Psychological outcomes of extended reality interventions in spinal cord injury rehabilitation: a systematic scoping review

STUDY DESIGN: Systematic scoping review.

OBJECTIVES: Extended reality (XR) is becoming a recognisable tool for assisting in spinal cord injury (SCI) rehabilitation. While the success of XR mediated interventions is often evaluated based on improvements in physical and functional performance, the present systematic scoping review aimed to identify and synthesize evidence on reported psychological outcomes of XR interventions in SCI rehabilitation. In doing so, we aimed to contribute towards an adaptation of XR that is meaningful for individuals living with SCI.

METHODS: Seven bibliometric databases were systematically searched. Included studies needed to be peer-reviewed, test structured and targeted XR interventions in an adult (≥ 16 years) SCI population, and assess any psychological construct. Individual double-screening against a pre-defined eligibility criteria was performed. Data from the included studies were extracted, tabulated, and analysed.

RESULTS: A total of 964 unique studies were initially identified. 13 studies were included in the analysis. The psychological outcomes most frequently quantified were depression, self-esteem, and anxiety. Among other things, qualitative evidence suggests VR-based interventions provided enjoyment, relaxation, and a source of positive distraction.

CONCLUSION: Immersive XR interventions in SCI rehabilitation have been positively evaluated, both qualitatively and quantitatively, based on the psychological outcomes of participants. While further research is needed, we find immersive XR to be an emerging treatment option with promise for maintaining and improving psychological health during SCI rehabilitation.