The Effectiveness of Virtual Reality in Patients With Spinal Pain: A Systematic Review and Meta-Analysis

Background Virtual reality (VR) technologies have been shown to be beneficial in various areas of health care; to date, there are no systematic reviews examining the effectiveness of VR technology for the treatment of spinal pain. Purpose To investigate the effectiveness of VR technology in the management of individuals with acute, subacute, and chronic spinal pain. Methods Six electronic databases were searched until November 2019. Randomized controlled trials (RCTs) assessing the effectiveness of VR were eligible for inclusion. Two independent reviewers extracted the data and assessed the risk of bias for each study and the overall quality of evidence. Mean differences of outcomes were pooled as appropriate using random-effects models. Results Seven RCTs with high risk of bias met review criteria. Quality of evidence ranged from very low to low quality. In patients with chronic neck pain, VR improved global perceived effect (GPE), satisfaction, and general health at short-term follow-up, as well as general health and balance at intermediate-term follow-up compared to kinematic training. VR improved pain intensity and disability at short-term and long-term follow-up compared to conventional proprioceptive training in patients with chronic neck pain. In patients with either subacute or chronic low back pain (LBP), VR improved pain, disability, and fear of movement compared to lumbar stabilization exercises and improved pain compared to conventional physical therapy (at short-term follow-up). In patients with chronic LBP, VR improved pain compared to lumbar stabilization exercises and improved fear of movement compared to conventional physical therapy (at short-term follow-up). Conclusion VR's potential for improvement in outcomes for spinal pain that demonstrated statistical and/or clinical significance (pain intensity, disability, fear of movement, GPE, patient satisfaction, general health status, and balance) highlights the need for more focused, higher-quality research on the efficacy and effectiveness of VR for treatment of patients with spinal pain.