Purpose: This paper details a brief history and rationale for the use of virtual reality (VR) technology for clinical research and intervention, and then focuses on game-based VR applications in the area of rehabilitation. An analysis of the match between rehabilitation task requirements and the assets available with VR technology is presented. Key messages and implications: Low-cost camera-based systems capable of tracking user behavior at sufficient levels for game-based virtual rehabilitation activities are currently available for in-home use. Authoring software is now being developed that aims to provide clinicians with a usable toolkit for leveraging this technology. This will facilitate informed professional input on software design, development and application to ensure safe and effective use in the rehabilitation context. Conclusion: The field of rehabilitation generally stands to benefit from the continual advances in VR technology, concomitant system cost reductions and an expanding clinical research literature and knowledge base. Home-based activity within VR systems that are low-cost, easy to deploy and maintain, and meet the requirements for "good" interactive rehabilitation tasks could radically improve users' access to care, adherence to prescribed training and subsequently enhance functional activity in everyday life in clinical populations. Implications for Rehabilitation Virtual reality (VR) technology has an established track record of success in addressing the therapeutic needs of persons across a range of clinical health conditions. In-home systems for VR rehabilitation are now technologically and pragmatically feasible, but it will require informed professional input on software design, development and application to ensure safe and effective use. New tools are being created that will allow clinicians without programming expertise to build game-based VR tasks and this will serve to drive advances in rehabilitation interventions.