following ACLR. Primary outcomes assessed were functional performance (e.g., hop tests, balance), patient-reported scores International Knee Documentation Committee (IKDC), and RTS rates. To assess the risk of bias, Cochrane RoB 2 was used and the quality of the articles was assessed by the Pedro scale.
Results: Six RCT involving 248 participants met the inclusion criteria. The VR interventions varied from fully immersive gaming to augmented reality biofeedback, with protocols ranging from 4 to 12 weeks. Meta-analysis was not feasible due to clinical heterogeneity. The findings consistently demonstrated that VR groups achieved significantly greater improvements in dynamic postural control (Star Excursion Balance Test), single-leg hop for distance, and IKDC scores compared to control groups. Two studies reported significantly higher RTS rates and greater psychological readiness to return to sport in the VR group at 6- and 9-month follow-ups.
Conclusion: VR-based rehabilitation appears to be a superior adjunct to conventional physiotherapy for improving functional performance, patient-reported outcomes, and potentially RTS rates after ACLR. Its benefits are likely mediated through enhanced neuromuscular control, proprioception, and cognitive engagement. Further high-quality RCT with standardized VR protocols and long-term follow-up are warranted to solidify these findings.
Keywords: virtual Reality, Return to Sport, Anterior Cruciate Ligament, Sport Rehabilitation,
Type of Study: Review |
Subject:
Acute pain managment
Received: 2025.10.19 | Accepted: 2025.11.1 | Published: 2026.03.1
Received: 2025.10.19 | Accepted: 2025.11.1 | Published: 2026.03.1
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