Virtual Reality in Chronic Conditions: An Umbrella Review

Background. Virtual reality (VR) is emerging as a non-pharmacological tool to support rehabilitation and self-management. Evidence of its effectiveness, however, remains fragmented. This umbrella review synthesized systematic reviews and meta-analyses on VR interventions in chronic conditions. Methods. Following the Joanna Briggs Institute Manual for Evidence Synthesis, comprehensive searches were conducted in MEDLINE, CINAHL, Cochrane Database, Web of Science, and Scopus. Eligible studies were systematic reviews and meta-analyses assessing VR interventions. Two reviewers independently performed screening, quality appraisal, and data extraction. Results. Seventeen reviews, including 229 primary studies, were analyzed. Stroke and chronic obstructive pulmonary disease were most frequently investigated. VR tools ranged from web- and smartphone-based systems to wearable devices and interactive games. Significant improvements were reported in respiratory outcomes, functional mobility, balance, and psychological symptoms. Cognitive effects were mixed. Reported adverse events, mainly cybersickness and dizziness, were mild. Conclusions. VR may improve physical, respiratory, psychological, and selected cognitive outcomes in chronic conditions. Despite study heterogeneity, evidence supports its integration into chronic care. Future work should standardize protocols, assess long-term effects, broaden target populations, and address equity and ethical issues to fully realize VR's potential as a person-centered tool.