Virtual reality (VR) methods are increasingly prevalent for physical and cognitive rehabilitation [1–3]. In this perspective, VR refers specifically to immersive systems delivered through head-mounted displays (HMDs) such as the Meta Quest, HTC Vive, or Pico headsets, combined with controllers or motion-tracking peripherals. This is distinct from augmented reality (AR), which overlays digital content on the real world, or mixed reality (MR), which blends both. While AR and MR have therapeutic potential, immersive VR offers the highest degree of environmental control and presence, which is particularly valuable for remote rehabilitation. Virtual reality provides immersive environments [4] for therapeutic regimes that can simulate realistic interactions [5] and better engage users in physical and cognitive practices through gamification [6]. Through programmable features that allow for greater accessibility and flexibility, VR platforms are increasingly recognized as a potent tool for remote therapy [7,8–11]; however, the current scope of application is still relatively limited. Computerized interfaces like VR can serve as another “bridge” for therapists to connect to patients in real-time within a shared environment. Furthermore, virtual reality therapy can be remotely accessed using affordable, commercial equipment compatible with personal computers, smart devices, and home networks.

The growing relevance of remote therapy more broadly is driven by several converging factors, including increasing prevalence of chronic neurological and musculoskeletal conditions, aging populations with limited mobility, and rising demand for home-based care that reduces travel burden and clinic congestion [12,13]. In parallel, clinicians have increasingly adopted telehealth and telerehabilitation approaches to improve patient convenience, continuity of care, and adherence, particularly when in-person access is limited by geography, transportation, or staffing constraints [14,15]. Advances in consumer networking infrastructure, audiovisual communication platforms, and cloud-based data services have further enabled remote therapeutic interactions with levels of audio–video quality, latency, and reliability that are generally acceptable to both patients and clinicians [16–18]. Within this evolving care landscape, VR provides a uniquely programmable and interactive modality that can unify therapeutic delivery, real-time interaction, and performance monitoring within a single remote platform. This article provides a narrative perspective informed by targeted literature synthesis (e.g., various Google Scholar searches coupling “virtual reality” with other related terms such as “remote therapy”, “rehabilitation”, and “artificial intelligence”) and reflections from clinical engineering practice.

The effectiveness of VR as a remote therapy tool is predicated on increased dosage, greater personalization, and more effective patient monitoring. VR rehabilitative training can supplement traditional approaches, exposing patients to larger therapeutic dosages to ensure positive cognitive and physical transformations [19,20]. Both therapists and patients can conveniently and consistently schedule remote sessions to ensure regular dosing. Virtual reality has already been proven to increase participation in therapy by motivating patients to engage in longer sessions or more training repetitions using gamified constructs and realistic task environments [21,22]. Still, the potential effectiveness of virtual reality as a rehabilitation tool is further realized when it is customized or adapted to each user, i.e., personalization. Even when delivering VR therapy remotely, capabilities to personalize treatments are preserved, if not enhanced, given the onus to monitor patient safety at a distance. Furthermore, computerized environments like VR facilitate digital time-stamping and activity tracking during therapeutic sessions, allowing therapists to monitor patient progress more accurately and precisely. Such quantifiable feedback should enable therapists to understand better how patients are responding and recommend adjustments to therapeutic courses in a more timely manner.

This perspective article discusses how remote therapies can benefit from VR based on its leading feature of supporting the creation of immersive, controlled, and customizable environments in which both patient and therapist can interact. This article will first briefly summarize various rehabilitation applications, both cognitive and physical, in which virtual reality approaches have gained traction. Then, how VR benefits the delivery of remote therapy will be described based on dosage (via accessibility and engagement), personalization, and monitoring. Finally, the article concludes with considerations, i.e., limitations and potential advancements, for implementing VR therapies in the future. The primary method for engaging literature to support this perspective article included searches on Google Scholar with various topics equivalent to: (1) virtual reality for remote therapy, (2) virtual reality physical rehabilitation, (3) virtual reality cognitive rehabilitation, (4) features and advantages of virtual reality therapies, and (5) virtual reality therapy artificial intelligence. These searches emphasized peer-reviewed studies of clinical relevance, including both foundational work and recent contributions, rather than an exhaustive enumeration of all available publications. Consistent with the scope of a narrative perspective, formal systematic review procedures (e.g., PRISMA-guided study identification and screening) were not applied. Instead, the literature was synthesized qualitatively to identify recurring therapeutic features and implementation considerations that informed the conceptual model proposed in this article.

These themes of dosage, personalization, and continuous monitoring provide the foundation for VR’s unique suitability for remote therapy delivery and inform the following guiding questions:

1. How can VR increase therapeutic dosage through accessibility and engagement when delivered remotely?
2. In what ways can VR enable greater personalization of therapy, especially when integrated with wearables and physiological monitoring?
3. What forms of precision monitoring can VR provide to reduce therapist burden while ensuring patient safety and progress tracking?
4. How can VR, in combination with artificial intelligence (AI) and telehealth platforms, advance the broader ecosystem of remote care?

This article is intentionally framed as a narrative perspective rather than a systematic review or meta-analysis. The literature was engaged through targeted searches of Google Scholar using thematically grouped keywords related to virtual reality, rehabilitation, remote therapy, and enabling technologies, with emphasis on peer-reviewed studies of clinical relevance. The goal of this approach was not to exhaustively catalogue or quantitatively compare all available studies, but rather to synthesize representative evidence and emerging trends to inform a conceptual discussion of the potential of immersive VR as a platform for remote rehabilitation. Accordingly, the article prioritizes integration of findings across cognitive, physical, and mental health domains to highlight common features, opportunities, and design considerations whether used remotely or in the clinic. As with any narrative synthesis, this approach has inherent limitations, including reduced reproducibility and potential selection bias compared with formal systematic reviews. These limitations are acknowledged, and the perspective offered here is intended to complement, rather than replace, future systematic and meta-analytic evaluations of VR-based rehabilitation efficacy. Findings were synthesized qualitatively to identify recurring design features, therapeutic mechanisms, and implementation considerations across cognitive, physical, and mental health domains. While this narrative approach limits strict reproducibility of study selection, analytical rigor is maintained by organizing the synthesis around explicit conceptual pillars—therapeutic dosage via accessibility and engagement, personalization, and monitoring—which provide a consistent logical framework for interpreting prior work.

This entry is adapted from the peer-reviewed paper 10.3390/encyclopedia6020037