Effectiveness of Immersive Virtual Reality Exercise on Reducing Females’ Depression: A Systematic Review

Immersive virtual reality exercise (VR) has gradually garnered attention as a potential intervention for alleviating depressive symptoms in females, yet existing research findings remain inconsistent and call for further validation. This study systematically evaluated the effectiveness of immersive VR exercise on females depression and explored potential moderating factors. A comprehensive literature search was performed across six major databases: PubMed, Embase, Web of Science, Cochrane Library, CNKI and Wanfang datebases, spanning all available records from their launch dates to June 2025, following PIOCS guidelines. Randomized controlled trials (RCTs) were assessed using the Cochrane Risk of Bias tool. RevMan 5.3 and Stata 17.0 software were used to perform meta-analysis, with effect sizes calculated based on random-effects models and Hedges’g adopted as the specific indicator. Subgroup analyses and meta-regression examined moderators including intervention dose, exercise modality, and age. Nine trials involving 379 female participants were included. Immersive VR exercise significantly reduced depressive symptoms compared with control conditions (SMD = −2.62, 95% CI: −3.96, −1.27). Intervention duration, frequency, and modality did not significantly moderate outcomes, although longer sessions and intervention periods showed more stable improvement trends. Age was identified as a significant moderator, with stronger effects observed in women younger than 60 years. This study systematically integrates evidence on the effects of immersive VR exercise interventions on depressive symptoms in females, identifying key moderators. It provides high-level evidence for precise stratification of digital exercise prescriptions, optimized intervention dosage, and standardized clinical promotion evaluation systems, thus advancing the scalable, accessible translation of nonpharmacological mental health interventions in females.