Effects of virtual reality on physical, cognitive, and psychological outcomes in cancer rehabilitation: a systematic review and meta-analysis

Purpose To systematically examine and summarize the current evidence regarding the effects of virtual reality (VR) on physical, cognitive, and psychological outcomes in cancer rehabilitation. Methods Six bioscience and engineering databases were searched. Two independent reviewers screened the titles and abstracts of 2397 records and retrieved 25 full-text articles. Inclusion criteria included patients with a current or previous diagnosis of cancer; VR was used as an intervention for physical, cognitive, or psychological impairments and functional limitations; and clinical trials with at least two arms and with both pre- and post-intervention assessments. Reviewers assessed methodological quality using the Physiotherapy Evidence Database scale. Results Seventeen studies including 799 patients with cancer were identified. Within-group pooled analysis indicated that patients demonstrated significant improvement in pain ( P < 0.001), fatigue ( P < 0.001), anxiety ( P < 0.001), upper extremity function ( P < 0.001), and quality of life ( P = 0.008) after VR intervention. Between-group pooled analysis indicated significant improvements with VR in pain ( P = 0.004), anxiety ( P < 0.001), and upper extremity function ( P < 0.001) compared with the control. Three studies reported the positive effects of VR on cognition. Conclusions VR demonstrates promising effects in physical, cognitive, and psychological aspects of patients with cancer. VR can be incorporated into a comprehensive cancer rehabilitation program to alleviate impairments and functional limitations.