Effects of virtual reality exercise on fatigue, pain, and psychological status among cancer patients: a meta-analysis.

Background: Cancer and its associated therapies can result in pain, fatigue, and high psychological depression with anxiety levels. Therefore, this meta-analysis explored the effects of virtual reality (VR) exercise on fatigue and pain in cancer patients, and the secondary outcomes assessed the levels of depression and anxiety. Methodology: Eligible studies were searched for through four databases and then screened. The inclusion criteria are as follows: (1) Participants with cancer; (2) randomised controlled trial and single-arm trials; (3) the intervention group received VR exercise; (4) conducted pre- and post-test, which include fatigue, pain, depression and anxiety. The Cochrane bias risk assessment tool was used to evaluate the quality of the selected study. Standardized Mean Difference (SMD) was selected as the appropriate effect scale index, and Revman 5.4 software was used to analyze the mean difference of the selected article data. (Registration number: CRD420251037421). Results: The meta-analysis outcomes implied a greater reduction in fatigue following the virtual reality group (VRG) intervention in comparison to control group (COG) (SMD, 0.77 [0.50, 1.04], p < 0.05, I2 = 61%). The heterogeneity of these outcomes then indicated that subgroup analyses were necessary. Consequently, these analyses denoted that fatigue was substantially improved in intervention durations below 30 min (SMD, 0.44 [0.08, 0.81], p < 0.05, I2 = 22%) and above 30 min (SMD, 1.20 [0.78, 1.61], p < 0.05, I2 = 0%). Significant pain improvement was also observed in VRG than COG (SMD, -0.88 [-1.15, -0.60], p < 0.05, I2 = 36%). Conclusions: This review indicated that VR exercise reduced fatigue, pain, and anxiety in cancer patients. Nevertheless, the effect of VR exercise on relieving depression is not clear, which may be a potentially effective non pharmacological intervention in this population.