Effectiveness of Virtual Reality Versus Exercise-Based Interventions in the Management of Chronic Spinal Pain: A Systematic Review and Meta-Analysis.

IF 1.7 Q3 REHABILITATION

Physiotherapy Research International Pub Date : 2026-10-01 DOI:10.1002/pri.70354

Julián Peralta-Álvarez, Francisco Nieto-Escámez, Remedios López-Liria, Juan José González-Geréz, María Jesús Benzo-Iglesias, Patricia Rocamora-Pérez

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Abstract

Background/purpose: This systematic review and meta-analysis assessed the comparative effectiveness of virtual reality (VR) versus exercise-based interventions for pain, disability, fear of movement, and quality of life in patients with chronic spinal pain.

Methods: Five databases were searched for randomized control trials (RCTs) in the last 10 years, comparing VR versus exercise-based interventions (with or without passive adjunct modalities) for adults (≥ 18 years) with chronic spinal pain. Risk of bias and certainty of evidence were assessed using the Cochrane RoB 2.0 tool and GRADE framework, followed by random-effect meta-analyses.

Results: Fifteen RCTs comprising 659 participants were included, with most presenting a high risk of bias. Based on very low-certainty evidence, VR showed statistically significant superiority over exercise-based interventions for pain (VAS: MD -1.05, 95% CI -1.92 to -0.18; p = 0.02; I² = 94%; NPRS: MD -0.95, 95% CI -1.59 to -0.31; p = 0.003; I² = 14%) and kinesiophobia (MD -3.52, 95% CI -6.08 to -0.96; p = 0.007; I² = 0%). None of these statistically significant reductions met the commonly established thresholds for Minimal Clinically Important Difference (MCID) for chronic spinal pain populations. Very low-certainty evidence found no significant differences for functional disability (MD -1.38, 95% CI -5.43 to 2.67; p = 0.50; I² = 0%), and results on quality of life were heterogeneous and inconclusive.

Discussion: Although VR may offer statistical advantages over exercise-based interventions for pain and kinesiophobia, the overall certainty of the evidence remains very low. The non-attainment of the MCID thresholds, coupled with high risk of bias and substantial statistical heterogeneity, underscores the need for strict caution.

Trial registration: PROSPERO (CRD420251101584).

查看原文本刊更多论文

虚拟现实与运动干预在慢性脊柱疼痛管理中的有效性：一项系统综述和荟萃分析。

背景/目的：本系统综述和荟萃分析评估了虚拟现实（VR）与基于运动的干预措施对慢性脊柱疼痛患者疼痛、残疾、运动恐惧和生活质量的比较效果。方法：在过去10年的随机对照试验（rct）中检索了5个数据库，比较了VR和基于运动的干预（有或没有被动辅助方式）对成人（≥18岁）慢性脊柱疼痛的影响。使用Cochrane RoB 2.0工具和GRADE框架评估偏倚风险和证据确定性，随后进行随机效应荟萃分析。结果：纳入了15项随机对照试验，包括659名受试者，其中大多数存在高偏倚风险。基于非常低确定性的证据，VR在疼痛（VAS: MD -1.05, 95% CI -1.92至-0.18;p = 0.02; I2 = 94%; NPRS: MD -0.95, 95% CI -1.59至-0.31;p = 0.003; I2 = 14%）和运动恐惧症（MD -3.52, 95% CI -6.08至-0.96;p = 0.007; I2 = 0%）方面比基于运动的干预具有统计学上的显著优势。这些具有统计学意义的降低均未达到慢性脊柱疼痛人群的最小临床重要差异（MCID）的通常设定阈值。非常低确定性的证据发现，在功能性残疾方面没有显著差异（MD -1.38, 95% CI -5.43至2.67;p = 0.50; I2 = 0%），生活质量方面的结果是异质性的，不确定的。讨论：尽管VR可能比基于运动的疼痛和运动恐惧症干预提供统计优势，但证据的总体确定性仍然很低。未达到MCID阈值，加上高偏倚风险和大量统计异质性，强调需要严格谨慎。试验注册：PROSPERO （CRD420251101584）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Physiotherapy Research International REHABILITATION-

CiteScore

3.30

自引率

5.90%

发文量

期刊介绍： Physiotherapy Research International is an international peer reviewed journal dedicated to the exchange of knowledge that is directly relevant to specialist areas of physiotherapy theory, practice, and research. Our aim is to promote a high level of scholarship and build on the current evidence base to inform the advancement of the physiotherapy profession. We publish original research on a wide range of topics e.g. Primary research testing new physiotherapy treatments; methodological research; measurement and outcome research and qualitative research of interest to researchers, clinicians and educators. Further, we aim to publish high quality papers that represent the range of cultures and settings where physiotherapy services are delivered. We attract a wide readership from physiotherapists and others working in diverse clinical and academic settings. We aim to promote an international debate amongst the profession about current best evidence based practice. Papers are directed primarily towards the physiotherapy profession, but can be relevant to a wide range of professional groups. The growth of interdisciplinary research is also key to our aims and scope, and we encourage relevant submissions from other professional groups. The journal actively encourages submissions which utilise a breadth of different methodologies and research designs to facilitate addressing key questions related to the physiotherapy practice. PRI seeks to encourage good quality topical debates on a range of relevant issues and promote critical reflection on decision making and implementation of physiotherapy interventions.