Progress in the application of virtual reality technology in the rehabilitation of patients with pusher syndrome after stroke

Pusher syndrome (PS) after stroke is a postural control disorder characterized by an abnormal perception of verticality, where patients persistently lean toward the hemiplegic side and resist postural correction, severely affecting balance function and rehabilitation progress. With its immersive, interactive, and programmable features, virtual reality (VR) technology offers new approaches for the rehabilitation of PS, including multisensory integration, real-time feedback, and personalized training. This article reviews the clinical features, pathological mechanisms, and rehabilitation challenges of PS, and systematically elaborates on the advantages of VR technology in correcting perceptual deviations, improving postural control, and enhancing treatment motivation and compliance through functions such as visual-postural recalibration, body schema reconstruction, and balance task training. Additionally, it analyzes the challenges faced by VR technology in clinical application, including hardware discomfort, insufficient standardization of protocols, uncertain cost-effectiveness, and limited evidence of long-term efficacy. Future research should focus on device optimization, protocol standardization, high-level evidence-based validation, and technology integration to promote the precise, personalized, and widespread application of VR in the rehabilitation of PS.