Virtual Reality for Pulmonary Rehabilitation: Comprehensive Review

Abstract

Background Pulmonary rehabilitation is a vital component of comprehensive care for patients with respiratory conditions, such as lung cancer, chronic obstructive pulmonary disease, and asthma, and those recovering from respiratory diseases like COVID-19. It aims to enhance patients’ functional ability and quality of life, and reduce symptoms, such as stress, anxiety, and chronic pain. Virtual reality is a novel technology that offers new opportunities for customized implementation and self-control of pulmonary rehabilitation through patient engagement. Objective This review focused on all types of virtual reality technologies (nonimmersive, semi-immersive, and fully immersive) that witnessed significant development and were released in the field of pulmonary rehabilitation, including breathing exercises, biofeedback systems, virtual environments for exercise, and educational models. Methods The review screened 7 electronic libraries from 2010 to 2023. The libraries were ACM Digital Library, Google Scholar, IEEE Xplore, MEDLINE, PubMed, Sage, and ScienceDirect. Thematic analysis was used as an additional methodology to classify our findings based on themes. The themes were virtual reality training, interaction, types of virtual environments, effectiveness, feasibility, design strategies, limitations, and future directions. Results A total of 2319 articles were identified, and after a detailed screening process, 32 studies were reviewed. Based on the findings of all the studies that were reviewed (29 with a positive label and 3 with a neutral label), virtual reality can be an effective solution for pulmonary rehabilitation in patients with lung cancer, chronic obstructive pulmonary disease, and asthma, and in individuals and children who are dealing with mental health–related disorders, such as anxiety. The outcomes indicated that virtual reality is a reliable and feasible solution for pulmonary rehabilitation. Interventions can provide immersive experiences to patients and offer tailored and engaging rehabilitation that promotes improved functional outcomes of pulmonary rehabilitation, breathing body awareness, and relaxation breathing techniques. Conclusions The identified studies on virtual reality in pulmonary rehabilitation showed that virtual reality holds great promise for improving the outcomes and experiences of patients. The immersive and interactive nature of virtual reality interventions offers a new dimension to traditional rehabilitation approaches, providing personalized exercises and addressing psychological well-being. However, additional research is needed to establish standardized protocols, identify the most effective strategies, and evaluate long-term benefits. As virtual reality technology continues to advance, it has the potential to revolutionize pulmonary rehabilitation and significantly improve the lives of patients with chronic lung diseases.

Virtual Reality Applications for the Implementation of Domestic Respiratory Rehabilitation Programs for Patients With Long COVID and Post-COVID Condition: Scoping Review

“…A previous study that is the most similar to ours is the comprehensive review of VR for pulmonary rehabilitation by Pittara et al [ 32 ] in 2023. They offer a broader overview of VR applications in pulmonary rehabilitation by including all types of VR experiences, ranging from nonimmersive to fully immersive, and various populations, including healthy individuals as well as patients with COPD and asthma.…”

“…They offer a broader overview of VR applications in pulmonary rehabilitation by including all types of VR experiences, ranging from nonimmersive to fully immersive, and various populations, including healthy individuals as well as patients with COPD and asthma. In comparison to Pittara et al [ 32 ], our review takes a more focused approach by specifically filtering publications to include only immersive VR experiences within pulmonary rehabilitation programs for outpatients. The main strength of our review therefore lies in its clearly defined goals to provide an overview of immersive VR experiences for outpatients experiencing long COVID and COPD.…”

Immersive Innovations: Exploring the Diverse Applications of Virtual Reality (VR) in Healthcare

“…This initiative presented a collection of mini-games designed to train participants in fundamental breathing skills. These games included popping bubbles with a forceful breath and extinguishing candles with a prolonged breath [68].…”

“…Collectively, these studies underscore a range of innovative approaches in utilizing VEs for respiratory exercises. They demonstrate creativity in design and interactivity, emphasizing the potential to enhance breathing awareness and control through diverse and engaging methodologies [68].…”

Updated research trend and clustering algorithm on virtual reality and pulmonary rehabilitation: Scopus-based bibliometric and visual analysis

“…However, a previous report documented seven electronic libraries and 32 review studies from 2010 to 2023 from Digital Library, Google Scholar, IEEE Explore, MEDICINE, PubMed, Sage, and ScienceDirect. 54 Therefore, the meaning of this study can be suggested that VR and PR have been studied concerning VR's impact on the quality of life from exercise and pulmonary rehabilitation in humans with chronic lung disease under a controlled study design. Moreover, the validity of the results of the three clusters in this study with the Cosine normalization algorithm can be supported by previous evidence, 33 data visualization from the occurrence matrix, 55 network mapping visualization with Kamada-Kawai layout algorithm, 56, and related to the Walktrap algorithm.…”