Virtual reality biofeedback reduced anxiety, stress, and pain at least as effectively as traditional biofeedback, while demonstrating potential advantages in user motivation, involvement, and attentional focus.
Does virtual reality based biofeedback improve anxiety, stress, or pain compared to traditional biofeedback in healthy and clinical populations?
Virtual reality biofeedback is as effective as traditional biofeedback for reducing anxiety and stress, while potentially offering advantages in user motivation and involvement.
Over the past decades, virtual reality (VR) has found its way into biofeedback (BF) therapy programs. Using VR promises to overcome challenges encountered in traditional BF such as low treatment motivation, low attentional focus and the difficulty of transferring learnt abilities to everyday life. Yet, a comprehensive research synthesis is still missing. Hence, this scoping review aims to provide an overview over empirical studies on VR based BF regarding key outcomes, included samples, used soft- and hardware, BF parameters, mode of application and potential limitations. We systematically searched Medline, PsycINFO, Scopus, CINAHL, Google Scholar and Open Grey for empirical research. Eighteen articles met the inclusion criteria. Samples mostly consisted of healthy (44.4%) and/or adult (77.7%) participants. Outcomes were mainly anxiety (44.4%), stress (44.4%) or pain reduction (11.1%), which were reduced by the VR-BF interventions at least as much as by classical BF. Participants in VR-BF interventions showed higher motivation and involvement as well as a better user experience. Heart rate or heart rate variability were the most frequently used BF parameters (50.0%), and most VR-BF interventions (72.2%) employed a natural environment (e.g., island). Currently, there is no clear evidence that VR-BF is more effective than traditional BF. Yet, results indicate that VR-BF may have advantages regarding motivation, user experience, involvement and attentional focus. Further research is needed to assess the specific impact of VR and gamification. Also, testing a broader range of clinical and younger samples would allow more far-reaching conclusions.
Lüddecke et al. (2021) conducted a review in Anxiety, stress, and pain (n=865). Virtual Reality Biofeedback (VR-BF) vs. Traditional biofeedback, waitlist, or no biofeedback was evaluated on Anxiety, stress, or pain reduction. Virtual reality biofeedback reduced anxiety, stress, and pain at least as effectively as traditional biofeedback, while demonstrating potential advantages in user motivation, involvement, and attentional focus.