EFECTIVIDAD DE LA REALIDAD VIRTUAL EN EL CONTROL MOTOR Y LA FUNCIONALIDAD EN PACIENTES CON TRASTORNOS MUSCULOESQUELÉTICOS PERSISTENTES: REVISIÓN SISTEMÁTICA
The effectiveness of virtual reality in improving motor control and functionality in patients with persistent musculoskeletal disorders: A systematic review
DOI:
https://doi.org/10.47187/cssn.Vol17.Iss1.503Palabras clave:
Realidad Virtual, Dolor Musculoesquelético, Control Motor, RehabilitaciónResumen
Introducción: El dolor musculoesquelético persistente, se asocia frecuentemente con alteraciones en el control motor, disminución funcional y miedo al movimiento. La realidad virtual ha emergido como una herramienta terapéutica innovadora que, además de modular el dolor, podría favorecer el reaprendizaje motor mediante retroalimentación visual, motivación lúdica y práctica intensiva en entornos seguros. Objetivo: Identificar y analizar la efectividad de la RV inmersiva en el mejoramiento del control motor y la funcionalidad en pacientes con dolor musculoesquelético crónico. Metodología: Se realizó una revisión sistemática de la literatura en bases de datos como PubMed, Web Of Science, Cochrane Library, Scielo. Se incluyeron ensayos clínicos comprendidos entre el 2020 y 2025 que evaluaron la realidad virtual aplicada a cambios clínicos en adultos con trastornos musculoesqueléticos. Resultados: Se recolectó un total de 7 ensayos clínicos (n=425 participantes). La mayoría de los estudios incluidos reportaron mejoras significativas en el control motor, asociado a variables como disminución de dolor y disminución de kinesiofobia reportada para todas las modalidades de realidad virtual. Discusión: La implementación de la realidad virtual puede optimizar los resultados clínicos, en sus diferentes modalidades de aplicación, sin embargo, los resultados están condicionados a variables como tipo de dolor, escalas aplicadas para vigilancia, diseño del programa y características poblacionales. Conclusiones: La realidad virtual inmersiva representa una estrategia eficaz y segura para mejorar la funcionalidad en pacientes con dolor musculoesquelético persistente.
Abstract
Introduction: Persistent musculoskeletal pain is frequently associated with impaired motor control, decreased function, and fear of movement. Virtual reality has emerged as an innovative therapeutic tool that, in addition to modulating pain, could promote motor relearning through visual feedback, playful motivation, and intensive practice in safe environments. Objective: To identify and analyze the effectiveness of immersive VR in improving motor control and functionality in patients with chronic musculoskeletal pain. Methodology: A systematic literature review was conducted using databases such as PubMed, Web of Science, Cochrane Library, and SciELO. Clinical trials conducted between 2020 and 2025 that evaluated virtual reality applied to clinical changes in adults with musculoskeletal disorders were included. Results: A total of 7 clinical trials were collected (n=425 participants). Most of the included studies reported significant improvements in motor control, associated with variables such as pain reduction and decreased kinesiophobia reported for all virtual reality modalities. Discussion: The implementation of virtual reality can optimize clinical outcomes in its different application modalities; however, the results are conditioned by variables such as type of pain, scales applied for monitoring, program design, and population characteristics. Conclusions: Immersive virtual reality represents an effective and safe strategy for improving functionality in patients with persistent musculoskeletal pain.
Descargas
Citas
1. Huang Q, Lin J, Han R, Peng C, Huang A. Using Virtual Reality Exposure Therapy in Pain Management: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Value in Health. 2022. doi:10.1016/j.jval.2021.04.1285
2. Guerra-Armas J, Flores-Cortes M, Pineda-Galan C, Luque-Suarez A, La Touche R. Role of Immersive Virtual Reality in Motor Behaviour Decision-Making in Chronic Pain Patients. Brain Sciences. 2023. doi:10.3390/brainsci13040617
3. Lo HHM, Zhu M, Zou Z, Wong CL, Lo SHS, Chung VCH, et al. Immersive and Nonimmersive Virtual Reality–Assisted Active Training in Chronic Musculoskeletal Pain: Systematic Review and Meta-Analysis. Journal of Medical Internet Research. 2024. doi:10.2196/48787
4. Cohen SP, Vase L, Hooten WM. Chronic pain: an update on burden, best practices, and new advances. The Lancet. 2021. doi:10.1016/ S0140-6736(21)00393-7
5. Treede RD, Rief W, Barke A, Aziz Q, Bennett MI, Benoliel R, et al. Chronic pain as a symptom or a disease: The IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11). Pain. 2019. doi:10.1097/j. pain.0000000000001384
6. El-Tallawy SN, Nalamasu R, Salem GI, LeQuang JAK, Pergolizzi J V., Christo PJ. Management of Musculoskeletal Pain: An Update with Emphasis on Chronic Musculoskeletal Pain. Pain and Therapy. 2021. doi:10.1007/s40122-021-00235-2
7. Chiarotto A, Maxwell LJ, Ostelo RW, Boers M, Tugwell P, Terwee CB. Measurement Properties of Visual Analogue Scale, Numeric Rating Scale, and Pain Severity Subscale of the Brief Pain Inventory in Patients With Low Back Pain: A Systematic Review. Journal of Pain. 2019. doi:10.1016/j.jpain.2018.07.009
8. Zheng X, Lamoth CJ, Timmerman H, Otten E, Reneman MF. Establishing central sensitization inventory cut-off values in Dutch-speaking patients with chronic low back pain by unsupervised machine learning. Comput Biol Med. 2024;178.
doi:10.1016/j.compbiomed.2024.108739
9. Bilika P, Karampatsou N, Stavrakakis G, Paliouras A, Theodorakis Y, Strimpakos N, et al. Virtual Reality-Based Exercise Therapy for Patients with Chronic Musculoskeletal Pain: A Scoping Review. Healthcare (Switzerland). 2023. doi:10.3390/ healthcare11172412
10. Stamm O, Dahms R, Müller-Werdan U. Virtual reality in pain therapy: A requirements analysis for older adults with chronic back pain. J s12984-020-00753-8
11. Kato PM. Video Games in Health Care: Closing the Gap. Review of General Psychology. 2010;14(2):113–21. doi:10.1037/a0019441
12. Zadro JR, Shirley D, Simic M, Mousavi SJ, Ceprnja D, Maka K, et al. Video-Game-Based Exercises for Older People with Chronic Low Back Pain: A Randomized Controlledtable Trial (GAMEBACK). Phys Ther. 2019;99(1). doi:10.1093/ptj/pzy112
13. Matheve T, Bogaerts K, Timmermans A. Virtual reality distraction induces hypoalgesia in patients with chronic low back pain: A randomized controlled trial. J Neuroeng Rehabil. 2020;17(1). doi:10.1186/s12984-020-00688-0
14. Kowatsch T, Lohse KM, Erb V, Schittenhelm L, Galliker H, Lehner R, et al. Hybrid ubiquitous coaching with a novel combination of mobile and holographic conversational agents targeting adherence to home exercises: Four design and evaluation studies. J Med Internet Res. 2021;23(2). doi:10.2196/23612
15. Gupta A, Scott K, Dukewich M. Innovative technology using virtual reality in the treatment of pain: Does it reduce pain via distraction, or is there more to it? Pain Medicine (United States). 2018;19(1). doi:10.1093/pm/pnx109
16. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. Declaración PRISMA 2020: una guía actualizada para la publicación de revisiones sistemáticas. Rev Esp Cardiol. 2021;74(9). doi:10.1016/j.recesp.2021.06.016
17. PEDro org. Escala PEDro-Español. PhysiotherapyEvidence Database. 2012;86(1).
18. Stamm O, Dahms R, Reithinger N, Ruß A, Müller-Werdan U. Virtual reality exergame for supplementing multimodal pain therapy in older adults with chronic back pain: a randomized controlled pilot study. Virtual Real. 2022;26(4). doi:10.1007/s10055-022-00629-3
19. Garcia LM, Birckhead BJ, Krishnamurthy P, Sackman J, Mackey IG, Louis RG, et al. An 8-week self-administered at-home behavioral skillsbased virtual reality program for chronic low back pain: Double-blind, randomized, placebo-controlled trial conducted during COVID-19. J Med Internet Res. 2021;23(2). doi:10.2196/26292
20. Lo HHM, Ng M, Fong PYH, Lai HHK, Wang B, Wong SY shan, et al. Examining the Feasibility, Acceptability, and Preliminary Efficacy of an Immersive Virtual Reality–Assisted Lower Limb Strength Training for Knee Osteoarthritis: Mixed Methods Pilot Randomized Controlled Trial. JMIR Serious Games. 2024;12. doi:10.2196/52563
21. Buztepe S, Çapik C. The effect of exercises done with virtual reality glasses on pain, daily life activities, and quality of life of individuals with lumbar disc hernia: a randomized controlled trial. BMC Musculoskelet Disord. 2025;26(1). doi:10.1186/ s12891-025-09130-9
22. Lo HHM, Fong PYH, Wang B, Fung CLC, Wong SYS, Sit RWS. Clinical Efficacy of Virtual Reality Cave Automatic Virtual Environments (CAVE) for Chronic Musculoskeletal Pain in Older Adults: A Randomized Controlled Trial. J Am Med Dir Assoc. 2025;26(1). doi:10.1016/j. jamda.2024.105344
23. Funao H, Momosaki R, Tsujikawa M, Kawamoto E, Esumi R, Shimaoka M. Application of Virtual Reality to Home-Visit Rehabilitation for Patients With Chronic Musculoskeletal Pain: A Single-Group Pre-post Comparison Study. Cureus.2025. doi:10.7759/cureus.80386
24. Emedoli D, Alemanno F, Iannaccone S, Houdayer E, Castellazzi P, Zangrillo F, et al. Sensory-motor training with virtual reality as a complementary intervention to manual therapy for persistent non-specific neck pain: a randomized controlled trial. Eur J Phys Rehabil Med. 2024;60(4). doi:10.23736/S1973-9087.24.08115-2
25. Lier EJ, De Vries M, Steggink EM, Ten Broek RPG, Van Goor H. Effect modifiers of virtual reality in pain management: a systematic review and meta-regression analysis. Pain. 2023. doi:10.1097/j.pain.0000000000002883
26. Wender R, Hoffman HG, Hunner HH, Seibel EJ, Patterson DR, Sharar SR. Interactivity influences the magnitude of virtual reality analgesia. J Cyber Ther Rehabil. 2009;2(1).
27. Wittkopf PG, Lloyd DM, Coe O, Yacoobali S, Billington J. The effect of interactive virtual reality on pain perception: a systematic review of clinical studies. Disability and Rehabilitation. 2020. doi:10.1080/09638288.2019.1610803
28. Li R, Li Y, Kong Y, Li H, Hu D, Fu C, et al. Virtual Reality–Based Training in Chronic Low Back Pain: domized Controlled Trials. Journal of Medical Internet Research. 2024. doi:10.2196/45406
29. Pogatzki-Zahn EM, Liedgens H, Hummelshoj L, Meissner W, Weinmann C, Treede RD, et al. Developing consensus on core outcome domains for assessing effectiveness in perioperative pain management: results of the PROMPT/IMI-PainCare Delphi Meeting. Pain. 2021;162(11). doi:10.1097/j.pain.0000000000002254
30. Guo Q, Zhang L, Han LL, Gui C, Chen G, Ling C, et al. Effects of Virtual Reality Therapy Combined With Conventional Rehabilitation on Pain, Kinematic Function, and Disability in Patients With Chronic Neck Pain: Randomized Controlled Trial.
JMIR Serious Games. 2024;12. doi:10.2196/42829
31. Yalfani A, Sahab Gholifar M, Raeisi Z, Asgarpoor Kaji A. Effect of Virtual Reality Training on Quality of Life and Risk of Falling in Older Men With Nonspecific Low Back Pain. Journal of Modern Medical Information. 2023. doi:https://doi.
org/10.32598/JMIS.9.2.4
Publicado
Cómo citar
Número
Sección
Licencia
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial 4.0.
