Virtual reality based rehabilitation in adults with chronic neck pain: a systematic review and meta‑analysis of randomized clinical trials

Abstract

Chronic neck pain is one of the most frequent musculoskeletal disorders, with high prevalence worldwide. Rehabilitation is an essential component of therapeutic strategy. Virtual reality based rehabilitation (VRBR) is a powerful distraction technique that could be beneficial for chronic neck pain patients. The objective of this systematic review was to analyse the effectiveness of VRBR in chronic neck pain treatment. We followed the PRISMA guidelines and used four databases (CINAHL, Medline (Via PubMed), Scopus and Web of Science) from their inception to August 2023. Eligibility criteria were established using PICOS. Methodological quality was evaluated with the Downs and Black scale and the risk of bias with the Revised Cochrane risk-of-bias tool. The meta-analysis was performed using the RevMan software. Six studies were included in the systematic review and the meta-analysis. We observed significant differences in favour of VRBR for pain intensity (SMD = − 0.46; 95% CI = − 0.74, − 0.19; p = 0.001), disability (MD = − 2.84; 95% CI = − 4.23, − 1.45; p < 0.0001), global perceived effect (MD = 0.49; 95% CI = 0.25, 0.72; p < 0.0001) and patient satisfaction (MD = 0.62; 95% CI = 0.38, 0.86; p < 0.00001). However, at short-term follow-up significant differences were only obtained for disability (MD = − 3.52; 95% CI = − 5.85, − 1.20; p = 0.003). VRBR can significantly improve pain intensity, disability, global perceived effect and patient satisfaction. The small number of articles included in the analysis is a limitation, even considering the good methodological quality of these studies. Investigating the effects of VRBR on mid and long-term follow-up and exploring different types of VR are needed.