Exploring the use of immersive virtual reality in adults with chronic primary pain: A scoping review

Abstract

Background The use of immersive virtual reality, wearing head mounted display, has recently increased for people with chronic pain, with no definitive conclusion of its efficacy on pain-related outcomes. Objective To map the available evidence on the use of immersive virtual reality as intervention for adults with chronic primary pain, illustrating gap in knowledge and direct future research. Methods The search was performed with a range of study designs, but only those written in English language. A search was created in CINAHL Plus, Medline, AMED, Embase, PsycINFO, ASSIA, Scopus, TripPro, CENTRAL and EmCare. Results Thirty-two studies were included. Several chronic conditions were identified including chronic musculoskeletal pain and fibromyalgia. The immersive virtual reality mechanisms included distraction, physical exercises, mindfulness/biofeedback, graded exposure, hypnosis, neuromodulation, and multi-mechanisms, and all these mechanisms were associated with varied dose. The use of customised software, with wide range of head mounted displays were common in clinical setting with some degree of supervision. Motion sickness, head mounted display discomfort and technical issues affect the usability of immersive virtual reality leading to poor engagement and dropouts. Conclusions The use of immersive virtual reality for chronic primary pain is in early stages with lack of consensus regarding the mechanisms and associated dose. Future research needs to address the need of customisation, clinical usability of head mounted display as well as safety strategies to enhance the uptake of immersive virtual reality technology in healthcare practice.