Background: Recovery of upper limb function after stroke secondary to ischemia or hemorrhage is crucial for patients’ independence in daily living and quality of life. Virtual reality (VR) is a promising computer-based technology designed to enhance the effects of rehabilitation; however, the results of VR-based interventions remain equivocal. Objective: This study aims to review the plausible factors that may have influenced VR’s therapeutic effects on improving upper limb function in patients with stroke, with the goal of synthesizing an optimal VR intervention protocol. Methods: The databases PubMed, EMBASE, Web of Science, and Cochrane Library were queried for English-language papers published from May 2022 onward. Two reviewers independently extracted data from the included papers, and discrepancies in their findings were resolved through consensus during joint meetings. The risk of bias was assessed using the Physiotherapy Evidence Database Scale and the Methodological Index for Non-Randomized Studies. Outcome variables included the Action Research Arm Test, Box-Block Test, Functional Independence Measure, Upper Extremity Fugl-Meyer Assessment, and Wolf Motor Function Test. The plausible factors examined were age, total dosage (hours), trial length (weeks), session duration (hours/session), frequency (sessions/week), and VR content design. The Bonferroni adjustment was applied to P values to prevent data from being incorrectly deemed statistically significant. Results: The final sample included 15 articles with a total of 1243 participants (age range 48.6-75.59 years). Participants in the VR therapy (VRT) group (n=455) demonstrated significantly greater improvements in upper limb function and independence in activities of daily living compared with those in the conventional therapy group (n=301). Significant factors contributing to improved outcomes in upper limb function were younger age (mean difference [MD] 5.34, 95% CI 2.18-8.5, P<.001; I2=0%), interventions lasting more than 15 hours (MD 9.67, 95% CI 4.19-15.15, P<.001; I2=0%), trial lengths exceeding 4 weeks (MD 4.02, 95% CI 1.39-6.65, P=.003; I2=15%), and more than 4 sessions per week (MD 3.48, 95% CI 0.87-6.09, P=.009; I2=0%). However, the design of the VR content, including factors such as the number of features (eg, offering exercise and functional tasks; individualized goals; activity quantification; consideration of comorbidities and baseline activity level; addressing patient needs; aligning with patient background such as education level; patient-directed goals and interests; goal setting; progressive difficulty levels; and promoting self-efficacy), did not demonstrate significant effects (MD 3.89, 95% CI –6.40 to 1.09; effect Z=1.36, P=.16). Conclusions: Greater VR effects on improving upper limb function in patients with stroke were associated with higher training doses (exceeding 15 hours) delivered over 4-6 weeks, with shorter sessions (approximately 1 hour) scheduled 4 or more times per week. Additionally, younger patients appeared to benefit more from the VR protocol compared with older patients.

Using a network meta-analysis, this study evaluates the clinical efficacy and safety of different types of stem cell therapy in regard to the recovery of neurological function, motor function, and daily living ability in ischemic stroke patients. A computerized search of the Cochrane Library, PubMed, Web of Science, Google Scholar, CNKI, and Wanfang Database was performed to collect randomized controlled clinical studies published from the time of library construction to December 2024, on the use of stem cells to improve function in patients with ischemic stroke. A total of 19 studies and 1055 patients were included, comprising five stem cell types: bone marrow mononuclear cells (BMMNC), bone marrow mesenchymal stem cells (BMSC), progenitor cells (PC), peripheral blood stem cells (PBSC), and umbilical cord blood mesenchymal stem cells (UBMSC). A network meta-analysis showed that, in terms of National Institute of Health Stroke Scale (NIHSS) scores, the ranked results of different stem cell transplants were: UBMSC [69.4%] > PBSC 29.2%] > BMSC [0.8%] > PC [0.6%] > BMMNC [0.0%] > CRT [0.0%]. In terms of Modified Rankin Scale (mRS) scores, the ranked results of different stem cell transplants were: BMMNC [66.8%] > PBSC [31.7%] > PC [1.3%] > BMSC [0.2%] > CRT [0%]. In terms of Modified Barthel Index (MBI) scores, the ranked results of different stem cell transplants were: BMMNC [56.3%] > PC [34.2%] > BMSC [9.5%] > CRT [0%]. In terms of Fugl-Meyer Assessment (FMA) scores, the results of the ranking of different stem cell transplants were: BMMNC [79.3%] > BMSC [17.3%] > UBMSC [3.4%] > CRT [0%]. UBMSC had the best efficacy in repairing neurological function in patients with ischemic stroke. BMMNC had the best efficacy in improving motor function and daily living ability in patients with ischemic stroke. BMMNC had a superior overall effect.

Objectives: This paper aims to explore the effects of demographic and social factors for those suffering from work-related injuries with musculoskeletal disorders and their employment status after discharge within three months. Method: The employment status and compensation-related information was caught by adopting telephone follow up with the designated data collection questionnaire; other demographic characteristic and social factors were obtained by reviewing injured workers' original admission records. Results: In total sixty-eight injured workers were involved with a 67.6% return to work rate. Time of hospitalization (t=2.34, p=0.02) and area of registered residence (x=8.37, p=0.02) significant differences were found between the return to work group and non-return to work group. The only predictor found by using Logistic Regression analysis was the length of hospitalization (OR=0.978, 95%CI: 0.959–0.998). Conclusions: The shorter the length of hospitalization during the rehabilitation process, the greater the rate of return to work for those workers suffering from work-related injuries with musculoskeletal disorders.