Virtual reality training for management of chronic neck pain: a systematic review with meta-analysis

PurposeWe conducted a systematic review with meta-analysis to examine the short- and long-term effects of virtual reality training (VRT) on pain, range of motion (RoM), kinesiophobia and perceived function in patients with chronic neck pain (CNP).MethodsWe searched the PubMed, Scopus, and PEDro databases for studies assessing effect of VRT against conventional therapy in CNP patients. Separate analyzes were performed for short-term (immediately after the intervention) and long-term (at follow-up) outcomes. Risk of bias was assessed with PEDro scale and the quality of evidence was assessed according to GRADE guidelines.ResultsWe found 11 studies, 8 of which were eligible for meta-analysis. Most studies had good methodological quality (6-8 points on the PEDro scale). The analysis showed significant differences in favour of VRT for neck disability index (long-term), kinesiophobia (long-term), and neck flexion RoM (short-term). No significant differences were found for pain intensity in the short- and long-term assessments. Heterogeneity between effect sizes was high in most analyzes, and the quality of evidence was low.ConclusionLow quality evidence suggests that VRT may contribute to long-term improvements in perceived function and kinesiophobia in CNP patients compared with conventional training programs. However, VRT and conventional training programs have similar effects on overall neck RoM and pain intensity.