Effectiveness of virtual reality based respiratory physiotherapy in patients withchronic bronchopulmonary disorders: a systematic review

Abstract

Chronic bronchopulmonary disorders are among the leading causes of morbidity and mortality worldwide, significantly affecting pulmonary function, physical endurance, psychological well-being, and quality of life. Conventional respiratory physiotherapy and pulmonary rehabilitation remain essential therapeutic approaches for managing chronic respiratory diseases. however, long-term patient adherence is frequently poor due to monotony, lack of motivation, transportation difficulties, and limited accessibility to specialized rehabilitation centers. In recent years, virtual reality (VR) technology has emerged as a promising adjunctive tool in rehabilitation medicine, offering immersive, interactive, and gamified therapeutic experiences that enhance patient engagement and adherence. The present systematic review evaluates the effectiveness of VR-based respiratory physiotherapy in patients with chronic bronchopulmonary disorders including chronic obstructive pulmonary disease (COPD), asthma, bronchiectasis, interstitial lung disease, cystic fibrosis, and post-COVID pulmonary dysfunction. Evidence from studies published during the last decade demonstrates that VR-assisted respiratory rehabilitation significantly improves pulmonary function, exercise tolerance, respiratory muscle performance, dyspnea perception, psychological health, and overall quality of life. Additionally, VR-based interventions promote motivation, reduce anxiety associated with physical activity, and facilitate home-based tele-rehabilitation. Despite promising outcomes, challenges related to cost, technological limitations, cybersickness, and lack of standardized protocols remain significant barriers to widespread implementation. Future integration of artificial intelligence, wearable biosensors, and telehealth systems may further enhance the effectiveness and accessibility of VR-based respiratory physiotherapy