Transcranial Direct Stimulation, Mirror Therapy, and Virtual Reality Interventions for Upper Limb Motor Recovery After Stroke: A Systematic Review and Meta-Analysis with Implications for Low-Resource Settings

Abstract Background: Stroke rehabilitation remains a major global challenge, especially in low-resource settings where access to specialized rehabilitation centers is limited. Structured, feasible, and evidence-based neuroplasticity intervention service delivery is not widely used in Sub-Saharan Africa, including Ethiopia. This meta-analysis assesses three neuroplasticity-based interventions: mirror therapy (MT), transcranial direct-current stimulation (tDCS), and virtual reality (VR) rehabilitation, with particular consideration of their potential applicability in resource-constrained settings.