Virtual Reality Therapy for the Management of Chronic Spinal Pain: Systematic Review and Meta-Analysis.

IF 3.8 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

JMIR Serious Games Pub Date : 2024-02-12 DOI:10.2196/50089

Tongtong Zhang, Xin Li, Xuan Zhou, Lixia Zhan, Fan Wu, Zefan Huang, Yuxun Sun, Yufei Feng, Qing Du

{"title":"Virtual Reality Therapy for the Management of Chronic Spinal Pain: Systematic Review and Meta-Analysis.","authors":"Tongtong Zhang, Xin Li, Xuan Zhou, Lixia Zhan, Fan Wu, Zefan Huang, Yuxun Sun, Yufei Feng, Qing Du","doi":"10.2196/50089","DOIUrl":null,"url":null,"abstract":"Background: The effectiveness of virtual reality (VR) therapy in adults with chronic spinal pain (CSP) is unclear.Objective: This study was conducted to compare the effectiveness of VR therapy and other therapies in adults with CSP, especially patients with inflammation-related pain.Methods: PubMed, Web of Science, Cochrane Library, Embase, and CINAHL databases were searched up to November 11, 2023. Randomized controlled trials (RCTs) comparing adults with CSP receiving VR therapy with those receiving other therapies were included. The trial registration platform as well as the reference lists of included studies and previous 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 weighted mean difference (WMD) was used as the effect size used to synthesize the outcome measure.Results: In total, 16 RCTs involving 800 participants were included in this meta-analysis. The pooled data from 15 (94%) RCTs including 776 (97%) participants showed that VR therapy was superior in improving pain intensity (WMD=-1.63, 95% CI -2.11 to -1.16, P<.001, I2=90%) and reducing inflammatory markers, including C-reactive protein (WMD=-0.89, 95% CI -1.07 to -0.70, P<.001, I2=0%), tumor necrosis factor-alpha (WMD=-6.60, 95% CI -8.56 to -4.64, P<.001, I2=98%), and interleukin-6 (WMD=-2.76, 95% CI -2.98 to -2.53, P<.001, I2=0%). However, no significant differences were found in terms of the spinal range of motion (ROM), disability level, or fear of movement. In addition, 10 (63%) of the included RCTs had a high risk of bias.Conclusions: VR therapy may be an effective and safe intervention for reducing symptoms in patients with CSP, as it is shown to exert significant analgesic effects and beneficial improvements in inflammatory factor levels. However, this approach may not have significant effects on the spinal ROM, disability level, or fear of movement. Notably, the quality of the evidence from the RCTs included in this study ranged from moderate to low. Therefore, we recommend that readers interpret the results of this study with caution.Trial registration: PROSPERO CRD42022382331; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=382331.","PeriodicalId":14795,"journal":{"name":"JMIR Serious Games","volume":null,"pages":null},"PeriodicalIF":3.8000,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10897798/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"JMIR Serious Games","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2196/50089","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}

引用次数: 0

Abstract

Background: The effectiveness of virtual reality (VR) therapy in adults with chronic spinal pain (CSP) is unclear.

Objective: This study was conducted to compare the effectiveness of VR therapy and other therapies in adults with CSP, especially patients with inflammation-related pain.

Methods: PubMed, Web of Science, Cochrane Library, Embase, and CINAHL databases were searched up to November 11, 2023. Randomized controlled trials (RCTs) comparing adults with CSP receiving VR therapy with those receiving other therapies were included. The trial registration platform as well as the reference lists of included studies and previous 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 weighted mean difference (WMD) was used as the effect size used to synthesize the outcome measure.

Results: In total, 16 RCTs involving 800 participants were included in this meta-analysis. The pooled data from 15 (94%) RCTs including 776 (97%) participants showed that VR therapy was superior in improving pain intensity (WMD=-1.63, 95% CI -2.11 to -1.16, P<.001, I²=90%) and reducing inflammatory markers, including C-reactive protein (WMD=-0.89, 95% CI -1.07 to -0.70, P<.001, I²=0%), tumor necrosis factor-alpha (WMD=-6.60, 95% CI -8.56 to -4.64, P<.001, I²=98%), and interleukin-6 (WMD=-2.76, 95% CI -2.98 to -2.53, P<.001, I²=0%). However, no significant differences were found in terms of the spinal range of motion (ROM), disability level, or fear of movement. In addition, 10 (63%) of the included RCTs had a high risk of bias.

Conclusions: VR therapy may be an effective and safe intervention for reducing symptoms in patients with CSP, as it is shown to exert significant analgesic effects and beneficial improvements in inflammatory factor levels. However, this approach may not have significant effects on the spinal ROM, disability level, or fear of movement. Notably, the quality of the evidence from the RCTs included in this study ranged from moderate to low. Therefore, we recommend that readers interpret the results of this study with caution.

Trial registration: PROSPERO CRD42022382331; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=382331.

查看原文本刊更多论文

虚拟现实疗法治疗慢性脊柱疼痛：系统综述与元分析》（Virtual Reality Therapy for the Management of Chronic Spinal Pain）。

背景：虚拟现实（VR）疗法对慢性脊柱疼痛（CSP）成人患者的疗效尚不明确：本研究旨在比较虚拟现实疗法和其他疗法对成人慢性脊柱疼痛患者（尤其是炎症相关疼痛患者）的疗效：方法：检索了截至 2023 年 11 月 11 日的 PubMed、Web of Science、Cochrane Library、Embase 和 CINAHL 数据库。方法：检索了截至 2023 年 11 月 11 日的 PubMed、Web Science、Cochrane Library、Embrane 和 CINAHL 数据库，并纳入了将接受 VR 治疗的成人 CSP 患者与接受其他疗法的患者进行比较的随机对照试验（RCT）。人工检索了试验注册平台、纳入研究的参考文献列表以及之前的系统综述和荟萃分析。两名独立审稿人负责研究筛选、数据提取、偏倚风险评估和证据质量评价。加权平均差（WMD）被用作综合结果测量的效应大小：本次荟萃分析共纳入了 16 项研究性试验，涉及 800 名参与者。来自 15 项（94%）研究性试验（包括 776 名（97%）参与者）的汇总数据显示，VR疗法在改善疼痛强度（WMD=-1.63，95% CI -2.11~-1.16，P2=90%）和降低炎症标志物（包括 C 反应蛋白）（WMD=-0.89，95% CI -1.07至-0.70，P2=0%）、肿瘤坏死因子-α（WMD=-6.60，95% CI -8.56至-4.64，P2=98%）和白细胞介素-6（WMD=-2.76，95% CI -2.98至-2.53，P2=0%）。然而，在脊柱活动范围（ROM）、残疾程度或对运动的恐惧方面没有发现明显差异。此外，10项（63%）纳入的RCT存在较高的偏倚风险：VR疗法可能是减少CSP患者症状的一种有效而安全的干预措施，因为它具有显著的镇痛效果，并能有效改善炎症因子水平。然而，这种方法对脊柱活动度、残疾程度或运动恐惧可能没有明显效果。值得注意的是，本研究纳入的研究性临床试验的证据质量从中度到低度不等。因此，我们建议读者谨慎解读本研究的结果：ProCORD42022382331; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=382331.

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

JMIR Serious Games Medicine-Rehabilitation

CiteScore

7.30

自引率

10.00%

发文量

审稿时长

12 weeks

期刊介绍： JMIR Serious Games (JSG, ISSN 2291-9279) is a sister journal of the Journal of Medical Internet Research (JMIR), one of the most cited journals in health informatics (Impact Factor 2016: 5.175). JSG has a projected impact factor (2016) of 3.32. JSG is a multidisciplinary journal devoted to computer/web/mobile applications that incorporate elements of gaming to solve serious problems such as health education/promotion, teaching and education, or social change.The journal also considers commentary and research in the fields of video games violence and video games addiction.

文献相关原料

公司名称	产品信息	采购帮参考价格