Effects of virtual reality on psychological distress in individuals with spinal cord injury: A systematic review

Psychological distress is common among individuals with spinal cord injury (SCI). Virtual reality (VR) is an innovative technology used in treating patients with neurological disorders. This systematic review aims to explore the effects of VR on psychological distress in individuals with SCI. A comprehensive search was conducted in "PubMed, PEDro, REHABDATA, MEDLINE, SCOPUS, EMBASE, CINAHL, and Web of Science" databases from inception to November 1, 2024. Studies included individuals with SCI with various levels or completeness of injury, administrated VR intervention independently or in combination with other treatments, compared with passive, active, or no control interventions, and evaluated psychological distress were included. The "Physiotherapy Evidence Database (PEDro)" scale was used to assess the risk of bias in eligible studies. Eight out of 405 studies were included in this systematic review. A total of 159 individuals with SCI (male 67%, mean age 49.6 years) were included in this systematic review. The results were synthesized using a a descriptive analysis. The included studies showed that administrating multiple sessions of VR independently or in combination with cognitive training or conventional physiotherapy reduces depression, anxiety, and stress in individuals with SCI. VR has potential immediate benefits on psychological distress in individuals with SCI. SCI individuals with various severity, level, and duration of injury might benefit from the intervention. However, these findings should be interpreted with caution. Further studies are strongly recommended to understand the long-term effects of VR, determine the most effective treatment protocol, and identify which SCI populations are more likely to benefit from the intervention.