Physical exercises are crucial for enhancing postural balance and muscle strength in children and adolescents with Down syndrome (DS). Virtual reality-based therapy (VRBT), which utilizes exergames, can favor performing physical activity. The aim of this review was to assess the effectiveness of VRBT in improving balance and muscular endurance in children and adolescents with DS. Since inception up to August 2024, we screened in PubMed Medline, SCOPUS, WOS, CINAHL, and PEDro studies that assessed the effectiveness of VRBT, compared to conventional therapy (CT) or usual care (UC), in improving balance and muscular endurance in DS. Methodological quality was assessed using the PEDro scale. Effect size in meta-analyses was calculated with the Cohen’s standardized mean difference (SMD) and its 95% confidence interval (95% CI). Nine studies providing data from 424 participants with good methodological quality (PEDro: 6.3 ± 1.2 points) were included. Our meta-analysis showed that VRBT is more effective than controls in increasing function (SMD = 1.22; 95% CI 0.64 to 1.81; p < 0.001), dynamic balance (SMD = −2.2; 95% CI −3.1 to −1.25; p < 0.001), and muscular endurance (SMD = 1.37; 95% CI 0.58 to 2.2; p < 0.001). This is the first meta-analysis to exclusively focus on children and adolescents with DS, demonstrating the effectiveness of VRBT in enhancing balance and muscular endurance.

Background and Objectives: Dual-task training (DTT) is an innovative therapeutic approach that involves the simultaneous application of two tasks, which can be motor, cognitive, or a combination of both. Children with cerebral palsy (CP) often exhibit impairments in balance, motor skills, and gait, conditions that may be amenable to improvement through DTT. The aim of this study was to determine the effectiveness of DTT in enhancing balance, walking speed, and gross motor function-related balance in children with CP. Materials and Methods: In accordance with PRISMA guidelines, a comprehensive systematic review with meta-analysis (SRMA) was conducted. Electronic databases like PubMed Medline, Scopus, Web of Science, CINAHL, and PEDro were searched up to March 2025, with no language or publication date restrictions. Only randomized controlled trials (RCTs) examining the effectiveness of DTT on balance, gross motor function, and walking speed in children with CP were included. The methodological quality and risk of bias of the included RCTs were assessed using the PEDro scale. Pooled effects were calculated using Cohen’s standardized mean difference (SMD) and its 95% confidence interval (95% CI) within random-effects models. Results: Eight RCTs, providing data from 216 children, were included. Meta-analyses suggested that DTT was more effective than conventional therapies for increasing functional (SMD = 0.65; 95% CI 0.18 to 1.13), dynamic (SMD = 0.61; 95% CI 0.15 to 1.1), and static balance (SMD = 0.46; 95% CI 0.02 to 0.9), as well as standing (SMD = 0.75; 95% CI 0.31 to 1.18; p = 0.001) and locomotion dimensions (SMD = 0.65; 95% CI 0.22 to 1.08) of the Gross Motor Function Measure (GMFM) and walking speed (SMD = 0.46; 95% CI 0.06 to 0.87). Subgroup analyses revealed that a motor–cognitive dual task is better than a motor single task for functional, dynamic, and static balance and standing and locomotion dimensions for the GMFM. Conclusions: This SRMA, including the major number of RCTs to date, suggests that DTT is effective in increasing balance, walking and gross motor function-related balance in children with CP.

Background: Novel approaches such as video games represent a promising tool in increasing visual acuity (VA) in children with amblyopia. The aim was to determine the effectiveness of video game-based interventions (VGBIs) in increasing VA in children with amblyopia. Secondarily, to estimate safety, satisfaction, and compliance with VGBIs. Methods: According to the PRISMA guidelines, a systematic review with meta-analysis (SRMA) was conducted, including studies retrieved from PubMed Medline, SCOPUS, WOS, CINAHL, and PEDro without publication date and language restrictions. We included randomized controlled trials (RCTs) and pilot RCTs, comprising children with amblyopia, that compared the effectiveness of VBGI vs. others in improving VA. Pooled effect was estimated with the Cohen’s standardized mean difference (SMD) and its 95% confidence interval (95%CI). Results: Twenty-one RCTs, providing data from 1515 children, were included. VGBIs are effective (SMD = 0.38; 95%CI 0.08 to 0.68; p = 0.013) in increasing VA. Subgroup analyses suggested that non-immersive video games are the most appropriate for improving VA (SMD = 0.35; 95%CI 0.02 to 0.68; p = 0.039) and that VGBI is more effective than patching therapy, especially in combination with patching therapy (SMD = 0.63; 95%CI 0.29 to 0.97; p < 0.001). Conclusion: This SRMA, including a large number of RCTs to date, demonstrates that VGBI is effective in improving VA in children with amblyopia.

Background: Ataxic symptoms are characterized by causing motor, balance and coordination disorders. Virtual reality-based interventions (VRBIs) including video games and exergames can improve ataxic symptoms. The aim of this systematic review with meta-analysis was to assess the effectiveness of VRBI on severity of ataxia, postural balance, mobility and manual dexterity in patients with ataxia. Methods: According to the PRISMA guidelines, we searched PubMed Medline, SCOPUS, WOS, CINAHL, PEDro and other sources for randomized controlled trials (RCTs) that assessed the effectiveness of VRBI, compared to others, on the severity of ataxia, balance, mobility and manual dexterity in patients with ataxia. The pooled effect was calculated using Cohen’s standardized mean difference (SMD) and a 95% confidence interval (95% CI). Results: With data from seven RCTs, providing data from 171 patients with ataxia, our meta-analysis elucidated that VRBI is effective in reducing the severity of ataxia (SMD = −0.43; 95% CI −0.84 to −0.03; p = 0.04) and increasing functional balance (SMD = 0.97; 95% CI 0.16 to 1.78; p = 0.02) and manual dexterity (SMD = −0.63; 95% CI −1.16 to −0.11; p = 0.018). Conclusions: Our findings suggest that VRBI could be a promising and effective therapeutic approach in reducing ataxia disability and increasing balance and manual dexterity in ataxic patients.

Background: The objective was to evaluate the efficacy of virtual reality-based therapy (VRBT) compared to therapeutic exercise in increasing balance and functional status in patients with acquired spinal cord injury (SCI). Methods: Following PRISMA recommendations, we searched randomized controlled trials that meets the inclusion criteria in PubMed Medline, Scopus, Web of Science and PEDro without language and publication date limitations. Methodological quality and risk of bias were evaluated using the PEDro scale. Results: Six RCTs providing data on 131 patients with SCI were included in this systematic review. Based on the information gathered from the included studies, both therapies can increase balance and functional status between pre- and post-assessment. However, it seems that there is a higher rate of improvement in balance and function in SCI patients in favor of the group that uses VRBT in their treatment (p < 0.05). Conclusions: Although there is evidence in favor of the effectiveness of VRBT in increasing balance and functional status in patients with SCI, this is limited, and further research is necessary. Even so, taking into account the results found, our systematic review suggests that VRBT provides an effective therapeutic use to implement alongside conventional therapies for patients with SCI.

Background: Non‐pharmacological and complementary therapeutic, notably immersive virtual reality‐based interventions (IVR), could alleviate pain and anxiety associated with gynecologic procedures. Objective: To evaluate the effectiveness of IVR in reducing peri‐ and post‐procedural pain and anxiety in gynecologic procedures. Secondarily, to determine the safety of IVR. Search Strategy: A systematic review with meta‐analysis was conducted, after searching in PubMed/Medline, SCOPUS, Web of Science, CINAHL Complete and PEDro from database inception to September 2025 with no language or publication date restrictions set. Selection Criteria: Inclusion criteria were based on the PICOS framework: Population (patients undergoing gynecologic procedures), Intervention (IVR), Comparison (standard care or other therapeutic approaches), Outcomes (pain, anxiety and adverse events) and Study design (randomized controlled trials [RCTs]). Data Collection and Analysis: Pooled effects were calculated using Cohen's standardized mean difference (SMD) and its 95% confidence intervals (95% CI) in a random‐effects model. Potential adverse events during IVR exposure were also compiled. Main Results: A total of 25 randomized controlled trials (RCTs), comprising data from 2438 women (mean age 35.3 ± 12.6 years), were included. Intraprocedural outcomes indicated that IVR significantly decreased both pain (SMD = −0.46, 95% CI: −0.71 to −0.21, P < 0.001) and anxiety (SMD = −0.33, 95% CI: −0.63 to −0.03, P = 0.031). Post‐procedurally, IVR yielded further reductions in pain (SMD = −0.81, 95% CI: −1.12 to −0.5, P < 0.001) and anxiety (SMD = −0.76, 95% CI: −1.22 to −0.3, P = 0.001). Reported adverse events were minor and infrequent. Conclusion: This meta‐analysis suggests that IVR serves as a highly effective and safe non‐pharmacological adjunct for mitigating peri‐ and post‐procedural pain and anxiety in gynecologic settings. Translating these findings into clinical practice could substantially enhance patient care and overall experience. PROSPERO Registration: CRD420251000835