| Sumario: | Background: Current gait rehabilitation strategies for stroke survivors have limitations. Virtual reality-integrated treadmill training shows promise by enhancing neuroplasticity and motor learning, but its comparative efficacy remains unclear. Objectives: This review evaluates the effectiveness of VR-integrated treadmill training on gait performance, balance, and functional outcomes in stroke survivors, addressing benefits and limitations. Methods: Following PRISMA guidelines, randomized controlled trials comparing Virtual reality-treadmill and conventional rehabilitation were analyzed. Outcomes included gait speed, balance, and participation. Methodological quality was assessed using the RoB 2 tool. Results: Ten RCTs involving 266 participants were included. Virtual reality interventions significantly improved gait speed, stride length, and balance compared to conventional training. Interactive Virtual reality systems demonstrated superior benefits by incorporating task-specific and feedback-driven elements. However, improvements in quality of life and participation were inconsistent. Most studies spanned 4–8 weeks, limiting long-term conclusions. Conclusion: Virtual reality-treadmill training improves gait and neuroplastic recovery but shows inconclusive effects on quality of life and participation. Future research should focus on longer interventions and translating gains to real-world activities, supporting Virtual reality as a complement to traditional rehabilitation.
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