Effects of virtual reality on pain,disability and kinesiophobia in patients with chronic low back pain: A systematic review with meta-analysis

Abstract

BACKGROUND:

Chronic low back pain (CLBP) significantly impairs function and productivity, emphasizing the need for effective solutions, with virtual reality (VR) emerging as a novel alternative for management.

OBJECTIVE:

The aim of this systematic review and meta-analysis was to examine the effects of VR interventions on pain, disability and kinesiophobia, compared with other therapeutic interventions in CLBP patients.

METHODS:

In July 2023, we searched PubMed and PEDro databases for studies that examined the effects of VR interventions on pain, disability or kinesiophobia in adults with CLBP. Using a meta-analysis with a random-effects model, we derived the standardized mean difference as the pooled effect.

RESULTS:

We found 33 studies, 22 of which were eligible for meta-analysis. Most studies were of good quality, with 12/22 reaching a score between 6 and 8 points on the PEDro scale. VR demonstrated superior results compared to placebo (SMD = –1.90; 95% CI = –3.60 to –0.20; p = 0.03), no intervention (SMD = –1.66; 95% CI = –2.49 to –0.83; p < 0.001), exercise (SMD = –0.61; 95% CI = –1.06 to –0.16; p = 0.008), and VR combined with physical therapy showed greater efficacy than exercise combined with physical therapy (SMD = –1.42; 95% CI = –2.33 to –0.52; p = 0.002) in pain intensity outcome. However, no significant differences were found for disability outcome.

CONCLUSION:

VR interventions are superior to non-VR interventions in terms of improving pain intensity in CLBP patients, but not also for disability outcomes. Further research is needed for conclusive insights into VR’s efficacy.