JMIR Publications

ABSTRACT

Background:

The effectiveness of virtual reality (VR) therapy in adult with chronic spinal pain (CSP) is uncertain.

Objective:

This study was conducted to determine the effectiveness of VR therapy compared to other therapy for adults with CSP, especially inflammation-related pain.

Methods:

The primary search was conducted using the Pubmed, Web of Science, Cochrane Library, Embase, and the Cumulative Index of Nursing and Allied Health Literature databases until November 11, 2023. Randomized controlled trials (RCTs) including adults with CSP receiving VR therapy compared with other therapy were included. The trial registration platform, reference lists of included studies, and systematic reviews and meta-analyses were manually searched. Two independent reviewers performed study selection, data extraction, risk of bias assessment, and evaluation of the quality of the evidence. The effect size used to synthesize the outcome measure was the weighted mean difference (WMD).

Results:

Sixteen RCTs containing 800 participants were included in the meta-analysis. The pooled data from 15 trials including 776 participants showed that the VR group was superior in improving pain intensity (MD = -1.63, 95% CI: -2.11 to -1.16, P < .001; I2 = 90%), and in reducing inflammatory markers, including C-reactive protein (CRP) (MD = -0.89, 95% CI: -1.07 to -0.70, P < .001; I2 = 0%), tumor necrosis factor-alpha (TNF-α) (MD = -6.60, 95% CI: -8.56 to -4.64, P < .001; I2 = 98%), and interleukins 6 (IL-6) (MD = -2.76, 95% CI: -2.98 to -2.53, P < .001; I2 = 0%). However, no significant differences were found in terms of spinal ROM (range of motion) disability level, or fear of movement. Ten studies had a high risk of bias among the included studies.

Conclusions:

VR may be an effective and safe intervention to reduce symptoms in patients with CSP, with significant analgesic effects and beneficial improvements in inflammatory factor levels, but it may not be significant for spinal ROM, disability level, or fear of movement. It is important to note that the quality of the evidence from the studies included in this study ranged from moderate to low quality. Therefore, we recommend that readers treat the results of this study with caution. Clinical Trial: CRD42022382331. (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=382331).