Abstract
Background: Virtual reality (VR) applied to patients with neck pain is a promising intervention to produce positive effects when used alone or combined with exercise. Therefore, the objective of this manuscript is to compare the effects of VR versus exercise treatment on pain intensity, conditioned pain modulation (CPM), temporal summation (TS) and functional and somatosensory outcomes in patients with non-specific chronic neck pain (NS-CNP). Methods: A single-blinded, randomized clinical trial was carried out. A total sample of 44 patients with NS-CNP was randomized into a VR treatment group or neck exercises group. The intervention consisted of two treatment sessions per week, for four weeks and eight sessions. Four measurement moments (at baseline, immediately, 1 month, and 3 months after intervention) were considered. Pain intensity, CPM, TS, functional and somatosensory outcomes were measured. Results: Statistically significant differences were revealed for time factor (F = 16.40, p < 0.01, ηp2 = 0.28) and group*time interaction for kinesiophobia (F = 3.89, p = 0.01, ηp2 = 0.08) showing post-hoc differences in favor of the VR group at 3 months (p < 0.05, d = 0.65). Significant effects were shown for time factor (p < 0.05) but not for the group*time interaction (p > 0.05) for pain intensity, rotation range of motion (ROM), Neck Disability Index, pain catastrophizing, fear-avoidance beliefs, left side pressure pain threshold (PPT) and anxiety. Statistically significant differences were not found for time factor (p > 0.05) and neither in group*time interaction (p > 0.05) for CPM, TS, right side PPT, flexo-extension and lateral-flexion ROM. Conclusions: Kinesiophobia was the only outcome that showed differences between VR and exercise at 3 months. Nevertheless, pain intensity, CPM, TS, ROM, neck disability, pain catastrophizing, fear-avoidance beliefs, PPT and anxiety did not show differences between both interventions.
Highlights
Between 50% and 85% of the general population experience neck pain at some point in their lives and every person who experiences neck pain is likely to experience it again 1–5 years later [1]
The second objective was to evaluate the effects of this experimental intervention on functional, somatosensory and psychosocial variables after Virtual reality (VR) treatment compared to the exercise group
Kinesiophobia showed significant differences in the group*time interaction. These differences between groups were relevant after 3 months when patients in the VR group showed lower levels of kinesiophobia compared to those in the exercise group
Summary
Between 50% and 85% of the general population experience neck pain at some point in their lives and every person who experiences neck pain is likely to experience it again 1–5 years later [1]. A recent study [2] showed that the prevalence, incidence and years lived with disability from 1990 to 2017 has not changed significantly from the previous report [3]. The global prevalence was 3.5%, 288.7 million cases, from which 65.3 million cases were incident and 28.6 million spent years living with a disability. Virtual reality (VR) applied to patients with neck pain is a promising intervention to produce positive effects when used alone or combined with exercise. The objective of this manuscript is to compare the effects of VR versus exercise treatment on pain intensity, conditioned pain modulation (CPM), temporal summation (TS) and functional and somatosensory outcomes in patients with non-specific chronic neck pain (NS-CNP). A total sample of 44 patients with NS-CNP was randomized into a VR treatment group or neck exercises group.
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