Accepted for/Published in: JMIR Serious Games
Date Submitted: Oct 21, 2021
Date Accepted: Mar 16, 2022
Virtual Reality in patients experiencing chronic pain: a systematic review and meta-analysis
ABSTRACT
Background:
Virtual reality (VR) is a computer technology that immerses the user in a completely different reality. The applications of VR in acute pain settings are well-known. In chronic pain, however, the applications and outcome parameters that are influenceable by VR are less clear.
Objective:
Therefore, the aim of this review is to systematically identify all outcome parameters that are reported in relation to VR in chronic pain patients.
Methods:
Four electronic databases (PubMed, Scopus, Web of Science and Embase) were searched. The study protocol was prospectively registered at PROSPERO (CRD42021227016). Multi-level random effect meta-analyses were calculated, whereby the standardized mean difference (SMD) was chosen as effect size to denote the difference between measurements before and after a VR intervention.
Results:
The initial database search identified a total of 1430 studies of which eventually 41 studies were included in the systematic review. Evidence was found for effects of VR on pain, functioning, mobility, functional capacity/mobility, psychological outcomes, quality of life, neuropsychological outcomes and physical sensations. The overall effect size (total of 194 effect sizes (N) from 25 studies) based on the three‐level meta‐analysis is estimated at 1.22 (95% CI from 0.55 to 1.89, z=3.56, p<0.001) in favour of improvements after a VR intervention. When categorising effect sizes, the following overall effect sizes were showed: 1.60 (95% CI from 0.83 to 2.36, z=4.09, p<0.001) for the effect of VR on pain (N=31), 1.40 (95% CI from 0.13 to 2.67, z=2.17, p=0.03) for functioning (N=60), 0.49 (95% CI from -0.71 to 1.68, z=0.80, p=0.42) for mobility (N=24) and 0.34 (95% CI from -1.52 to 2.20, z=0.36, p=0.72) for functional capacity/mobility (N=21).
Conclusions:
This systematic review revealed a broad range of outcome variables that are influenced by an intervention of VR-technology, with statistically significant pain relief and improvements in functioning. These findings indicate that VR does not only has its application in acute pain management but also in chronic pain settings whereby VR might be able to become a promising first-line intervention as complementary therapy for patients with chronic pain. Clinical Trial: The study protocol was prospectively registered at PROSPERO (CRD42021227016).
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