Effectiveness of head-mounted virtual reality rehabilitation in individuals with Parkinson’s disease: A systematic review and meta-analysis

Immersive virtual reality (VR) delivered through a head-mounted device is an emerging rehabilitation modality for Parkinson's disease (PD). Previous reviews investigated VR-based intervention; none specifically focused on head-mounted display-based virtual reality rehabilitation (head-mounted VRehab). This systematic review and meta-analysis aimed to evaluate the effectiveness of head-mounted VRehab on balance, gait, motor and cognitive function, and quality of life in individuals with PD, compared with conventional therapy (CT) or baseline outcomes. Following PRISMA 2020 guidelines, PubMed, Cochrane Library, and Web of Science were searched through June 2025. Studies included individuals with PD, applied a head-mounted VRehab lasting ≥3 weeks, and reported pre-post or comparative outcomes. Methodological quality was assessed using the Cochrane RoB-2 tool for RCTs and the JBI checklist for non-RCTs. Eleven studies (<i>n</i> = 278 participants) met the inclusion criteria. Meta-analysis of RCTs; head-mounted VRehab significantly improved quality of life (PDQ-39) compared with CT. Pre-post pooled analysis demonstrated significant improvement in Tinetti balance and gait and TUG dual-task, while no significant pooled effects were observed for TUG and UPDRS-III. Individual studies also reported improvements in static balance, gait endurance, and upper-limb function. Head-mounted VRehab enhances quality of life, balance, gait, and cognitive-motor function in PD, warranting further rigorous RCTs.<b>PROSPERO Registration No</b>: CRD42024611662 https://www.crd.york.ac.uk/prospero/#recordDetails.