Int. J. Environ. Res. Public Health 2022, 19, 1525. https://doi.org/10.3390/ijerph19031525 www.mdpi.com/journal/ijerph Article Virtual Reality Aided Therapy towards Health 4.0: A Two-Decade Bibliometric Analysis Zhen Liu 1 , Lingfeng Ren 1, *, Chang Xiao 1, *, Ke Zhang 1 and Peter Demian 2 1 School of Design, South China University of Technology, Guangzhou 510006, China; liuzjames@scut.edu.cn (Z.L.); kezh@scut.edu.cn (K.Z.) 2 School of Architecture, Building and Civil Engineering, Loughborough University, Loughborough LE11 3TU, UK; p.demian@lboro.ac.uk * Correspondence: 201921052600@mail.scut.edu.cn (L.R.); xiaocsd@scut.edu.cn (C.X.) Abstract: Health 4.0 aligns with Industry 4.0 and encourages the application of the latest technolo- gies to healthcare. Virtual reality (VR) is a potentially significant component of the Health 4.0 vision. Though VR in health care is a popular topic, there is little knowledge of VR-aided therapy from a macro perspective. Therefore, this paper was aimed to explore the research of VR in aiding therapy, thus providing a potential guideline for futures application of therapeutic VR in healthcare towards Health 4.0. A mixed research method was adopted for this research, which comprised the use of a bibliometric analysis (a quantitative method) to conduct a macro overview of VR-aided therapy, the identification of significant research structures and topics, and a qualitative review of the literature to reveal deeper insights. Four major research areas of VR-aided therapy were identified and inves- tigated, i.e., post-traumatic stress disorder (PTSD), anxiety and fear related disorder (A&F), diseases of the nervous system (DNS), and pain management, including related medical conditions, thera- pies, methods, and outcomes. This study is the first to use VOSviewer, a commonly used software tool for constructing and visualizing bibliometric networks and developed by Center for Science and Technology Studies, Leiden University, the Netherlands, to conduct bibliometric analyses on VR-aided therapy from the perspective of Web of Science core collection (WoSc), which objectively and visually shows research structures and topics, therefore offering instructive insights for health care stakeholders (particularly researchers and service providers) such as including integrating more innovative therapies, emphasizing psychological benefits, using game elements, and intro- ducing design research. The results of this paper facilitate with achieving the vision of Health 4.0 and illustrating a two-decade (2000 to year 2020) map of pre-life of the Health Metaverse. Keywords: health care; virtual reality; therapy; VOSviewer; bibliometric; post-traumatic stress disorder (PTSD); anxiety and fear related disorder (A&F); diseases of the nervous system (DNS); pain management; Health 4.0; Health Metaverse 1. Introduction Health is a state of complete physical, mental, and social well-being [1] that has been given particular attention following the establishment of the Millennium Development Goals [2]. In September 2015, the General Assembly of the United Nations adopted the Sustainable Development Goals (SDGs) to ensure healthy lives and promote well-being for all ages [3]. Concurrently, there has been increasing demand for guidance regarding the pathways and resources needed to realize health-related SDGs [4]. Health care (HC) is typically considered a chief determinant to promote the health of people around the world. The share of HC in global revenue has been slowly but steadily increasing in the past few decades, and cross-country evidence has shown that health in- vestment will return substantial health returns [5]. However, there are massive conflicting Citation: Liu, Z.; Ren, L.; Xiao, C.; Zhang, K.; Demian, P. Virtual Reality Aided Therapy towards Health 4.0: A Two-Decade Bibliometric Analysis. Int. J. Environ. Res. Public Health 2022, 19, 1525. https://doi.org/10.3390/ ijerph19031525 Academic Editors: José-Antonio Gil- Gómez, Patricia Mesa Gresa and Sergio Albiol-Pérez Received: 24 December 2021 Accepted: 25 January 2022 Published: 28 January 2022 Publisher’s Note: MDPI stays neu- tral with regard to jurisdictional claims in published maps and institu- tional affiliations. Copyright: © 2022 by the authors. Li- censee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and con- ditions of the Creative Commons At- tribution (CC BY) license (https://cre- ativecommons.org/licenses/by/4.0/).