Effects of virtual reality based rehabilitation in the treatment of patients with fibromyalgia syndrome: a systematic review and meta-analysis of randomized clinical trials

Abstract

The aim was to analyse the effects of virtual reality based rehabilitation (VRBR) in patients with fibromyalgia syndrome (FMS). This systematic review and meta-analysis was performed following PRISMA guidelines. A search was conducted in CINAHL, Medline (via PubMed), Scopus and Web of Science up to January 2023. Eligibility criteria were defined with PICOS. To assess the methodological quality, the Modified Downs and Black scale was used. The risk of bias was assessed through The Cochrane Collaboration’s tool. Meta-analysis was performed using RevMan software. 17 studies were included in the systematic review and 11 in the meta- analysis. We obtained significant differences in favour of VRBR for FMS impact (SMD: -0.49; 95% CI: -0.72 to -0.26), pain intensity (SMD: -0.50; 95% CI: -0.87 to -0.12), fatigue (SMD: - 0.55, 95% CI: -0.89 to -0.22), depression (SMD: -0.39; 95% CI: -0.55 to -0.23), anxiety (SMD: -0.36; 95% CI: -0.57 to -0.14), health-related quality of life (SMD: 0.56; 95% CI: 0.29 to 0.83), health perception (MD:10.56; 95% CI: 6.23 to 14.88), functional exercise capacity (SMD: 0.60; 95% CI: 0.33 to 0.87) and physical function (MD: 10.90; 95% CI: 7.04 to 14.77). No significant differences were found for kinesiophobia. VRBR significantly improves FMS symptoms, quality of life and physical condition. VRBR applied alone or combined with other interventions shows good results. VRBR was superior to treatment as usual. Better results were obtained when specialized VRBR was used. More research is needed to determine how to implement this treatment and to study VRBR effects on follow-up.