Synergistic effects of virtual reality and traditional treatment methods in the management of chronic obstructive pulmonary disease: a systematic review and meta-analysis of randomized controlled trials

Abstract

Objective: To systematically evaluate the synergistic effects of virtual reality (VR) combined with traditional therapies in the treatment of chronic obstructive pulmonary disease (COPD). Methods: A systematic review was conducted to identify relevant randomized controlled trials (RCTs) evaluating the effects of VR combined with conventional therapy on lung function, exercise tolerance, quality of life, and mental health in patients with COPD. Two researchers independently screened the literature, extracted data, and assessed study quality. A meta-analysis was performed on the outcome measures. Results: Included 15 RCTs (eight from China, three from Poland, one from Turkey, one from Indonesia, and two from Italy), involving a total of 809 COPD patients (published between 2014 and 2024). All studies demonstrated significant improvements in at least one aspect (lung function, mental health, or quality of life). The meta-analysis showed that VR-based therapy significantly improved the 6-min walk test (6MWT), forced expiratory volume in 1 s (FEV1/FVC), and the Hospital Anxiety and Depression Scale (HADS). High heterogeneity was observed for FEV1% predicted, COPD Assessment Test (CAT), and modified Medical Research Council Dyspnea Scale (mMRC); subgroup analyses suggested that intervention duration and single-session duration were potential contributing factors. Conclusion: VR combined with traditional therapy has significant advantages over traditional therapy alone, with synergistic effects that can improve lung function and exercise endurance in COPD patients, alleviate psychological problems such as anxiety and depression, and enhance quality of life. Although the effects are significant, future research is needed to verify its clinical relevance (e.g., meeting the Minimal Clinically Important Difference (MCID) criteria for COPD patients) and to develop personalized plans based on individual differences to enhance its clinical application value.