The effectiveness of immersive virtual reality in simulating landscapes for promoting psychological and physiological recovery in non-clinical populations: A systematic review and meta-analysis

Background: Contact with natural environments supports stress recovery, yet urbanization and pandemic-related constraints have reduced everyday access to restorative landscapes. Immersive virtual nature (IVN) can simulate nature experiences independent of time and place, but the strength and consistency of its restorative benefits across outcomes and study designs remain unclear. Method: Following PRISMA guidelines, we searched three databases for studies published from 2010 to December 2025. Eligible studies examined IVN in non-clinical populations and reported psychological and/or physiological recovery outcomes. Random-effects meta-analyses were conducted for outcomes with sufficient data, and restoration-related post-exposure scales were additionally synthesized using z-score normalization when change scores were unavailable. Meta-regression was used to examine whether control conditions contributed to heterogeneity. Risk of bias was assessed using Cochrane tools. Results: Fifty studies met inclusion criteria. IVN was associated with improved affective recovery and reduced physiological arousal indicators, though heterogeneity was substantial in several models. Meta-regression suggested that variation in control conditions generally did not undermine the rationale for pooling, while helping explain residual between-study variability. Descriptive synthesis also indicated a field-wide shift toward theory-driven, content- and design-oriented, and increasingly multisensory IVN interventions. Conclusions: This review integrates emotional and experiential–perceptual mechanisms, situated within established theories, to describe a coherent conceptual foundation for understanding restoration in IVN. By mapping empirical findings onto established frameworks in environmental psychology, it advances theoretical clarification of restorative processes in digitally mediated nature experiences and provides a structured basis for future research to refine mechanism-oriented designs and outcome models.