# Therapeutic Use of Virtual Reality for Patients With Fibromyalgia and Chronic Neck Pain: Randomized Controlled Trial

## TL;DR

Virtual reality combined with exercises helps reduce chronic neck pain and fibromyalgia symptoms more effectively than exercises alone.

## Contribution

This study demonstrates that VR combined with physical therapy provides sustained improvements in fibromyalgia and chronic neck pain.

## Key findings

- VR combined with exercises showed greater pain reduction and improved function compared to exercise alone.
- Improvements in disease impact and cervical disability were maintained for one month only in the VR group.
- VR therapy increased treatment adherence and reduced fear of movement in fibromyalgia patients.

## Abstract

Fibromyalgia (FM) causes widespread pain, fatigue, and cognitive abnormalities. Cervical pain is a common and debilitating symptom.

This study aims to evaluate the effectiveness of virtual reality (VR) as a treatment for chronic cervical pain experienced by patients with FM.

A single-blind randomized clinical trial was conducted. A total of 56 women were randomly assigned to 3 groups: G1 (VR+cervical mobility exercises), G2 (cervical mobility exercises), and the control group. Therapy was administered twice a week for 4 weeks. Variables such as disease impact, quality of life, kinesiophobia, pain, range of motion, fatigue, and treatment adherence were measured.

The mean age of the participants was 54.26 (SD 7.7) years. Participants were overweight, with a mean BMI of 28.7 (SD 7.8). The mean visual analog scale value was 6.72 (SD 1.8). The baseline values for age, BMI, visual analog scale, algometric measures, and functional capacity (measured using the Timed Up and Go test, cervical rotation, and lateral displacement) were similar across the 3 groups. Following the intervention therapy, the control group did not exhibit notable improvement (mean 3.5, SD 1.4; differences of mean values –0.46, 95% CI –1.1 to 0.2; P=.15), particularly in pain perception, while both therapy groups did show improvements (G1: mean 3.8, SD 1.1; differences of mean values 1.2, 95% CI 0.78-1.54; P<.001; G2: mean 2.8, SD 1.8; differences of mean values 1.2, 95% CI 0.66-1.7; P<.001). Both intervention groups improved significantly compared to control postintervention in FM impact (CG vs G1: differences of mean values 9.31, 95% CI 14.7-3.8; P<.001; CG vs G2: differences of mean values 8.4, 95% CI 13.84-3.06; P<.001), central sensitization (CG vs G2: differences of mean values 7.53, 95% CI 12.12-2.95; P<.001), and cervical disability (CG vs G2: differences of mean values 6.44, 95% CI 9.93-2.94; P<.001). However, at 1 month, only G1 maintained superior improvements across all measures, including a reduction in kinesiophobia (G2: differences of mean values 6.2, 95% CI 4.7-9.8; P<.001), indicating a more sustained effect of the combined approach.

The combination of VR with cervical mobility and strengthening exercises produced superior and sustained improvements in women with FM compared to exercise alone or control. Significant benefits were observed in disease impact, central sensitization, cervical disability, and kinesiophobia, with effects maintained at 1 month only in the VR group. These findings support VR as an effective adjunct to enhance symptom management and treatment adherence in FM.