A Rapid Evidence Assessment of Immersive Virtual Reality as an Adjunct Therapy in Acute Pain Management in Clinical Practice

Immersive Virtual Reality (IVR) therapy has been investigated as an adjunct therapy for the management of acute pain among children and adults for several conditions. Therapeutic approaches have traditionally involved medication and physiotherapy but these approaches are limited over time by their cost and/or side effects. This review sought to make a critical evaluation of the evidence for/against IVR as an adjunctive therapy for acute clinical pain applications. A rapid evidence assessment strategy (REA) was used. CINAHL, Medline, Web of Science, IEEE Xplore Digital Library, and the Cochrane Library databases were screened in from December 2012 to March 2013 to identify studies exploring IVR therapies as an intervention to assist in the management of pain. Main outcome measures were for acute pain and functional impairment. Seventeen research studies were included in total including five RCTs, six randomized crossover studies, two case series studies and four single patient case studies. This included a total of 337 patients. Of these studies only four had a low risk of bias. There was strong overall evidence for immediate and short-term pain reduction, while moderate evidence was seen for short-term effects on physical function. Not much evidence exists for longer-term benefits. IVR was not associated with any serious adverse events.

This review found moderate evidence for lowering the level of pain and functional impairment after IVR in patients with acute pain. Further high-quality studies are necessary for the conclusive judgment of its effectiveness in acute pain, to establish possible benefits for chronic pain, and for safety.