Immersive Virtual Reality in Cognitive Rehabilitation: A systematic Review

Despoti, Akyllina; Karatzanos, Eleftherios; Patsaki, Irini; Tzoumi, Dimitra; Roussou, Georgia; Leventakis, Nikolaos; Papathanasiou, Argyro; Nanas, Serafim; Dimitriadi, Nefeli · 2022 · Crossref

DOI: 10.12681/healthresj.28872

archive: archived pipeline: cataloged verified

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Summary

This systematic review investigates the efficacy, safety, and feasibility of immersive virtual reality (iVR) as a rehabilitation tool for cognitive functions in adults with neurological disorders, traumatic brain injuries, or age-related cognitive decline. The study addresses the growing interest in VR technologies for clinical neuropsychology, aiming to determine if iVR offers advantages over traditional methods by providing high ecological validity, automated performance tracking, and personalized therapeutic protocols. The authors conducted a systematic search of PubMed, Cochrane, OTseeker, PsycINFO, and Scopus for articles published until August 2021. Eligibility criteria restricted the review to peer-reviewed studies involving adult patients with neurological conditions or elderly individuals with cognitive decline, excluding psychiatric disorders and review articles. From an initial pool of 468 records, 16 studies were included in the qualitative synthesis. These comprised six randomized controlled trials (RCTs), five feasibility studies, one reliability study, and four lower-level evidence studies. The methodological quality of the RCTs was assessed using the Physiotherapy Evidence Database (PEDro) scale, yielding a mean score of 7.2, indicating high quality. Data extraction focused on participant characteristics, intervention details, and neuropsychological outcomes, including attention, executive function, memory, visuospatial skills, and navigation. The results indicate that all included intervention studies reported improvements in either cognitive functions or stress management. Specifically, six studies demonstrated improvements in attention, five in memory, three in executive functions, and one in navigation skills. One study noted stress relief in older adults. Regarding safety and feasibility, the majority of participants (134 out of 142 in relevant studies) successfully completed tasks without reporting significant side effects such as simulator sickness, dizziness, or disorientation. Participants generally reported high engagement and enjoyment. In comparative studies, iVR showed mixed results; some studies found iVR superior to non-immersive VR or traditional training in specific domains like executive function and inhibitory control, while others found comparable improvements across groups. The authors conclude that immersive VR is a feasible, safe, and effective tool for cognitive rehabilitation, capable of promoting neuroplasticity through the activation of fronto-parietal networks. The technology provides a flexible and engaging environment that supports recovery in conditions such as stroke, traumatic brain injury, Alzheimer’s disease, and mild cognitive impairment. However, the review highlights the need for large-scale longitudinal clinical trials to assess long-term impacts and maintenance of cognitive gains. Future research should also compare different levels of immersion and integrate quantitative techniques like EEG to better understand psychophysiological responses.

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• cognitive impairment