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Updated: Oct 7, 2025
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The use of Biofeedback in Clinical Virtual Reality: The INTREPID Project
Published on: November 12, 2009
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Virtual reality biofeedback interventions for treating anxiety : A systematic review, meta-analysis and future
Oswald D Kothgassner1, Andreas Goreis2,3, Ines Bauda4
1Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria. oswald.kothgassner@meduniwien.ac.at.
Wiener Klinische Wochenschrift
|January 6, 2022
Summary
Virtual reality (VR) biofeedback effectively reduces anxiety and heart rate in patients. While promising, further research is needed to explore its full potential, especially in younger populations.
Area of Science:
- Clinical Psychology
- Neuroscience
- Biomedical Engineering
Background:
- Virtual reality (VR) biofeedback is an emerging intervention for anxiety disorders.
- This study offers the first research synthesis on the effects and efficacy of VR biofeedback.
Purpose of the Study:
- To systematically review and meta-analyze the efficacy of VR biofeedback for treating anxiety symptoms.
- To assess the impact of VR biofeedback on self-reported anxiety, heart rate (HR), and heart rate variability (HRV).
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials (RCTs) and pre-post studies.
- Searched MEDLINE/PubMed, Scopus, and Web of Science databases.
- Primary outcome measures included self-reported anxiety, HR, and HRV.
Main Results:
- VR biofeedback significantly reduced self-reported anxiety (g = -0.28) and HR (g = -0.45), but not HRV.
- No significant differences were found between VR biofeedback and 2D biofeedback.
- VR biofeedback showed a significant HR reduction compared to waiting list controls (g = -0.52).
Conclusions:
- Initial findings suggest VR biofeedback is a promising intervention for anxiety.
- More controlled studies with diverse samples are necessary to advance the field.
- Children and adolescents may particularly benefit from VR biofeedback, leveraging gamification elements.
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