Effects of virtual reality-based interventions on the physical and mental health of older residents in long-term care facilities: A systematic review

Background: Older residents in long-term care facilities often experience physical and mental health problems along with vulnerability to psychological and social stressors. Due to the shortage of human resources, the appli-cation of virtual reality technology may be a new way to promote healthy aging for older residents in long-term care facilities.Objectives: To identify the effects of virtual reality-based interventions for improving physical and mental health outcomes among older residents in long-term care facilities. Design: Systematic review.Methods: A systematic review was reported in accordance with the Preferred Reporting Items for Systematic Re-views and Meta-Analyses 2020 Statement. Four databases (the Cochrane Library, PubMed, EMBASE, and Web of Science) were searched from their inception until May 2022 for original articles. Randomized controlled trials (RCTs) and quasi-experimental trials reporting the effects of virtual reality-based interventions on physical and mental health outcomes were included. Two independent reviewers extracted trial data and assessed the risk of bias using the risk of bias tool recommended by the Cochrane Back Review Group and the Methodological Index for Non-Randomized Studies.Results: Of the 8511 articles that were screened, 30 articles including 1057 participants met the inclusion criteria. Many studies have investigated multiple outcomes. Eighteen of the twenty-five studies that assessed physical health-related outcomes (n = 18/25, 72%) reported positive intervention effects, and fourteen (n = 14/25, 56%) reported negative postintervention effects. Eight of the sixteen studies that assessed mental health -related outcomes (n = 8/16, 50%) reported positive intervention effects, while twelve (n =12/16, 75%) reported negative intervention effects. Meta-analysis was not conducted due to the heterogeneity of the study designs and outcome measures.Conclusions: This study demonstrated that virtual reality-based interventions could be a safe and effective ap-proach to improve the physical outcomes of older residents in long-term care facilities, but this evidence lacks certainty. The effectiveness of virtual reality-based interventions for mental health outcomes is uncertain. Virtual reality-based interventions have the potential to provide individualized, error-free self-training for older resi-dents in long-term care facilities, but the usability for these residents requires further study. Future studies should use RCT designs and aim to include larger sample sizes and have longer intervention durations. Registration number: PROSPERO registration ID: CRD42022331917. Tweetable abstract: Virtual reality-based interventions are possibly effective for improving physical health of older residents in long-term care facilities.(c) 2022 Elsevier Ltd. All rights reserved.