Which people and conditions the guideline covers

NICE NG252, published on 15 October 2025, covers rehabilitation for specified chronic neurological disorders, including acquired brain injury. It explicitly excludes adult stroke rehabilitation, cerebral palsy, dementia and epilepsy. Adult stroke teams should use NICE NG236 and the other guidance applicable to their service.

This distinction matters when discussing VR. NG252 should not be described as a new stroke guideline or as approval for a particular headset, programme or product.

Where NICE mentions virtual reality

Recommendation 1.18.16 includes VR and computerised cognitive tasks among possible activities for memory and learning, alongside compensatory aids. Recommendation 1.16.3 separately suggests considering gaming or VR to encourage engagement with exercises for stability, mobility or limb function. These address different rehabilitation goals.

The same chapter calls for standard cognitive tests and functional assessments in recommendation 1.18.9, with expert neuropsychological oversight described in 1.18.4. Recommendation 1.18.17 addresses strategies and environmental changes for executive difficulties. Read the recommendations on function.

For a service choosing software, a useful next step is to specify the intended activity, the person’s needs and the evidence required for that use. The presence of VR in a guideline does not answer those product-level questions.

An everyday activity example for an OT discussion

Imagine an adult who wants to organise items for a familiar outing. An occupational therapist could break the activity into choosing the items, finding them, checking the selection and deciding whether anything is missing. This is an illustrative planning example, not a treatment protocol from NICE.

Using activity analysis, the therapist can describe the demands of each stage before deciding whether physical objects, written material or a digital scene would be useful. A headset might add a spatial environment to explore; a tabletop version might be easier for the person to access. The choice needs a reason that is specific to that session.

For either format, useful observations might include when the person starts, what they check, which prompts are used and how they explain their choices. Changing the number of objects or the wording of instructions also changes the task, so those details belong in the session record.

Our functional cognition activity guide and sequencing and planning examples offer more ways to describe everyday activity demands.

Questions to resolve before introducing a headset

These are practical questions for a service review rather than additional NICE recommendations:

  • Purpose: What will the person do, and why is this format useful for the planned session?
  • Access: Can they understand the instructions and use the available controls comfortably?
  • Support: Who will introduce the activity, supervise it and respond if the person wants to stop?
  • Review: What will the therapist record, and how will it inform the next discussion?
  • Evidence: What supports the supplier’s intended use and any claimed outcomes?

Ask to see the exact activity and its settings. A general demonstration can leave important details unresolved, such as whether instructions can be repeated or how the therapist knows that help is needed. Our VR session workflow and using VR in occupational therapy practice guides cover the practical sequence from preparation to review.

How this relates to CorteXR Studio

CorteXR Studio is non-medical activity software for supervised professional sessions. Its everyday scenarios can be explored in the activity library, including videos showing what the person actually does. NG252 does not endorse Studio or establish that it treats a neurological condition.

Teams can use the neurorehabilitation service page to explore activity use and discuss their session requirements. When a medical rehabilitation purpose is intended, product selection needs a separate review of intended use, evidence and governance; our Studio and Stroke comparison explains the distinction between the two products.

For stroke-specific reading, see Canada’s cognitive rehabilitation recommendations and our community stroke rehabilitation guide.

Sources

Studio note: CorteXR Studio is non-medical activity software for therapist-led sessions. It is not intended to diagnose, treat, monitor, prevent, or alleviate any disease, injury, or impairment.

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