Virtual Reality Intervention for Patients With Neck Pain: Systematic Review and Meta-analysis of Randomized Controlled Trials (Preprint)

Abstract

BACKGROUND Neck pain is a prevalent condition and causes an enormous healthcare burden due to the lacking of efficient therapies. As a promising technologies, Virtual reality (VR) had shown its advantages in orthopedic rehabilitation. However, there is no meta-analysis evaluating the effectiveness of VR in neck pain management. OBJECTIVE To review original randomized controlled trials (RCTs) evaluating the effectiveness of virtual reality for neck pain and provide evidence for the clinical application of a new alternative approach for pain management. METHODS Nine electronic databases were systematically searched for relevant articles published from inception to February 2022. Randomized controlled trials in English or Chinese that investigated VR therapy in patients with neck pain were included. The methodological quality and evidence level were assessed using the Cochrane Back and Neck (CBN) Risk of Bias tool and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) guideline, respectively. RESULTS Seven studies including 348 participants were included for final analysis. As for the pain intensity, the overall pooled effect size was 0.51 (standard mean difference[SMD] -0.51, 95% confidence interval[CI] -0.98 to -0.04), favouring VR therapy compared with controls. Subgroups analyses revealed that significant differences in pain intensity were found in the multimodal intervention (VR in combination with other therapies) than other interventions (SMD -0.43, 95% CI -0.81 to -0.05), and better analgesic effects were also observed in patients with chronic neck pain receiving VR intervention than controls (SMD -0.74, 95% CI -1.21 to -0.28). Regarding other health outcomes, the VR group could lead to less disability, lower level of kinesiophobia and greater kinematic function (cervical range of motion[CROM], mean and peak velocity). Nevertheless, the follow-up effects of VR therapy on pain intensity and disability was not found. CONCLUSIONS VR is a beneficial non-pharmacological approach to improve pain intensity in patients with neck pain, with advantages to multimodal intervention and subjects with chronic neck pain. However, limited quantity and high heterogeneity across articles limit our findings.

The effect of rehabilitation in a virtual reality environment on improving balance in older adults with Parkinsons disease: A systematic review

“…The findings of our review are consistent with those of a similar systematic review and meta-analysis [9] , which reports that VR rehabilitation can improve balance, motor function, gait, and ability to perform daily activities in older adults with PD. In contrast, yet another similar systematic review and meta-analysis [11] despite arguing that rehabilitation in VR environments can be applied as an alternative treatment to improve balance, did not find any statistically significant differences. Measurements were made with the BBS, DGI, and FGA scales and indices similar to several studies in our review [12][13][14][15][16] .…”

“…Consequently, the senses of touch, sight, and hearing, as well as the interest of the patients in rehabilitation are promoted [10] . Due to its low cost and ease of use, VR technology is now often used in the rehabilitation of neurological disorders [11] .…”