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BACKGROUND Early rehabilitation has been shown to enhance functional outcomes. Whether the addition of virtual reality (VR) training could further improve muscle strength, mood state, and functional status for patients with acute stroke is unknown. AIMS To investigate the effectiveness of VR training on muscle strength, mood state (depression, anxiety), and functional status in patients following acute stroke. METHODS A randomized controlled trial was conducted. Patients with acute ischemic stroke (N = 152) were selected and randomly assi