Describe the contraindications and adverse effects of immersive virtual reality reported in international scientific literature.
This scoping review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR), as per current recommendations of JBI (Johanna Briggs Institute). Scientific documents were obtained from the PubMed, Scielo, Google Scholar, Trip Database, and Open Grey databases. The selection process was conducted according to the following criteria: either observational or experimental studies that considered adult population (>18 years) and the use of immersive virtual reality as a therapeutic tool were included, whereas those studies not having a physiotherapeutic focus, reviews, letters to the editor, recommendations, or comments were excluded. Two reviewers filtered by title, abstract and full text, and a third reviewer solved the conflicts. Bibliometric variables (year of publication, research design, language) and main outcomes (adverse effects, contraindications, physical therapy area) were extracted. All variables were organized in a data extraction matrix in Excel.
A total of 5,947 articles were retrieved. After removing 912 duplicates and excluding 5,035, 293 articles were included for data extraction. From these, 51 adverse/side effects were reported either by participants/patients or researchers. The most reported effects were dizziness (13.2%), nausea (11.1%), a sense of instability or imbalance (7.7%), and cybersickness (5.5%). Regarding contraindications, dizziness (19%), fatigue (9.5%), and nausea (7.1%) were the most described.
The scientific literature describes a wide variety of adverse effects and contraindications. Future research should aim to categorize them based on consensus criteria to prevent potential risks and events.
The findings of this review highlight the importance of thoroughly assessing patients before incorporating IVR into physical therapy treatment. Clinicians must be aware of common side effects such as dizziness, nausea, and cybersickness, which can negatively impact patient outcomes and their adherence to therapy. Additionally, recognizing potential risks provides valuable insights for refining patient selection criteria. Future research should focus on developing standardized guidelines to manage better, control, and minimize these adverse effects in clinical settings, ensuring that IVR is used safely and effectively across different patient populations.
adverse effects
Virtual reality contraindications
