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Physiological Responses to Virtual Reality-Based Stress Regulation and Relaxation Interventions: A Systematic Review.

Lisanne M Robbemond1, Matthijs L Noordzij2, Catheleine M G van Driel1

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Virtual Reality (VR) stress interventions show promise in reducing stress, evidenced by physiological markers. However, inconsistent methods and low study quality limit current findings, necessitating standardized protocols and ambulant measurements for future research.

Keywords:
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Area of Science:

  • Psychophysiology
  • Virtual Reality (VR) applications
  • Stress and Health Research

Background:

  • Physiological markers are increasingly utilized to monitor stress responses during Virtual Reality (VR) interventions.
  • Challenges exist in consistently applying these markers to accurately assess the impact of VR stress interventions.
  • Existing literature on VR stress interventions using physiological markers requires systematic synthesis and critical evaluation.

Purpose of the Study:

  • To systematically review and critically discuss the literature on VR stress interventions employing physiological markers.
  • To analyze study designs, marker usage, measurement setups, data interpretation trends, and assigned meanings to marker changes.
  • To identify methodological inconsistencies and suggest future research directions for enhancing the validity and comparability of VR stress intervention studies.

Main Methods:

  • Systematic literature review following PRISMA guidelines, searching EMBASE, IEEE Xplore, PsycINFO, PubMed, and Web of Science until March 12, 2024.
  • Inclusion criteria: head-mounted display (HMD) VR stress intervention and evaluation of at least one physiological marker.
  • Study quality assessed using the Evaluation Public Health Practice Project tool; data extracted and summarized thematically and narratively.

Main Results:

  • Sixty-nine studies were included, primarily in the general population (59), with most using nature-based VR experiences and inducing stress via mental arithmetic or the Trier Social Stress Test (TSST).
  • Common physiological markers included heart rate (HR), heart rate variability (HRV), and blood pressure; 56 studies reported stress reduction.
  • Significant methodological limitations were noted, including lack of theoretical grounding, small sample sizes, single laboratory sessions, low study quality, and wide variation in marker selection and measurement protocols.

Conclusions:

  • While VR interventions show potential for stress reduction, methodological inconsistencies and quality issues currently limit the robustness of findings.
  • Standardizing physiological marker selection and measurement protocols is crucial for improving the validity and comparability of research in this field.
  • Future research should prioritize ambulant measurements and assess long-term effects to enhance the real-world applicability and evidence base of VR stress interventions.