Virtual reality distraction induces hypoalgesia in patients with chronic low back pain: a randomized controlled trial.
Thomas Matheve, Katleen Bogaerts, Annick Timmermans
PMID 32321516WHAT IT FOUND
During one pelvic tilt exercise session, chronic low back pain patients who played nonimmersive VR games reduced pain 2.20 points more than controls on a 0 to 10 scale, and reduced pain 1.31 points more immediately after, and thought less about pain.
Key findings
01When pelvic tilt exercises were performed with nonimmersive VR games, the VR group reduced pain 2.20 points more than the control group from baseline to during the exercises.
02The VR group reduced pain 1.31 points more than the control group immediately after the exercises and reported thinking about pain 3.26 points less than controls.
03Exploratory analyses found no evidence that pain-related fear or pain catastrophizing changed how much the VR condition helped compared with controls.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The trial tested a single exercise session and measured pain only during and immediately after it, so it did not show how long the benefit lasts or whether it caused a delayed rebound. Participants and investigators were not blinded to group assignment, which could influence reported pain. Most participants had mild to moderate baseline pain, and only 30% of those in the high baseline pain groups had severe pain, so the study may not apply to very severe chronic low back pain. The moderation analyses were exploratory and not sufficiently powered to detect small effects, so the lack of moderation by fear, catastrophizing or baseline pain should be interpreted cautiously. The control condition used beep tones, which may have made the control situation more unnatural or anxiety-provoking than everyday practice. The exercises were familiar and not perceived as harmful, so the results may not extend to unfamiliar or threatening activities. The study was done at one hospital in Belgium, so applicability may vary.
The easy way to misread this
Do not conclude that VR distraction is a proven treatment for chronic low back pain. The study measured pain during and immediately after a single familiar exercise session, not long-term pain, disability, function or exercise adherence.