Research & Studies

MCI / dementia / older adults

Yang Q, Zhang L, Chang F, Yang H, Chen B, Liu Z · 2025 · Journal of Medical Internet Research, 27, e59195

VR interventions led to small but statistically significant improvements, particularly in memory, attention, and executive function. The findings suggest that VR can be a useful adjunct in MCI – but not a universal solution for every domain.

Target group

Older adults with mild cognitive impairment (MCI)

Technology

VR with varying levels of immersion; cognitive, physical, and dual-task training

Study type

Systematic review and meta-analysis of randomized controlled trials

Outcomes studied

Memory, attention, processing speed, executive function, overall cognition, mood, ADLs, balance

Sample

18 studies; 722 participants

Evidence level

High – meta-analysis of randomized controlled trials

Limitations: Heterogeneous forms of VR and training; evidence quality was low to moderate for several outcomes; long-term data are lacking.

MCI / dementia / older adults

Zhu S, Sui Y, Shen Y, Zhu Y, Ali N, Guo C, Wang T · 2021 · Frontiers in Aging Neuroscience, 13, 586999

VR showed a medium-sized positive effect on cognition, memory, and attention, as well as a smaller effect on motor skills and balance. No convincing benefit could be established for gait or visuospatial abilities.

Target group

People over 60 with MCI or dementia

Technology

Low, semi-, and fully immersive VR; cognitive and motor tasks

Study type

Systematic review and meta-analysis of randomized controlled trials

Outcomes studied

Overall cognition, attention/executive function, memory, visuospatial function, motor skills, balance, gait

Sample

11 RCTs; 359 participants

Evidence level

High – meta-analysis of randomized controlled trials

Limitations: Small number of studies and participants; differing devices, tasks, and diagnoses; clinical significance requires further confirmation.

MCI / dementia / older adults

Papaioannou T, Voinescu A, Petrini K, Stanton Fraser D · 2022 · Journal of Alzheimer's Disease, 88(4), 1341–1370

VR-based cognitive training was associated with improved cognitive outcomes in both MCI and dementia. However, the effect depended strongly on the design of the intervention and the characteristics of the participants.

Target group

People with MCI or dementia

Technology

VR-based cognitive training with varying levels of immersion

Study type

Systematic review and meta-analysis

Outcomes studied

Cognitive function; moderators of the effect such as VR type, dose, and nature of the training

Sample

11 studies; 359 participants

Evidence level

High – systematic review and meta-analysis

Limitations: Small, heterogeneous studies; differing outcome measures; limited data on long-term transfer into everyday life.

MCI / dementia / older adults

Kim O, Pang Y, Kim JH · 2019 · BMC Psychiatry, 19, 219

The review found a small, overall positive effect of VR interventions on cognition and physical outcomes. However, the evidence came from heterogeneous and predominantly smaller studies.

Target group

People with MCI or dementia

Technology

VR-based cognitive and physical interventions

Study type

Meta-analysis

Outcomes studied

Cognition and physical fitness

Sample

11 included studies; total number of participants not stated in the abstract

Evidence level

Moderate to high – meta-analysis of heterogeneous studies

Limitations: Non-randomized studies were also included; heterogeneity in technologies and outcomes; limited ability to determine the optimal type of VR.

Older adults / exergaming / depression

Yen HY, Chiu HL · 2021 · Journal of the American Medical Directors Association, 22(5), 995–1002

Movement-based VR games were associated with favorable changes in cognition, memory, and depressive symptoms. The strongest effect on mood was seen with more immersive forms of movement.

Target group

Older adults

Technology

VR exergames controlled by body movement

Study type

Systematic review and meta-analysis of randomized controlled trials

Outcomes studied

Cognition, memory, depressive symptoms

Sample

9 RCTs; 379 female participants

Evidence level

High – meta-analysis of randomized controlled trials

Limitations: Small number of studies; the sample was predominantly female; differing dosages and types of exercise.

MCI / cognition / movement

Thapa N, Park HJ, Yang JG, Son H, Jang M, Lee J, et al. · 2020 · Journal of Clinical Medicine, 9(5), 1283

The program showed that VR can be a feasible way to combine cognitive and movement training in MCI, and can promote several functional domains.

Target group

Older adults with MCI

Technology

VR training combining cognitive and physical tasks

Study type

Randomized controlled trial

Outcomes studied

Cognition, brain function, physical function

Sample

68 participants

Evidence level

Moderate to high – randomized controlled trial

Limitations: Relatively small sample; short observation period; results from a single setting cannot necessarily be generalized to all groups.

Dementia / quality of life / negative emotions

Wen J, Yan H, Wang S, Xu J, Zhou Z · 2024 · Ageing Research Reviews, 93, 102135

VR interventions were associated with improvements across several outcomes, including cognition, quality of life, and mood. However, the authors emphasized that the available studies are limited both in number and methodologically.

Target group

Older adults with dementia

Technology

VR interventions in nursing and care contexts

Study type

Systematic review and meta-analysis

Outcomes studied

Cognition, quality of life, activities of daily living, negative emotions

Sample

8 RCTs; 514 people with dementia

Evidence level

High – systematic review and meta-analysis

Limitations: Limited number and quality of included studies; heterogeneous interventions; risk of publication bias.

Dementia / BPSD / acceptance

Wang LC, Montgomery A, Smerdely P, Paulik O, Barton C, Halcomb E, et al. · 2025 · Age and Ageing, 54(5), afaf117

VR can reduce some behavioral and psychological symptoms of dementia and is generally well accepted. However, the evidence is still limited and not sufficient for strong clinical conclusions.

Target group

People with dementia and behavioral/psychological symptoms

Technology

Immersive and non-immersive VR; reminiscence, relaxation, and experiential interventions

Study type

Systematic review and meta-analysis

Outcomes studied

Aggression, depressive symptoms, apathy, acceptance, and adverse effects

Sample

10 studies (1 RCT and 9 quasi-experimental studies); total number of participants not stated in the abstract

Evidence level

Formally high, but with low certainty of the outcomes

Limitations: Few studies, differing methodology and quality, varying dosages and settings; uncertainty about the optimal intervention.

Mental health / multiple diagnoses

Zeka F, Clemmensen L, Valmaggia L, Veling W, Hjorthøj C, Glenthøj LB · 2025 · Acta Psychiatrica Scandinavica, 151(3), 210–230

VR interventions showed favorable outcomes for some diagnoses, particularly when compared with passive control conditions. Against active comparison conditions, however, the benefit was often smaller or uncertain.

Target group

People with various mental health disorders

Technology

Immersive VR treatment and training

Study type

Systematic review and meta-analysis

Outcomes studied

Symptoms of anxiety, psychosis, substance use disorders, and other conditions

Sample

55 studies; 3,031 participants; 10 diagnostic areas

Evidence level

High – meta-analysis, though heterogeneous

Limitations: Considerable heterogeneity in diagnoses, interventions, and control conditions; many small studies; uncertainty regarding the quality of the evidence.

Anxiety disorders

Powers MB, Emmelkamp PMG · 2008 · Journal of Anxiety Disorders, 22(3), 561–569

VR exposure therapy achieved large effects relative to control conditions, and results comparable to exposure in a real-world setting.

Target group

People with anxiety disorders and specific phobias

Technology

VR exposure therapy

Study type

Meta-analysis

Outcomes studied

Anxiety, avoidance behavior, comparison with in vivo exposure and control conditions

Sample

13 studies; 397 participants

Evidence level

High – meta-analysis

Limitations: Older generation of technology; small samples; predominantly specific phobias; limited data on transfer into everyday life.

Anxiety / PTSD / social anxiety

Carl E, Stein AT, Levihn-Coon A, Pogue JR, Rothbaum B, Emmelkamp P, et al. · 2019 · Journal of Anxiety Disorders, 61, 27–36

VRET was more effective than waitlist or minimal interventions, and roughly comparable to active psychological interventions.

Target group

People with phobias, social anxiety, PTSD, and panic disorder

Technology

VR exposure therapy

Study type

Meta-analysis of randomized controlled trials

Outcomes studied

Symptoms of anxiety and related disorders

Sample

Randomized controlled trials included in the meta-analysis; the aggregated number of participants is given in the full text

Evidence level

High – meta-analysis of randomized controlled trials

Limitations: Differing diagnoses, protocols, and follow-up durations; not all studies used modern immersive headsets.

Mental health disorders / diagnostics and therapy

Wiebe A, Kannen K, Selaskowski B, Mehren A, Thöne AK, Pramme L, et al. · 2022 · Clinical Psychology Review, 98, 102213

The strongest evidence exists for exposure therapy in anxiety disorders. In other areas, VR is promising, but the research is often still young and methodologically inconsistent.

Target group

People with various mental health disorders

Technology

VR diagnostics, exposure therapy, training, and simulations

Study type

Systematic review

Outcomes studied

Diagnostic validity, symptoms, functioning, feasibility

Sample

Extensive systematic review spanning multiple diagnoses; figures are reported separately by diagnostic area

Evidence level

High – extensive systematic review

Limitations: Wide range of diagnoses and methods; some of the research has small samples and lacks active control conditions.

Preoperative anxiety

Xu H, Hou J, Zhou J, Wang S · 2025 · Journal of PeriAnesthesia Nursing, 40(2), 422–430.e3

VR before the procedure lowered the average level of anxiety and improved patient satisfaction. The effect was medium-sized but differed considerably between studies.

Target group

Adults prior to a surgical procedure

Technology

Immersive VR relaxation or distraction

Study type

Systematic review and meta-analysis

Outcomes studied

Preoperative anxiety and postoperative satisfaction

Sample

9 studies; 1,046 adult patients

Evidence level

High – meta-analysis

Limitations: Heterogeneous surgical settings, VR content, and timing; some estimates had wide confidence intervals.

Pain and anxiety during procedures

Micheluzzi V, Burrai F, Casula M, Serra G, Al Omary S, Merella P, Casu G · 2024 · Current Problems in Cardiology, 49, 102532

VR likely reduces anxiety and, in some situations, also perceived pain during cardiac procedures. The findings support VR mainly as a safe complement to standard care.

Target group

Patients undergoing cardiac procedures

Technology

Immersive VR for distraction and relaxation

Study type

Systematic review and meta-analysis

Outcomes studied

Pain, anxiety, satisfaction, safety

Sample

Randomized controlled trials on cardiac procedures; the exact aggregated number is given in the full text

Evidence level

Formally high, moderate certainty

Limitations: Small, heterogeneous studies; differing procedures and VR content; limited blinding.

Pediatrics / pain / anxiety

Hu Z, Yao J, He L, Li X, Guo Y · 2024 · Journal of Pediatric Nursing, 78, e364–e374

In most of the included studies, VR was associated with lower anxiety and less pain, especially for brief and unpleasant procedures.

Target group

Children undergoing medical procedures

Technology

Immersive VR distraction and relaxation

Study type

Systematic review and meta-analysis

Outcomes studied

Anxiety and pain during procedures

Sample

Systematic review and meta-analysis of pediatric studies; the exact aggregated number is given in the full text

Evidence level

Moderate to high – systematic review

Limitations: Differing age groups, procedures, and measurement instruments; risk of bias and inconsistent study quality.

Intensive care / anxiety / pain / sleep

Lu S, Ji Y, Wang N, Ou M, Zhang N, Wang X, Yan M, Dallakoti N, Wu Y, Wang J · 2025 · Australian Critical Care, 38(4), 101233

VR showed favorable effects on some psychological and physical outcomes in the intensive care setting, but was not consistent across all measures.

Target group

Critically ill patients in the intensive care unit

Technology

Immersive VR relaxation, nature environments, and distraction

Study type

Systematic review and meta-analysis

Outcomes studied

Anxiety, pain, sleep quality, PTSD

Sample

Randomized controlled trials in intensive care units; the exact aggregated number is given in the full text

Evidence level

Formally high, moderate to low certainty

Limitations: Small number of studies per outcome; differing protocols and clinical conditions; limited generalizability.

Stroke / rehabilitation

Khan A, Imam YZ, Muneer M, Al Jerdi S, Gill SK · 2024 · Bioelectronic Medicine, 10, 23

The highest-quality reviews point to a benefit of VR primarily as a complement to conventional therapy. The most convincing results concern the upper limb, gait, and balance.

Target group

People after stroke

Technology

VR rehabilitation for the upper and lower limbs, gait, balance, and cognition

Study type

Meta-review / overview of reviews

Outcomes studied

Motor function, gait, balance, upper limb, cognition

Sample

58 systematic reviews; 345 unique primary studies

Evidence level

Very high – meta-review

Limitations: Overlap of primary studies between reviews; differing quality of the systematic reviews; the optimal dose cannot be precisely determined.

Stroke / immersive rehabilitation

Demeco A, Zola L, Frizziero A, Martini C, Palumbo A, Foresti R, et al. · 2023 · Sensors, 23(3), 1712

Fully immersive VR was associated with improvements in motor function and was able to increase participation in rehabilitation. The results are promising, but the protocols have so far varied considerably.

Target group

People after stroke

Technology

Fully immersive VR with an HMD

Study type

Systematic review

Outcomes studied

Upper limb dexterity, gait, dynamic balance, independence, adherence

Sample

Systematic review of studies on fully immersive VR after stroke; the aggregated number is given in the full text

Evidence level

Moderate to high – systematic review

Limitations: Small samples, differing devices and protocols; few long-term comparisons; risk of cybersickness.

Stroke / comprehensive rehabilitation

Laver KE, Lange B, George S, Deutsch JE, Saposnik G, Chapman M, Crotty M · 2025 · Cochrane Database of Systematic Reviews, Issue 6, CD008349

VR can slightly improve some functional outcomes, especially when used in addition to usual therapy and when it increases total training time. It is not clearly better than conventional therapy of equal intensity.

Target group

People after stroke

Technology

VR and interactive video games in rehabilitation

Study type

Cochrane systematic review

Outcomes studied

Upper limb function, ADLs, balance, gait, global motor function

Sample

Updated Cochrane review of randomized and quasi-randomized trials; exact figures are given in the full text

Evidence level

Very high – Cochrane review

Limitations: Wide variety of technologies; the quality of individual evidence was low; the effect may mainly reflect the higher dose of exercise.

Stroke / upper limb

Soleimani M, Ghazisaeedi M, Heydari S · 2024 · BMC Medical Informatics and Decision Making, 24, 135

VR as a complement to conventional therapy improved several domains of upper limb motor recovery. It worked best as part of a combined rehabilitation program.

Target group

People after stroke with upper limb impairment

Technology

VR motor training for the upper limb

Study type

Systematic review and meta-analysis

Outcomes studied

Motor recovery, dexterity, activity, and hand function

Sample

Systematic review and meta-analysis of randomized controlled trials; the exact number of studies and participants is given in the full text

Evidence level

High – meta-analysis

Limitations: Differing protocols and measurement methods; variable quality of the randomized controlled trials; limited long-term follow-up.

Stroke / telerehabilitation

Hao J, Pu Y, Chen Z, Siu KC · 2023 · Journal of Stroke and Cerebrovascular Diseases, 32(3), 106960

VR telerehabilitation can be an effective alternative or complement when access to in-person therapy is limited.

Target group

People after stroke training remotely or at home

Technology

VR telerehabilitation

Study type

Systematic review and meta-analysis of randomized controlled trials

Outcomes studied

Motor function, balance, ADLs, and feasibility of home-based training

Sample

Randomized controlled trials on VR telerehabilitation; the exact aggregated number is given in the full text

Evidence level

Formally high, moderate certainty

Limitations: Small studies, differing technological platforms and levels of supervision; open questions regarding digital literacy and safety.

Stroke / safety and efficacy

Bargeri S, Scalea S, Agosta F, Banfi G, Corbetta D, Filippi M, Sarasso E, Turolla A, Castellini G, Gianola S · 2023 · eClinicalMedicine, 64, 102220

Several meta-analyses agree that VR can improve upper limb function and other outcomes, especially in combination with usual therapy.

Target group

People after stroke

Technology

Various VR rehabilitation platforms

Study type

Overview of reviews

Outcomes studied

Motor function, ADLs, balance, safety

Sample

Overview of systematic reviews after stroke; figures are reported per review

Evidence level

Very high – overview of reviews

Limitations: Overlap of studies between reviews; differing quality of the review articles; limited data on adverse effects.

Early phase after stroke

Hao J, Yao Z, Harp K, Gwon Y, Chen Z, Siu KC · 2023 · Physiotherapy Theory and Practice, 39(12), 2569–2588

VR was feasible in the early phase, but the meta-analysis showed no clear advantage over control therapy for the main outcomes.

Target group

Patients in the early phase after stroke

Technology

VR motor and cognitive rehabilitation

Study type

Systematic review and meta-analysis

Outcomes studied

Upper limb, ADLs, balance, cognition

Sample

16 RCTs; 428 participants

Evidence level

High – meta-analysis of randomized controlled trials

Limitations: Differing protocols and intensity; sample sizes may have been insufficient; the early recovery phase is clinically very heterogeneous.

Stroke / robotics / balance

Zhang B, Wong KP, Kang R, Fu S, Qin J, Xiao Q · 2023 · Archives of Physical Medicine and Rehabilitation, 104(10), 1711–1719

The combination of robot-assisted rehabilitation and VR was rated best; several technology-assisted interventions outperformed usual care on balance outcomes.

Target group

People after stroke with balance impairment

Technology

VR, robot-assisted rehabilitation, and combinations of the two

Study type

Systematic review and network meta-analysis

Outcomes studied

Balance and functional mobility

Sample

52 RCTs; 1,559 participants

Evidence level

Very high – network meta-analysis

Limitations: Indirect comparisons between interventions; differing platforms and dosages; a SUCRA ranking does not imply confirmed clinical superiority.

Autism / therapeutic interventions

Karami B, Koushki R, Arabgol F, Rahmani M, Vahabie AH · 2021 · Frontiers in Psychiatry, 12, 665326

VR/AR interventions overall had a favorable effect on several skills, with the best results occurring for clearly focused training programs.

Target group

People with autism spectrum disorder

Technology

VR and AR therapeutic and training interventions

Study type

Meta-analysis

Outcomes studied

Social, communicative, cognitive, emotional, and functional skills

Sample

Meta-analysis of VR/AR interventions in autism; the exact number of studies and participants is given in the full text

Evidence level

High – meta-analysis

Limitations: Heterogeneous age groups, outcome measures, and technologies; often small samples; limited data on transfer into real life.

Autism / children and adolescents

Mesa-Gresa P, Gil-Gómez H, Lozano-Quilis JA, Gil-Gómez JA · 2018 · Sensors, 18(8), 2486

The review found moderate support for VR interventions, particularly for training specific skills in a controlled environment.

Target group

Children and adolescents on the autism spectrum

Technology

VR training of social, emotional, cognitive, and everyday practical skills

Study type

Systematic review

Outcomes studied

Social skills, emotion recognition, communication, learning, and functional abilities

Sample

31 studies

Evidence level

Moderate to high – systematic review

Limitations: Considerable methodological diversity; few robust randomized controlled trials; follow-up and evidence of generalization were often lacking.

Autism / adaptive VR

Maddalon L, et al. · 2024 · Journal of Medical Internet Research, e57093

Adaptive systems can tailor tasks to the needs and performance of the user, thereby promoting engagement and learning. However, the research to date is small in scale and technically inconsistent.

Target group

Children and young people on the autism spectrum

Technology

Adaptive VR systems that adjust level, stimuli, or feedback according to performance

Study type

Systematic review

Outcomes studied

Social-cognitive skills, learning, personalization, and transfer into reality

Sample

10 studies; 129 participants

Evidence level

Moderate – systematic review of small studies

Limitations: Only 10 studies and 129 participants; differing adaptation mechanisms; limited comparison with non-adaptive VR.

Autism / social skills

Ahn SN · 2025 · Hong Kong Journal of Occupational Therapy, 38(2), 167–178

Immersive technologies can create controlled situations for practicing social responses. The biggest challenge remains transferring learned skills into natural communication.

Target group

People on the autism spectrum

Technology

Social training with VR, AR, and MR

Study type

Systematic review

Outcomes studied

Social skills, communication, interaction, and transfer of learning

Sample

Systematic review of social training with VR, AR, and MR; the exact number of studies is given in the full text

Evidence level

Moderate to high – systematic review

Limitations: Differing interventions and age groups; frequently small samples; few long-term results and low ecological validity.

Autism / social skills in children

Yang X, Wu J, Ma Y, Yu J, Cao H, Zeng A, Fu R, Tang Y, Ren Z · 2025 · Journal of Medical Internet Research, 27, e60845

VR interventions had a positive effect on social skills. More immersive environments appeared more suitable for complex social situations, whereas for people with higher support needs, results tended to lie in the area of basic skills.

Target group

Children and adolescents on the autism spectrum

Technology

Immersive and non-immersive VR for social skills training

Study type

Systematic review

Outcomes studied

Basic and complex social skills, communication, and behavior

Sample

Systematic review; the exact number of included studies is given in the full text

Evidence level

Moderate to high – systematic review

Limitations: Differing support levels and diagnostic profiles; heterogeneous programs; possible publication bias.

Autism / social training

Altın Y, et al. · 2025 · Journal of Autism and Developmental Disorders, advance online publication

The review of 31 studies showed a possible benefit of VR for social training, but at the same time pointed to a lack of standardization and few high-quality comparative designs.

Target group

People on the autism spectrum

Technology

VR social training

Study type

Systematic review

Outcomes studied

Social skills and communication

Sample

31 empirical studies, published between 2014 and 2024

Evidence level

Moderate – systematic review

Limitations: Heterogeneous interventions, small samples, differing scales, and a limited follow-up period.