###### Abstract  
Background: Stroke patients with motor, sensory and cognitive diseases can take profits from information and communication technologies--in particular, from the latest commercial video consoles, which are based on motion capture. These technologies are positioning themselves as complementary therapeutic tools for treating gait and balance disorders. In this paper, a systematic review of the effect of video game-based therapy on balance and gait in stroke patients is shown and compared with other types of treatments. Methods: A systematic review of prospective controlled clinical trials published in the main biomedical databases in English and Spanish between 2005 and 2020 was performed. The systematic review presented in this paper has been done following the Cochrane Manual recommendations and the PRISMA Declaration by two independent reviewers. Data about participants, intervention, outcome measurements and outcome measurement results were extracted. The quality of evidence of each study was assessed using Cochrane's standard quality assessment format, which includes a description of the risk of bias. Additionally, the Physiotherapy Evidence Database (PEDro) scale was used to assess the methodological quality of each paper. Results: A total of 18 papers, including 479 patients, were included in this systematic review, in which the use of video consoles (in combination with conventional rehabilitation or exclusively) was compared with conventional rehabilitation to treat balance or gait in post-stroke patients. In all studies, a tendency to improve balance was found in both intervention groups, finding, in 10 of 17 studies that analysed it, a better capacity in the experimental group that included video consoles compared to the conventional rehabilitation control group. Regarding gait, in six of seven studies that analysed it, improvements were found in both intervention groups, and these improvements were greater in the experimental group than compared to the control group in three of them. Conclusions: Commercial video game systems, in combination with conventional rehabilitation, have shown positive results on balance and gait in post-stroke patients. There were variations between the trials in terms of the video consoles used and the duration, frequency and number of sessions with commercial video games. Future studies should compare the effects of commercial video game treatments on balance and gait in stroke patients with a nonintervention group to know their real efficacy. commercial gaming devices; balance; gait; stroke; virtual reality; video consoles; video games +
Footnote †: journal: Applied  
the World Health Organization (WHO), the average incidence of stroke is around 200 new cases per 100,000 inhabitants/year [2; 3]. Stroke induces sensory, motor, cognitive and psychological deficits, which directly affect the individual's functionality and quality of life [1]. In this context, between 50% and 70% of stroke patients present with balance and gait disorders and frequent falls [4; 5]. Therefore, balance and gait disturbances in stroke patients are a key objective for the rehabilitation team. Continued rehabilitation during the first year after stroke reduces the risk of functional impairment and improves independence in activities of daily living. In the chronic phase, continuity in rehabilitation programmes is also necessary due to the appearance of associated functional deterioration [2]. In this context, virtual reality (VR) has become extremely relevant in the rehabilitation of cognitive and motor disorders in these patients. VR has been defined as the \"use of interactive simulations created with computer hardware and software to present users with opportunities to engage in environments that appear and feel similar to real-world objects and events\" [6]. VR possesses a highly motivating multidimensional virtual environment that the user can interact with, which provides sensory feedback, thus allowing the individual to perform in activities or tasks comparable to real situations.