Effects of virtual reality interventions on motor skills in children and adolescents with intellectual disabilities: a systematic review and meta-analysis.

BACKGROUND: Virtual reality (VR) technology is increasingly applied in rehabilitation and adapted physical activity programmes for children and adolescents with intellectual disabilities (ID). However, evidence on the efficacy of VR-based interventions in improving motor skills is limited and inconclusive. OBJECTIVE: This systematic review and meta-analysis aimed to evaluate the effects of VR-based interventions on motor skills in children and adolescents with ID and summarise the methodological quality of the available evidence. METHODS: Seven electronic databases were searched for English-language VR intervention studies involving children and adolescents with ID or related conditions affecting intellectual function. Study selection, data extraction, and risk-of-bias assessment were conducted systematically. Methodological quality was assessed using the Cochrane Risk of Bias 2 tool. Where sufficient data were available, a meta-analysis was performed to estimate the pooled effect sizes, and subgroup analyses were conducted to compare the immersive and non-immersive VR interventions. RESULTS: Ten studies involving 414 participants were included. VR interventions had significant positive effects on gross motor skills, locomotor skills, object-control skills, balance, agility and strength. Subgroup analyses indicated favourable effects for both immersive and non-immersive VR; significant subgroup differences were observed in gross motor skills. CONCLUSION: VR-based interventions may improve motor-related outcomes in children and adolescents with ID, although effect robustness varied across domains and the apparent advantage of immersive VR remains exploratory. Adequately powered, rigorously designed randomised controlled trials with standardised outcomes are needed to confirm these findings. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251088479, identifier CRD420251088479.