Business Models and Delivery Structures Driving Adoption of Virtual Reality Stroke Rehabilitation in the United States

Stroke rehabilitation in the United States faces major delivery challenges because many survivors require repetitive therapy that is long-term but experience barriers related to transportation, cost, therapist availability, and adherence. Virtual reality rehabilitation has become a potential solution because it can make therapy more engaging, measurable, and accessible beyond traditional rehabilitation settings. This narrative review examines literature on VR stroke rehabilitation, telerehabilitation, digital therapeutics, remote therapeutic monitoring, reimbursement, and healthcare innovation adoption. This review argues that adoption of VR stroke rehabilitation will depend less on the technology itself than on its fit with the economic and operational structure of the U.S. healthcare system. Clinic-based VR may remain useful for supervised rehabilitation, but home-based and hybrid models are more scalable because they can extend therapy beyond the clinic while preserving therapist oversight. Some technologies like consumer level VR hardware and remote monitoring systems make these delivery models more feasible. The main finding is that VR stroke rehabilitation is most likely to scale when clinical evidence, patient engagement, workflow integration, and reimbursement pathways align. Future adoption will depend on the care platforms and delivery methods, not just the VR technology.