# Could Immersive Virtual Reality Facilitate the Recovery of Survivors of Critical Illness? A Systematic Review

## TL;DR

This study explores how immersive virtual reality could help survivors of critical illness recover from physical, cognitive, and psychological impairments after ICU stays.

## Contribution

The novelty lies in systematically reviewing VR's potential to address all aspects of post-intensive care syndrome (PICS) in a rehabilitation context.

## Key findings

- VR was found safe and effective in improving psychological outcomes like anxiety and PTSD in ICU survivors.
- VR showed positive effects on muscle strength and cognitive recovery in post-ICU patients.
- Only a limited number of RCTs currently exist due to the novelty of VR in this context.

## Abstract

Background/Objective: Post-intensive care syndrome (PICS) is a multifactorial, multidimensional condition common among patients who survive critical illness with protracted intensive care unit (ICU) length of stay. Survivors often present physical, cognitive, and psychological impairments that can arise during ICU hospitalization. Virtual reality has emerged as a promising tool in the healthcare field, as it offers innovative solutions to the challenges faced by critically ill survivors. We think that VR might help support people recovering from PICS at home, and this study aims to explore the benefits across the spectrum of PICS to describe the technological characteristics that could support and augment these interventions and present clinical recommendations. Methods: This systematic review searched PubMed, the Cochrane library, Science Direct, and Scopus databases up to July 2025. In this study we included randomized controlled trials (RCTs) examining the impact of VR on PICS. The methodological quality was assessed with the PEDro scale for RCTs and with NOC for non-RCTs. Results: A total of five studies met the inclusion criteria and were included. Three were RCTs, one non-RCT, and one series of cases. The studies presented good methodological quality. Virtual reality was found to be safe for critically ill survivors. All aspects of PICS were examined, with positive results in recovery of psychological disorders, such as anxiety and PTSD, and muscle strength as assessed by hand grip and cognition. The main limitation could be the limited number of RCT studies due to the novelty of the intervention. Conclusions: Virtual reality technology could be safely implemented in the field of post-ICU recovery and effectively assist the rehabilitation of physical, cognitive, and mental disorders of ICU patients. The protocol was registered in the Open Science Framework registry.