VIRTUAL reality rehabilitation improved cognition, quality of life, and anxiety during early recovery after acute respiratory distress syndrome.
Virtual Reality Rehabilitation Tested After ARDS
Researchers randomized 88 adults recovering from acute respiratory distress syndrome (ARDS) to usual rehabilitation alone or a four-week augmented rehabilitation package incorporating immersive virtual reality (VR). One control participant was lost to follow-up, leaving 87 participants in the available-case analysis.
The VR group received immersive respiratory training, exercise rehabilitation, and psychological interventions alongside usual care. Sessions incorporated paced breathing, simulated walking and functional exercises, relaxation, and mindfulness within virtual environments. Training was adjusted according to vital signs and patient tolerance.
The primary outcome was change in Montreal Cognitive Assessment (MoCA) score after four weeks. Secondary outcomes assessed health-related quality of life using the SF-36 and anxiety and depressive symptoms using the Hospital Anxiety and Depression Scale.
Cognition and Quality of Life Improve
After adjustment for baseline MoCA scores, the virtual reality rehabilitation group showed greater cognitive improvement than controls, with an adjusted between-group effect of 1.42 points.
Health-related quality of life also favored the VR group. SF-36 scores increased from 63.95 to 75.19 in the intervention group, compared with a slight decline from 54.00 to 53.23 among controls. The adjusted between-group effect was 13.20 points.
Anxiety symptoms decreased more substantially with augmented rehabilitation. HADS anxiety scores fell by 2.98 points in the VR group compared with 0.95 points in controls, producing an adjusted effect of −2.55 points.
Findings for depressive symptoms were less consistent. Although baseline-adjusted analysis favored the VR group, change-score and sensitivity analyses were not statistically significant, making the depression findings exploratory.
Benefits Cannot Be Attributed to VR Alone
The results suggest that immersive virtual reality rehabilitation may have potential during early ARDS recovery, but the study does not establish that VR itself produced the improvements.
The intervention group received additional structured rehabilitation, staff interaction, feedback, and treatment time, while controls were not matched for attention or rehabilitation exposure. Baseline differences in age and several outcome measures also limited causal interpretation.
Among participants receiving VR, 65.9% reported being satisfied or very satisfied. However, the single-center trial followed patients for only four weeks, leaving the durability of the observed benefits uncertain.
Larger multicenter trials with matched treatment exposure and longer follow-up are needed to determine whether immersive VR provides benefits beyond additional structured rehabilitation.
Reference
Li M et al. An augmented rehabilitation package incorporating immersive virtual reality during early recovery after ARDS: A randomized controlled trial. Ann Intensive Care. 2026;16:100154.
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