EFFECTIVENESS OF VIRTUAL REALITY-BASED PHYSIOTHERAPY IN REDUCING CHRONIC LOWER BACK PAIN: A SYSTEMATIC REVIEW

Abstract

Background: Chronic low back pain (CLBP) is a leading cause of disability worldwide, and conventional physiotherapy, while effective, is limited by modest effect sizes and poor long-term adherence. Virtual reality (VR) has emerged as a technology-assisted adjunct with the potential to increase engagement and target both the sensory and psychological components of chronic pain. Objective: To systematically review randomized controlled trial evidence on the effectiveness of VR-based physiotherapy for reducing pain and disability in adults with CLBP. Methods: A systematic search of seven electronic databases was conducted to identify randomized controlled trials evaluating VR-based physiotherapy interventions in adults with non-specific CLBP. Data on study characteristics, interventions, and outcomes for pain, disability, and kinesiophobia were extracted and synthesised narratively. Results: Seven randomized controlled trials involving 641 participants met the inclusion criteria. VR-based interventions, whether immersive or non-immersive, and whether delivered alone or as an adjunct to conventional physiotherapy, were associated with statistically significant reductions in pain intensity relative to comparator conditions in six of the seven trials. Evidence for disability, kinesiophobia, and quality-of-life outcomes was more variable, and only one trial reported outcomes beyond three months post-treatment. Conclusions: VR-based physiotherapy shows promising, though not yet conclusive, evidence of effectiveness for reducing pain in CLBP. Larger, longer-term, and more methodologically standardised trials are required before it can be recommended as a standard component of care.