Alotibi Fahad Salman, Mohammed Walid, Hendrick Paul, Moffatt Fiona
Department of Physiotherapy, College of Applied Medical Sciences Taif University Taif City Makkah Province Kingdom of Saudi Arabia.
Department of Physiotherapy and Rehabilitation Sciences, School of Medical and Health Sciences University of Nottingham Nottingham UK.
Health Sci Rep. 2025 Aug 12;8(8):e71163. doi: 10.1002/hsr2.71163. eCollection 2025 Aug.
Virtual reality (VR) has been proposed for the management of chronic musculoskeletal pain (MSKP). This umbrella review aimed to systematically search, critically appraise, summarize, and synthesize the current systematic reviews (SRs) on delivering VR interventions to rehabilitate patients with chronic primary MSKP and disability.
Data were obtained from five databases. Only SRs were included. This umbrella review utilized the AMSTAR-2 to assess the methodological quality of the included SRs and the GRADE to assess the certainty in the body of evidence.
Seven SRs were included. The overall confidence in the SRs ranged from low to critically low, whereas the certainty in the body of evidence ranged from moderate to very low. Whilst the majority of the SRs suggested that VR, standalone or adjunctive to other interventions, had a significant short-term positive effect on patient-reported outcomes for pain in patients with chronic primary MSKP, results on patient-reported outcomes for disability and kinesiophobia were inconsistent. Adverse events included motion sickness, nausea, and vertigo.
Although the current evidence indicates that VR may hold promise in patients with chronic primary MSKP, the included studies suffered from critical weaknesses that precluded this review from drawing a conclusive conclusion. It remains uncertain which VR interventions, including dosage, mode of delivery, supervision, frequency, duration, level of immersion, VR platform, displayed content, and mechanism of action, are more effective than the others. Future SRs should sub-group VR based on the treatment types. Further rigorously designed studies focusing on immersive VR, standalone or adjunctive to other interventions, with long-term follow-up, are warranted. It is worth repeating the call for an agreed consensus on a clear definition and classification of VR within the healthcare context.
虚拟现实（VR）已被提议用于慢性肌肉骨骼疼痛（MSKP）的管理。本伞状综述旨在系统检索、严格评价、总结和综合当前关于提供VR干预措施以康复慢性原发性MSKP和残疾患者的系统评价（SRs）。
数据从五个数据库中获取。仅纳入SRs。本伞状综述利用AMSTAR-2评估纳入SRs的方法学质量，并利用GRADE评估证据体的确定性。
纳入了七项SRs。SRs的总体可信度从低到极低，而证据体的确定性从中等到非常低。虽然大多数SRs表明，VR单独使用或作为其他干预措施的辅助手段，对慢性原发性MSKP患者报告的疼痛结局有显著的短期积极影响，但关于患者报告的残疾和运动恐惧结局的结果并不一致。不良事件包括晕动病、恶心和眩晕。
尽管目前的证据表明VR可能对慢性原发性MSKP患者有前景，但纳入的研究存在严重缺陷，妨碍了本综述得出确凿结论。目前仍不确定哪种VR干预措施，包括剂量、交付方式、监督、频率、持续时间、沉浸程度、VR平台、显示内容和作用机制，比其他措施更有效。未来SRs应根据治疗类型对VR进行亚组分析。有必要开展进一步设计严谨的研究，重点关注沉浸式VR，单独使用或作为其他干预措施的辅助手段，并进行长期随访。值得再次呼吁在医疗保健背景下就VR的清晰定义和分类达成共识。
