{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T19:42:06Z","timestamp":1790710926588,"version":"4.1.0"},"reference-count":56,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Vice-Rector\u2019s Office for University Outreach (VCM) at the Universidad San Sebasti\u00e1n, Concepci\u00f3n, Chile","award":["ID3422"],"award-info":[{"award-number":["ID3422"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Fibromyalgia (FM) is a chronic and complex condition characterized by widespread pain, fatigue, psychological burden, and cognitive impairment, posing significant challenges for treatment. Immersive virtual reality exercise (iVRE) has been proposed as an innovative therapeutic approach to increase adherence, motivation, and multidimensional benefits, but evidence in FM remains limited. This study aimed to evaluate the effects of a six-week iVRE program on cortisol levels, quality of life, cognitive function, and psychological symptoms in women with FM. Materials and Methods: A quasi-experimental pre\u2013post design was conducted with 21 women (mean age 48.1 \u00b1 10.7 years) diagnosed with FM, who completed twelve 30 min sessions of iVRE using Oculus Quest 2\u2122 and the FitXR platform. Outcomes assessed pre- and post-intervention included salivary cortisol (ELISA), quality of life (FIQR), emotional status (DASS-21), and cognitive function (MoCA). Adherence and safety were monitored throughout. Results: The intervention was well tolerated, with no adverse events and 100% adherence. Statistically significant improvements were observed in FIQR scores (p &lt; 0.001, d = 3.54), depression (p &lt; 0.001, d = 1.19), anxiety (p &lt; 0.001, d = 1.39), and stress (p &lt; 0.001, d = 2.28). Cognitive performance improved significantly, with higher MoCA total scores (p &lt; 0.001, d = 1.52) and better outcomes in visuospatial ability, language, and delayed recall domains. No significant changes were detected in salivary cortisol levels (p = 1.000). Conclusions: A six-week iVRE program is safe and feasible, promoting clinically relevant improvements in quality of life, emotional well-being, and cognitive function in women with FM, despite the absence of changes in cortisol. These findings highlight iVRE as a promising complementary therapeutic strategy within multidisciplinary FM management, warranting further controlled studies with larger samples and long-term follow-up to confirm its efficacy and explore underlying mechanisms.<\/jats:p>","DOI":"10.3390\/medicina62030446","type":"journal-article","created":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T08:31:19Z","timestamp":1772181079000},"page":"446","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Immersive Virtual Reality Exercise: Effects on Cortisol, Quality of Life, Cognitive Function, and Psychological Symptoms in Fibromyalgia"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5129-6612","authenticated-orcid":false,"given":"Gonzalo","family":"Arias-\u00c1lvarez","sequence":"first","affiliation":[{"name":"Departamento de Medicina y Especialidades M\u00e9dicas, Universidad de Alcal\u00e1, 28805 Alcal\u00e1 de Henares, Spain"},{"name":"Escuela de Kinesiolog\u00eda, Facultad de Ciencias de la Rehabilitaci\u00f3n y Calidad de Vida, Universidad San Sebasti\u00e1n, Concepci\u00f3n 4080871, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2323-192X","authenticated-orcid":false,"given":"Mar\u00eda","family":"Santamera-Lastras","sequence":"additional","affiliation":[{"name":"Departamento de Medicina y Especialidades M\u00e9dicas, Universidad de Alcal\u00e1, 28805 Alcal\u00e1 de Henares, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8112-0140","authenticated-orcid":false,"given":"Dina","family":"Guzm\u00e1n-Oyarzo","sequence":"additional","affiliation":[{"name":"Escuela de Tecnolog\u00eda M\u00e9dica, Facultad de Ciencias, Universidad San Sebasti\u00e1n, Lientur 1439, Concepci\u00f3n 4030000, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2714-5852","authenticated-orcid":false,"given":"Waldo","family":"Osorio-Torres","sequence":"additional","affiliation":[{"name":"Escuela de Kinesiolog\u00eda, Facultad de Ciencias de la Rehabilitaci\u00f3n y Calidad de Vida, Universidad San Sebasti\u00e1n, Concepci\u00f3n 4080871, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-5602-3286","authenticated-orcid":false,"given":"Benjam\u00edn","family":"Parada-Norambuena","sequence":"additional","affiliation":[{"name":"Escuela de Kinesiolog\u00eda, Facultad de Ciencias de la Rehabilitaci\u00f3n y Calidad de Vida, Universidad San Sebasti\u00e1n, Concepci\u00f3n 4080871, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8690-0998","authenticated-orcid":false,"given":"Daniel","family":"Pecos-Mart\u00edn","sequence":"additional","affiliation":[{"name":"Departamento de Enfermer\u00eda y Fisioterapia, Universidad de Alcal\u00e1, 28801 Alcal\u00e1 de Henares, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5982-7761","authenticated-orcid":false,"given":"Jes\u00fas G. 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