Objective To systematically evaluate the efficacy of using in-teractive devices in patients with ischemic stroke (IS).

Method　China National Knowledge Infrastructure (CNKI), WanFang Data, VIP, PubMed, Web of Science, The Cochrane Library, and Embase databases were searched to identify randomized controlled trials examining the effects of nursing models based on interactive devices on indicators such as the Fugl-Meyer Assessment for Upper Extremity (FMA-UE), the Action Research Arm Test (ARAT), the Berg Balance Scale (BBS) and walking speed in patients with IS. The search period was from the inception to April 13, 2025. After independent screening literature, extracting data, and evaluating the risk of bias in the included studies by two researchers, a Meta-analysis was conducted using RevMan 5.1 software.

Results　A total of 9 studies  involving 600 patients were included. The Meta-analysis results showed that in the group using interactive devices, the FMA-UE [MD=6.92, 95%CI (4.78, 9.07)], ARAT [MD=3.85, 95%CI (3.24, 4.46)], BBS [MD=1.05, 95%CI (0.69, 1.40)] were all higher than those in the routine rehabilitation care group (P < 0.001). There was no significant difference in walking speed [MD=0.18, 95%CI (-0.01,0.37), P=0.06]. Subgroup analysis revealed that the use of virtual reality-based devices was more effective in improving FMA-UE [MD=7.28, 95%CI (4.78, 9.79), P < 0.001].

Conclusion　The use of interactive devices has significant advantages in improving the motor ability of IS patients, but their effectiveness may be influenced by the type of intervention, and their long-term efficacy remains to be further validated.

1.Guzik A, Bushnell C. Stroke epidemiology and risk factor management[J]. Continuum (Minneapolis, Minn), 2017, 23(1, Cerebrovascular Disease): 15-39.

2.Tater P, Pandey S. Post-stroke movement disorders: clinical spectrum, pathogenesis, and management[J]. Neurology India, 2021, 69(2): 272-283.

3.Kleindorfer DO, Towfighi A, Chaturvedi S, et al. 2021 guideline for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline from the American Heart Association/American Stroke Association[J]. Strokehttps://pubmed.ncbi.nlm.nih.gov/?term=2021+guideline+for+the+prevention+of+stroke+in+pa-tients+with+stroke+and+transient+ischemic+attack%3A+a+guideline+from+the+American+Heart+Association%2FAmerican+Stroke+Association, 2021, 52(7): e364-e467.

4.Kernan WN, Ovbiagele B, Black HR, et al. Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association[J]. Strokehttps://pubmed.ncbi.nlm.nih.gov/?term=Guidelines+for+the+prevention+of+stroke+in+patients+with+stroke+and+transient+ischemic+attack%3A+a+guideline+for+healthcare+professionals+from+the+American+Heart+Association%2FAmerican+Stroke+Association, 2014, 45(7): 2160-2236.

5.杨敏. 脑卒中患者康复护理指南[J]. 家庭百事通, 2025, (2): 55-57. [Yang M. Guidelines for rehabilitation nursing of stroke patients[J]. Family Guide, 2025, (2): 55-57.]

6.徐妍, 黄馨睿, 严铮, 等. 脑卒中患者中西医结合居家运动康复的最佳证据总结[J]. 浙江中医药大学学报, 2024, 48(11): 1440-1449. [Xu Y, Huang XR, Yan Z, et al. Best evidence summary of integrated traditional Chinese and Western medicine home exercise rehabilitation for stroke patients[J]. Journal of Zhejiang University of Chinese Medicine, 2024, 48(11): 1440-1449.]

7.Jiang L, Zhang W, Qian L, et al. Clinical practice guideline appraisal and algorithm development to identify recommendations related to nursing practice for post-stroke dysphagia[J]. J Clin Nurs, 2023, 32(17-18): 6089-6100.

8.Lens C, Demeestere J, Casolla B, et al. From guidelines to clinical practice in care for ischaemic stroke patients: a systematic review and expert opinion[J]. Eur J Neurol, 2024, 31(12): e16417.

9.Khan MA, Das R, Iversen HK, et al. Review on motor imagery based BCI systems for upper limb post-stroke neurorehabilitation: from designing to application[J]. Comput Biol Med, 2020, 123: 103843.

10.Afridi A, Obaid S, Raheel N, et al. Integrating artificial intelligence in stroke rehabilitation: current trends and future directions; a mini review[J]. JPMA, 2025, 75(2): 445-447.

11.Huo CC, Zheng Y, Lu WW, et al. Prospects for intelligent rehabilitation techniques to treat motor dysfunction[J]. Neural Regen Res, 2021, 16(2): 264-269.

12.Liu X, Zhang W, Li W, et al. Effects of motor imagery based brain-computer interface on upper limb function and attention in stroke patients with hemiplegia: a randomized controlled trial[J]. BMC Neurol, 2023, 23(1): 136.

13.程雪. 下肢康复机器人对慢性期脑卒中辅助步态训练康复效果的初步研究[D]. 重庆: 重庆医科大学, 2020.

14.李洋, 孙钰, 王兴蕾, 等. 可穿戴智能设备在脑卒中患者中应用的研究进展[J]. 广西医学, 2023, 45(18): 2276-2279. [Li Y, Sun Y, Wang XL, et al. Research progress on the application of wearable intelligent devices in stroke patients[J]. Guangxi Medical Journal, 2023, 45(18): 2276-2279.]

15.Ma ZZ, Wu JJ, Cao Z, et al. Motor imagery-based brain-computer interface rehabilitation programs enhance upper extremity performance and cortical activation in stroke patients[J]. J Neuroeng Rehabil, 2024, 21(1): 91.

16.Sana V, Ghous M, Kashif M, et al. Effects of vestibular rehabilitation therapy versus virtual reality on balance, dizziness, and gait in patients with subacute stroke: a randomized controlled trial[J]. Medicine, 2023, 102(24): e33203.

17.Brunner I, Lundquist CB, Pedersen AR, et al. Brain computer interface training with motor imagery and functional electrical stimulation for patients with severe upper limb paresis after stroke: a randomized controlled pilot trial[J]. J Neuroeng Rehabil, 2024, 21(1): 10.

18.Hsu HY, Kuo LC, Lin YC, et al. Effects of a virtual reality-based mirror therapy program on improving sensorimotor function of hands in chronic stroke patients: a randomized controlled trial[J]. Neurorehabil Neural Repair, 2022, 36(6): 335-345.

19.Molinari M, Masciullo M. Stroke and potential benefits of brain-computer interface[J]. Handb Clin Neurol, 2020, 168: 25-32.

20.Rajashekar D, Boyer A, Larkin-Kaiser KA, et al. Technological advances in stroke rehabilitation: robotics and virtual reality[J]. Phys Med Rehabil Clin N Am, 2024, 35(2): 383-398.

21.Lima EO, Silva LM, Melo ALV, et al. Transcranial direct current stimulation and brain-computer interfaces for improving post-stroke recovery: a systematic review and Meta-analysis[J]. Clin Rehabil, 2024, 38(1): 3-14.

22.Chen J, Or CK, Chen T. Effectiveness of using virtual reality-supported exercise therapy for upper extremity motor rehabilitation in patients with stroke: systematic review and Meta-analysis of randomized controlled trials[J].J Med Internet Res, 2022, 24(6): e24111.

23.Hong W, Zhang X. MRI assessment of the relationship between cortical morphological features and hemiparetic motor-related outcomes in chronic subcortical stroke patients[J]. J Magn Reson Imaging, 2023, 58(2): 571-580.

24.Zeng X, Zhang Y, Kwong JS, et al. The methodological quality assessment tools for preclinical and clinical studies, systematic review and Meta-analysis, and clinical practice guideline: a systematic review[J]. J Evid Based Med, 2015, 8(1): 2-10.

25.曾宪涛, Kwong JSW, 田国祥, 等. Meta分析系列之二:Meta分析的软件[J]. 中国循证心血管医学杂志, 2012, 4(2): 89-91. [Zeng XT, Kwong JSW, Tian GX, et al. Meta analysis series 2: Meta analysis software[J]. Chinese Journal of Evidence Based Cardiovascular Medicine, 2012, 4(2): 89-91.]

26.杨娟, 郑青山. Meta分析的统计学方法[J]. 中国临床药理学与治疗学, 2005(11): 1309-1314. [Yang J, Zheng QS. Statistical methods for Meta-analysis[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2005(11): 1309-1314.]

27.Ase H, Honaga K, Tani M, et al. Effects of home-based virtual reality upper extremity rehabilitation in persons with chronic stroke: a randomized controlled trial[J]. J Neuroeng Rehabil, 2025, 22(1): 20.

28.Choi JB, Cho KI. Effects of virtual reality-based robot therapy combined with task-oriented therapy on upper limb function and cerebral cortex activation in patients with stroke[J]. Medicine, 2024, 103(27): e38723.

29.Korkusuz S, Taşkın G, Korkusuz BS, et al. Examining the effects of non-immersive virtual reality game-based training on knee hyperextension control and balance in chronic stroke patients: a single-blind randomized controlled study[J]. Neurol Sci, 2025, 46(3): 1267-1275.

30.Kwak HD, Chung E, Lee BH. The effect of balance training using touch controller-based fully immersive virtual reality devices on balance and walking ability in patients with stroke: a pilot randomized controlled trial[J]. Medicine, 2024, 103(27): e38578.

31.Lu R, Pang Z, Gao T, et al. Multisensory BCI promotes motor recovery via high-order network-mediated interhemispheric integration in chronic stroke[J]. BMC Med, 2025, 23(1): 380.

32.Maggio MG, Bonanno L, Rizzo A, et al. The role of virtual reality-based cognitive training in enhancing motivation and cognitive functions in individuals with chronic stroke[J]. Sci Rep, 2025, 15(1): 25258.

33.Wang A, Tian X, Jiang D, et al. Rehabilitation with brain-computer interface and upper limb motor function in ischemic stroke: a randomized controlled trial[J]. Med (New York, NY), 2024, 5(6): 559-569.e554.

34.Xu Y, Yao J, Ni J, et al. Comparison of combined virtual reality combined with standing balance training versus standard practice in patients with hemiplegia: a single-blinded, randomized controlled trial[J]. Am J Phys Med Rehabil, 2025, 104(4): 312-317.

35.Zolkefley MKI, Firwana YMS, Hatta HZM, et al. An overview of fractional anisotropy as a reliable quantitative measurement for the corticospinal tract (CST) integrity in correlation with a Fugl-Meyer assessment in stroke rehabilitation[J]. J Phys Ther Sci, 2021, 33(1): 75-83.

36.Leong SC, Tang YM, Toh FM, et al. Examining the effectiveness of virtual, augmented, and mixed reality (VAMR) therapy for upper limb recovery and activities of daily living in stroke patients: a systematic review and Meta-analysis[J]. J Neuroeng Rehabil, 2022, 19(1): 93.

37.Chang WK, Lim H, Park SH, et al. Effect of immersive virtual mirror visual feedback on Mu suppression and coherence in motor and parietal cortex in stroke[J]. Sci Rep, 2023, 13(1): 12514.

38.Hao J, Xie H, Harp K, et al. Effects of virtual reality intervention on neural plasticity in stroke rehabilitation: a systematic review[J]. Arch Phys Med Rehabil, 2022, 103(3): 523-541.

39.Patel J, Fluet G, Qiu Q, et al. Intensive virtual reality and robotic based upper limb training compared to usual care, and associated cortical reorganization, in the acute and early sub-acute periods post-stroke: a feasibility study[J]. J Neuroeng Rehabil, 2019, 16(1): 92.

40.王明珠, 胡思鸿, 王琴,等. 体感互动游戏Wii改善脑卒中病人康复效果研究进展[J]. 护理研究, 2022, 36(23): 4228-4232. [Wang MZ, Hu SH, Wang Q, et al. Research progress on improving the rehabilitation effect of stroke patients through sensory interactive games [J]. Chinese Nursing Research, 2022, 36(23): 4228-4232.]

41.Mane R, Chouhan T, Guan C. BCI for stroke rehabilitation: motor and beyond[J]. J Neural Eng, 2020, 17(4): 041001.

42.Zhang Y, Zhao W, Wan C, et al. Exoskeleton rehabilitation robot training for balance and lower limb function in sub-acute stroke patients: a pilot, randomized controlled trial[J]. J Neuroeng Rehabil, 2024, 21(1): 98.

43.Savić AM, Novičić M, Ðorđević O, et al. Novel electrotactile brain-computer interface with somatosensory event-related potential based control[J]. Front Hum Neurosci, 2023, 17: 1096814.

44.Bonan IV, Gaillard F, Ponche ST, et al. Early post-stroke period: a privileged time for sensory re-weighting?[J].J Rehabil Med, 2015, 47(6): 516-522.

45.Kübler A, Neumann N. Brain-computer interfaces--the key for the conscious brain locked into a paralyzed body[J]. Prog Brain Res, 2005, 150: 513-525.

46.Kim M, Thawisuk C, Kaneko F, et al. Effectiveness of VR intervention coupled with treadmill training on gait function for stroke patients: a systematic review[J]. NeuroRehabilitation, 2025, 57(1): 3-13.

47.Wei X, Huang C, Ding X, et al. Effect of virtual reality training on dual-task performance in older adults: a systematic review and Meta-analysis[J]. J Neuroeng Rehabil, 2025, 22(1): 141.

48.Ren C, Li X, Gao Q, et al. The effect of brain-computer interface controlled functional electrical stimulation training on rehabilitation of upper limb after stroke: a systematic review and Meta-analysis[J]. Front Hum Neurosci, 2024, 18: 1438095.