Using Virtual Reality Expose Therapy in Reducing Pain --- A Systematic Review and Meta-Analysis

Abstract

Objectives: To evaluate the existing evidence of the clinical effect of VR in the treatment of pain. Summary and Background Data: Pain, the most universal medical complaint, is a severe hygiene problem. Virtual reality (VR) is a new technique introduced as an intervention for pain. However, whether VR can reduce the sense of pain is still under discussion. Method: A systematic search in PubMed, Cochrane library database, Web of science, ProQuest medicine, Science direct, Ovid (Ovid and BIOSIS), Embase, Clinicaltrials.gov identified 43 studies accounting for 1812 patients. The report was organized according to the items mentioned in the guideline of Meta-analysis. Pain intensity was set to be the primary outcome, and the secondary outcome included pain unpleasantness, time spent thinking about pain, fun, FLACC, nausea, pain threshold, and pain tolerance. The random effects model or Fixed effects model were used in pooling data. Sensitive and subgroup analysis were used to explore study heterogeneity by age, VR environment and Intervention. Publication bias were assessed by Egger's and Begg's test. Result: Pain intensity decreased in VR group (95% CI= (-1.040i¼Œ-0.550)) with low hetero-geneity(I2=37.5%). Pain unpleasantness, time spent thinking about pain, FLACC decreased ob-viously in VR group. Fun, pain threshold and pain tolerance increased notably. What's more, 95% researches reported no nausea or slight nausea. Conclusion: VR treatment can alleviate pain sensory by increasing tolerance and threshold to pain, meanwhile, bring more fun to the patients. Immersive VR showed its better effect than non-immersive and VR program is a recommended virtual environment in clinical analgesia. Funding Statement: Central South university library provide the database resources for us to systematic search the literatures. Declaration of Interests: Cheng Peng is currently receiving a grant (81301636) from National Natural Science Foundation of China. For the remaining authors, none were declared. Ethics Approval Statement: The quality of the systematic review and meta-analysis was strictly controlled by the PRISM statement and MOOSE, the checklist can be seen in the supplement Appendix 2