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Mapping the Evidence on Virtual Reality for Post-Intensive Care Syndrome: A Systematic Review and a Five-Axis VR-PICS
Inês Oliveira1, André Torneiro2, João Ferreira-Coimbra3
1Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal.
Biomedicines
|February 27, 2026
Summary
Virtual Reality (VR) shows promise for reducing anxiety in Intensive Care Unit (ICU) survivors, but evidence for long-term physical and cognitive recovery remains limited. Further research is needed to explore VR
Area of Science:
- Critical Care Medicine
- Rehabilitation Technology
- Digital Health
Background:
- Post-Intensive Care Syndrome (PICS) affects 50-75% of ICU survivors, causing physical, cognitive, and psychological impairments.
- Immersive Virtual Reality (VR) is explored for stress reduction and recovery support in critical care, but evidence is fragmented.
- Heterogeneity in VR interventions complicates comparisons and understanding of their effects in critical care.
Purpose of the Study:
- To systematically review the safety, feasibility, and effects of immersive VR on PICS-related outcomes in ICU and post-ICU populations.
- To introduce a standardized taxonomy for classifying and comparing VR interventions in critical care.
Main Methods:
- Systematic review following PRISMA 2020 guidelines, registered in PROSPERO.
- Searched seven databases from inception to August 2, 2025, for studies on immersive VR in ICU patients targeting PICS domains.
- Assessed methodological quality using the Mixed Methods Appraisal Tool (MMAT); synthesized findings narratively due to heterogeneity.
Main Results:
- Eleven studies were included; 63.6% reported reduced anxiety or distress, showing consistent acute psychological benefits.
- Evidence for physical, cognitive, or long-term PICS outcomes was limited and inconsistent.
- Small sample sizes, non-randomized designs, and brief intervention durations contributed to inconsistent findings.
Conclusions:
- Immersive VR is a feasible adjunct for acute psychological support in Intensive Care Unit settings.
- Meaningful rehabilitation effects of VR for PICS require further exploration.
- The Five-Axis VR-PICS taxonomy offers a framework to standardize and guide future VR research in critical care rehabilitation.
