Virtual reality interventions for physical activity and stress reduction in neurodevelopmental disorder family contexts: A scoping review (2015–2025)

BACKGROUND: Children with neurodevelopmental disorders (NDDs) and their families face barriers to physical activity and often accumulate excessive sedentary time. Virtual reality (VR) offers a promising modality to promote active engagement. OBJECTIVE: This scoping review mapped studies using immersive VR nature simulations for stress reduction in NDD family contexts (Tier 1) and recreation-focused VR supporting physical activity (Tier 2). METHODS: Guided by the JBI Manual and PRISMA-ScR, we searched PubMed, CINAHL, Web of Science, and APA PsycInfo (2015-2025). Searches were executed Oct 30-Nov 1, 2025. Strategies combined VR with nature/outdoor, pediatric/caregiver, and NDD terms. Two reviewers screened and charted data. RESULTS: Of 101 records identified, 32 duplicates were removed and 69 records were screened; 2 studies met inclusion criteria. A caregiver pilot (Tier 1) using a single 15-minute VR nature session showed immediate mood improvements and reduced perceived stress at days 3 and 7, with no serious adverse events. A school-based feasibility study (Tier 2) demonstrated that supervised VR exergaming can achieve moderate-intensity exercise. CONCLUSIONS: VR-enabled interventions appear feasible for caregiver stress reduction and promoting physical activity in children with disabilities. Evidence remains limited; comparative trials examining VR's role in active lifestyle promotion are needed. IMPLICATIONS: Practitioners can integrate VR into structured service delivery. Research should examine dose-response relationships, physiological endpoints, and equity-oriented implementation to advance lifestyle interventions for NDD populations.