Division of Physical Therapy, Duke University, Durham, North Carolina, U.S.A.
Division of Physical Therapy, Duke Clinical Research Institute, Duke University, Durham, North Carolina, U.S.A.
Pain Pract. 2020 Jul;20(6):656-675. doi: 10.1111/papr.12885. Epub 2020 May 21.
Virtual reality (VR) technologies have been shown to be beneficial in various areas of health care; to date, there are no systematic reviews examining the effectiveness of VR technology for the treatment of spinal pain.
To investigate the effectiveness of VR technology in the management of individuals with acute, subacute, and chronic spinal pain.
Six electronic databases were searched until November 2019. Randomized controlled trials (RCTs) assessing the effectiveness of VR were eligible for inclusion. Two independent reviewers extracted the data and assessed the risk of bias for each study and the overall quality of evidence. Mean differences of outcomes were pooled as appropriate using random-effects models.
Seven RCTs with high risk of bias met review criteria. Quality of evidence ranged from very low to low quality. In patients with chronic neck pain, VR improved global perceived effect (GPE), satisfaction, and general health at short-term follow-up, as well as general health and balance at intermediate-term follow-up compared to kinematic training. VR improved pain intensity and disability at short-term and long-term follow-up compared to conventional proprioceptive training in patients with chronic neck pain. In patients with either subacute or chronic low back pain (LBP), VR improved pain, disability, and fear of movement compared to lumbar stabilization exercises and improved pain compared to conventional physical therapy (at short-term follow-up). In patients with chronic LBP, VR improved pain compared to lumbar stabilization exercises and improved fear of movement compared to conventional physical therapy (at short-term follow-up).
VR's potential for improvement in outcomes for spinal pain that demonstrated statistical and/or clinical significance (pain intensity, disability, fear of movement, GPE, patient satisfaction, general health status, and balance) highlights the need for more focused, higher-quality research on the efficacy and effectiveness of VR for treatment of patients with spinal pain.
虚拟现实（VR）技术已被证明在医疗保健的各个领域有益；迄今为止，尚无系统评价检查 VR 技术治疗脊柱疼痛的效果。
调查 VR 技术在管理急性、亚急性和慢性脊柱疼痛个体中的效果。
检索了 6 个电子数据库，截至 2019 年 11 月。有资格纳入评估 VR 效果的随机对照试验（RCT）。两名独立评审员提取数据并评估每项研究的偏倚风险和总体证据质量。根据需要使用随机效应模型汇总结果的均值差异。
有 7 项 RCT 存在高偏倚风险，符合审查标准。证据质量从极低到低不等。在慢性颈痛患者中，与运动训练相比，VR 在短期随访时改善了总体知觉疗效（GPE）、满意度和一般健康状况，以及中期随访时的一般健康和平衡。与常规本体感受训练相比，VR 在慢性颈痛患者中可在短期和长期随访时降低疼痛强度和残疾。对于亚急性或慢性腰痛（LBP）患者，与腰椎稳定运动相比，VR 可改善疼痛、残疾和运动恐惧，与常规物理治疗相比，可改善疼痛（短期随访）。对于慢性 LBP 患者，与腰椎稳定运动相比，VR 可改善疼痛，与常规物理治疗相比，可改善运动恐惧（短期随访）。
VR 在脊柱疼痛结局方面的改善潜力（疼痛强度、残疾、运动恐惧、GPE、患者满意度、一般健康状况和平衡）显示出需要更集中、更高质量的研究来评估 VR 治疗脊柱疼痛患者的疗效和有效性。
