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Peer-reviewedCC BY 4.0Frontiers in Public Health

The effectiveness of virtual reality-based rehabilitation in patients with neck pain: a systematic review and meta-analysis with trial sequential analysis of randomized controlled trials

  • Amu Jike1
  • Xiang Zhang2
  • Hao Liu2
  • Anyun Yu1
  1. 1First People's Hospital of Liangshan Yi Autonomous Prefecture
  2. 2Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University
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Abstract

Background: Neck pain is a widespread condition impacting daily functioning and quality of life. Virtual Reality (VR) technology has gained attention as a non-pharmacological intervention in rehabilitative medicine, offering potential benefits for pain management. This study systematically reviewed and conducted a meta-analysis on the effectiveness of VR rehabilitation for neck pain.

Methods: Following PRISMA guidelines, a comprehensive literature search was performed across databases (e.g., PubMed) up to October 1, 2024, targeting randomized controlled trials (RCTs) comparing VR-based rehabilitation with alternative interventions for neck pain. Data extraction focused on outcomes like the Visual Analogue Scale (VAS) and Neck Disability Index (NDI). Quality and bias were assessed using the Cochrane Risk of Bias Tool, and the GRADE approach evaluated evidence certainty. Trial Sequential Analysis (TSA) was also employed to ensure robustness in conclusions. This protocol was prospectively registered with PROSPERO (CRD42022334319).

Results: The meta-analysis, which included 11 randomized controlled trials with 476 participants, demonstrated that virtual reality-based rehabilitation significantly reduced VAS scores [471 patients, mean difference (MD) −0.70, p = 0.01] and NDI scores (411 patients, MD −3.06, p < 0.0001) within the first week. Furthermore, significant reductions in VAS (315 patients, MD −1.00, p < 0.05) and NDI scores (315 patients, MD −3.81, p = 0.005) were observed from the first week to 6 months in the VR-based rehabilitation group. Trial sequential analysis further confirmed the statistical strength and reliability of these findings. Improvements in cervical mobility were observed, as evidenced by increased neck flexion and extension.

Conclusion: VR-based rehabilitation shows promise as an effective strategy for managing neck pain, improving both pain levels and functional capacity.

Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42022334319 , identifier PROSPERO (CRD42022334319).

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Cite

BibTeXRIS
BibTeX
@article{jike2026effectiveness,
  title = {{The effectiveness of virtual reality-based rehabilitation in patients with neck pain: a systematic review and meta-analysis with trial sequential analysis of randomized controlled trials}},
  author = {Amu Jike and Xiang Zhang and Hao Liu and Anyun Yu},
  journal = {Frontiers in Public Health},
  year = {2026},
  month = oct,
  doi = {10.3389/fpubh.2026.1933999},
  url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1933999/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - The effectiveness of virtual reality-based rehabilitation in patients with neck pain: a systematic review and meta-analysis with trial sequential analysis of randomized controlled trials
AU  - Amu Jike
AU  - Xiang Zhang
AU  - Hao Liu
AU  - Anyun Yu
PY  - 2026
DA  - 2026/10/22
JO  - Frontiers in Public Health
DO  - 10.3389/fpubh.2026.1933999
UR  - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1933999/full
AB  - Background: Neck pain is a widespread condition impacting daily functioning and quality of life. Virtual Reality (VR) technology has gained attention as a non-pharmacological intervention in rehabilitative medicine, offering potential benefits for pain management. This study systematically reviewed and conducted a meta-analysis on the effectiveness of VR rehabilitation for neck pain.  Methods: Following PRISMA guidelines, a comprehensive literature search was performed across databases (e.g., PubMed) up to October 1, 2024, targeting randomized controlled trials (RCTs) comparing VR-based rehabilitation with alternative interventions for neck pain. Data extraction focused on outcomes like the Visual Analogue Scale (VAS) and Neck Disability Index (NDI). Quality and bias were assessed using the Cochrane Risk of Bias Tool, and the GRADE approach evaluated evidence certainty. Trial Sequential Analysis (TSA) was also employed to ensure robustness in conclusions. This protocol was prospectively registered with PROSPERO (CRD42022334319).  Results: The meta-analysis, which included 11 randomized controlled trials with 476 participants, demonstrated that virtual reality-based rehabilitation significantly reduced VAS scores [471 patients, mean difference (MD) −0.70, p = 0.01] and NDI scores (411 patients, MD −3.06, p < 0.0001) within the first week. Furthermore, significant reductions in VAS (315 patients, MD −1.00, p < 0.05) and NDI scores (315 patients, MD −3.81, p = 0.005) were observed from the first week to 6 months in the VR-based rehabilitation group. Trial sequential analysis further confirmed the statistical strength and reliability of these findings. Improvements in cervical mobility were observed, as evidenced by increased neck flexion and extension.  Conclusion: VR-based rehabilitation shows promise as an effective strategy for managing neck pain, improving both pain levels and functional capacity.  Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42022334319 , identifier PROSPERO (CRD42022334319).
SN  - 2296-2565
ER  -