JMIR Publications

ABSTRACT

Background:

Heart failure (HF) is a chronic condition that causes physical, psychological, and cognitive decline, leading to reduced quality of life (QOL). Despite the proven benefits of exercise-based cardiac rehabilitation, participation remains low due to accessibility and motivational barriers. Virtual reality (VR)–based interventions offer immersive, interactive experiences that may enhance engagement and promote physical activity.

Objective:

This systematic review examined the effects of VR-based interventions on physical activity, psychosocial outcomes, and self-management behaviors in patients with HF.

Methods:

A systematic search of PubMed, CINAHL, Embase, and Scopus identified interventional studies published in recent 10 years. Eligible studies included patients with HF who participated in VR-based interventions in randomized controlled trials (RCTs) or non-RCTs. The reviewers screened, extracted, and assessed data quality using the Cochrane RoB 2.0 and ROBINS-I tools.

Results:

Nine studies met inclusion criteria, comprising seven RCTs and two non-RCTs. Most interventions were home-based (n = 7), with exergaming as the most common approach. Significant improvements were reported in exercise capacity (n = 6), physical activity (n = 5), and QOL (n = 4). Three studies found reduced depressive symptoms, while effects on anxiety and self-efficacy were mixed. Studies reported high adherence, positive usability, and no adverse events, confirming feasibility and safety.

Conclusions:

VR-based interventions are feasible, safe, and effective for enhancing physical activity and QOL in patients with HF. Future large-scale, theory-based RCTs with standardized protocols and long-term follow-up are needed to validate sustained clinical effects. Clinical Trial: Not applicable