Evidence map›Paper›PMID 42665847›Full record

ArticleSystematic reviews2026

Virtual reality for chronic primary low back pain in adults: systematic review protocol.

Axel Schäfer, Ulrike Kaiser, Alexander Elser, Christian Kopkow, Bernhard Elsner

Abstract read
In one paragraph

Article in Systematic reviews, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Axel SchäferFaculty of Social Work and Health, University of Applied Sciences and Arts Hildesheim/Holzminden/Göttingen, Goschentor 1, Hildesheim, 31134, Germany. axel.schaefer@hawk.de.ORCID 0000-0003-4222-1605
Ulrike KaiserClinic for Anaesthesiology and Intensive Care Medicine, University Hospital Schleswig Holstein, Lübeck, Germany.
Alexander ElserFaculty of Social Work and Health, University of Applied Sciences and Arts Hildesheim/Holzminden/Göttingen, Goschentor 1, Hildesheim, 31134, Germany.
Christian KopkowDepartment of Physiotherapy, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany.
Bernhard ElsnerInstitute for Health Sciences, University of Luebeck, Lübeck, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChronic primary low back pain (LBP) is a costly and disabling condition, with complex interacting factors contributing to pain experience and disability. Although multimodal therapy, including physiotherapy, behavioural therapy/psychotherapy and education is recommended, implementation is limited due to shortcomings in healthcare delivery. Digital solutions such as virtual reality (VR) could offer possibilities to address these shortcomings and become increasingly common. However, the evidence base for VR in chronic LBP is conflicting. Nine existing meta-analyses show substantial variance in effect sizes, ranging from SMD 0.07 to 8.15, due to heterogeneity in population, interventions and outcome measurements, with most often limited quality of evidence. Therefore, a high-quality systematic review focussing on chronic primary LBP, incorporating mechanisms of action and state-of-the-art meta-analysis is warranted.

methodsWe will conduct a systematic review, employing a comprehensive and sensitive search strategy in all relevant databases. We will include randomised controlled studies that investigate the effects of virtual reality versus other interventions (active and non-active) or no intervention on physical functioning, pain intensity and health related quality of life in patients with chronic primary low back pain. We will assess risk of bias with the Cochrane risk of bias tool 2 (RoB2) and certainty of the evidence with GRADE criteria. We will use a random-effects model for all statistical analyses. DISCUSSION: This systematic review will provide trustworthy evidence about the effects of VR in chronic primary low back pain by employing rigorous methods of search string development, comprehensive database search, quality evaluation and control, data extraction, documentation and analysis incorporating theory of change. Anticipated intervention heterogeneity will be addressed by pre-specified subgroup analyses and appropriate methods of meta-analysis. SYSTEMATIC REVIEW REGISTRATION: PROSPERO 2025 CRD420251250648.

Indexed as

Chronic PainLow Back PainVirtual RealityAdultHumansQuality of LifeResearch DesignSystematic Reviews as TopicChronic primary low back painMeta-analysesPainPhysical functioningSystematic reviewVirtual reality

Identifiers

PMID42665847
PMCPMC13525690

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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.