ArticleJMIR serious games2020
A Graded Exposure, Locomotion-Enabled Virtual Reality App During Walking and Reaching for Individuals With Chronic Low Back Pain: Cohort Gaming Design.
Article in JMIR serious games, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 34 citations in OpenAlex.
- Virtual Reality for Chronic Pain Management Among Historically Marginalized Populations: Systematic Review of Usability Studies.Journal of medical Internet research · 2023Pooled it
- Use and efficacy of virtual, augmented, or mixed reality technology for chronic pain: a systematic review.Pain management · 2022Pooled it
- Physiotherapy with integrated virtual reality for patients with severe chronic low back pain: cluster-randomized controlled trial (VARIETY).BMC musculoskeletal disorders · 2026Trial
- Exposure-based Interventions for Chronic Pain and Bodily Symptoms: A Special Interest Meeting Report.Behaviour research and therapy · 2026Article
- A Therapeutic Conversational Agent (Solace) for Management of Chronic Pain: Acceptability and Usability Study.JMIR rehabilitation and assistive technologies · 2026Article
- A Virtual Reality Intervention to Promote Uptake of Medications for Opioid Use Disorder in the Emergency Department Following Opioid-Involved Overdose Based on Input From People With Lived Experience: Development Study.JMIR XR and spatial computing · 2026Article
- Virtual Reality Interventions and Chronic Pain: Scoping Review.Journal of medical Internet research · 2025Article
- Integration of Conventional and Virtual Reality Approaches in Augmented Reality for Theory-Based Psychoeducational Intervention Design for Chronic Low Back Pain: Scoping Review.Interactive journal of medical research · 2025Review
- Feasibility, acceptability, patient experience, and preliminary efficacy of a virtual reality guided imagery intervention for chronic pain.Frontiers in digital health · 2025Article
- Barriers and Facilitators to the Implementation of Virtual Reality Interventions for People With Chronic Pain: Scoping Review.JMIR XR and spatial computing · 2024Review
- Immersive virtual reality for shoulder rehabilitation: evaluation of a physical therapy program executed with oculus quest 2.BMC musculoskeletal disorders · 2023Article
- Virtual embodiment for improving range of motion in patients with movement-related shoulder pain: an experimental study.Journal of orthopaedic surgery and research · 2023Article
- Rehabilitation Is the Main Topic in Virtual and Augmented Reality and Physical Activity Research: A Bibliometric Analysis.Sensors (Basel, Switzerland) · 2023Review
- Article
- Novel Therapies for Centralized Pain: a Brief Review.Current pain and headache reports · 2022Review
- Virtual Reality in the Management of Chronic Low Back Pain: A Scoping Review.Frontiers in pain research (Lausanne, Switzerland) · 2022Article
- Virtual Environment Rehabilitation for Patients with Motor Neglect Trial (VERMONT): A Single-Center Randomized Controlled Feasibility Trial.Brain sciences · 2021Article
- Physiotherapist beliefs and perspectives on virtual reality-supported rehabilitation for the assessment and management of musculoskeletal shoulder pain: a focus group study protocol.HRB open research · 2021Article
- The Challenges and Perspectives of the Integration Between Virtual and Augmented Reality and Manual Therapies.Frontiers in neurology · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundChronic low back pain (cLBP) can interfere with daily activities, and individuals with elevated pain-related fear (also known as kinesiophobia or the fear of injury due to movement) can develop worse long-term disability. Graded exposure (GEXP) protocols use successive participation in avoided activities to help individuals overcome fearful movement appraisals and encourage activity. We sought to develop a series of GEXP virtual reality (VR) walking and reaching scenarios to increase the exposure and engagement of people with high kinesiophobia and cLBP.
objectiveThis study aims to (1) determine GEXP content validity of the VR application and (2) determine the feasibility of individuals with cLBP performing locomotion-enabled physical activities.
methodsWe recruited 13 individuals with cLBP and high pain-related fear to experience six VR modules, which provide progressive movement exposure over three sessions in a 1 week period. At session 1, participants ranked each module by likelihood to avoid and assigned an expected pain and concern for harming their back rating to each module. Participants provided a rating of perceived exertion (RPE) after experiencing each module. To test feasibility, we administered the system usability scale (SUS) and treatment evaluation inventory (TEI) following the final session. In addition, we measured pain and pain-related fear at baseline and follow-up.
resultsThe 12 participants who completed the study period assigned higher avoidance (P=.002), expected pain (P=.002), and expected concern (P=.002) for session 3 modules compared with session 1 modules. RPE significantly increased from session 1 (mean 14.8, SD 2.3) to session 3 (mean 16.8, SD 2.2; P=.009). The VR application showed positive feasibility for individuals with cLBP through acceptable SUS (mean 76.7, SD 13.0) and TEI (mean 32.5, SD 4.9) scores. Neither pain (P=.20) nor pain-related fear (P=.58) changed significantly across sessions.
conclusionsThe GEXP VR modules provided progressive exposure to physical challenges, and participants found the VR application acceptable and usable as a potential treatment option. Furthermore, the lack of significant change for pain and pain-related fear reflects that participants were able to complete the modules safely.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.