Comparative effects of virtual reality training and sensory motor training on bone morphogenic proteins and inflammatory biomarkers in post-traumatic osteoarthritis

Nambi, Gopal; Abdelbasset, Walid Kamal; Elsayed, Shereen; Khalil, Mona A.; Alrawaili, Saud M; Alsubaie, Saud F

doi:10.1038/s41598-020-72587-2

Cited by 15 publications

(20 citation statements)

References 28 publications

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“…Numerous studies have previously reported an association between CSP and changes in inflammatory cytokines, such as IL-1 and TNF-α, which are thought to be closely related to the pathogenesis of disc herniation and degeneration [ 64 , 65 ]. Similarly, Nambi et al [ 66 ] reported that 4 weeks of VR training could significantly decrease pain intensity, increase functional impairment, and improve CRP, TNF-α, IL-2, IL-4, and IL-6 levels. However, the limited number and low quality of the included studies need to be noted, and further RCTs with large samples and rigorous study designs are needed to elucidate these results.…”

Section: Discussionmentioning

confidence: 98%

Virtual Reality Therapy for the Management of Chronic Spinal Pain: Systematic Review and Meta-Analysis

Zhang,

Li,

Zhou

et al. 2024

JMIR Serious Games

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Background The effectiveness of virtual reality (VR) therapy in adults with chronic spinal pain (CSP) is unclear. Objective This study was conducted to compare the effectiveness of VR therapy and other therapies in adults with CSP, especially patients with inflammation-related pain. Methods PubMed, Web of Science, Cochrane Library, Embase, and CINAHL databases were searched up to November 11, 2023. Randomized controlled trials (RCTs) comparing adults with CSP receiving VR therapy with those receiving other therapies were included. The trial registration platform as well as the reference lists of included studies and previous systematic reviews and meta-analyses were manually searched. Two independent reviewers performed study selection, data extraction, risk-of-bias assessment, and evaluation of the quality of the evidence. The weighted mean difference (WMD) was used as the effect size used to synthesize the outcome measure. Results In total, 16 RCTs involving 800 participants were included in this meta-analysis. The pooled data from 15 (94%) RCTs including 776 (97%) participants showed that VR therapy was superior in improving pain intensity (WMD=–1.63, 95% CI –2.11 to –1.16, P<.001, I2=90%) and reducing inflammatory markers, including C-reactive protein (WMD=–0.89, 95% CI –1.07 to –0.70, P<.001, I2=0%), tumor necrosis factor-alpha (WMD=–6.60, 95% CI –8.56 to –4.64, P<.001, I2=98%), and interleukin-6 (WMD=–2.76, 95% CI –2.98 to –2.53, P<.001, I2=0%). However, no significant differences were found in terms of the spinal range of motion (ROM), disability level, or fear of movement. In addition, 10 (63%) of the included RCTs had a high risk of bias. Conclusions VR therapy may be an effective and safe intervention for reducing symptoms in patients with CSP, as it is shown to exert significant analgesic effects and beneficial improvements in inflammatory factor levels. However, this approach may not have significant effects on the spinal ROM, disability level, or fear of movement. Notably, the quality of the evidence from the RCTs included in this study ranged from moderate to low. Therefore, we recommend that readers interpret the results of this study with caution. Trial Registration PROSPERO CRD42022382331; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=382331

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Section: Discussionmentioning

confidence: 98%

Virtual Reality Therapy for the Management of Chronic Spinal Pain: Systematic Review and Meta-Analysis

Zhang,

Li,

Zhou

et al. 2024

JMIR Serious Games

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“…In patients with mid-stage KOA (K-L grade 3), joint space narrowing, significant cartilage damage, increased functional impairment, and intensified pain are observed. Most of the studies we included (Abdelazeem et al, 2016;Nambi et al, 2020;Mete and Sari, 2022;Ozlu et al, 2023;Oliveira et al, 2024)…”

Section: Effects Of Vr-based Exercise On Different K-l Grades Of Koamentioning

confidence: 99%

Efficacy of virtual reality exercise in knee osteoarthritis rehabilitation: a systematic review and meta-analysis

Wei,

Tang,

Luo

et al. 2024

Front. Physiol.

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BackgroundThis systematic review and meta-analysis aims to investigate the effects of virtual reality (VR) exercise compared to traditional rehabilitation on pain, function, and muscle strength in patients with knee osteoarthritis (KOA). Additionally, the study explores the mechanisms by which VR exercise contributes to the rehabilitation of KOA patients.MethodsWe systematically searched PubMed, the Cochrane Library, Embase, Web of Science, Scopus, and PEDro according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Our search spanned from the library construction to 24 May 2024, focusing on randomized controlled trials Primary outcomes included pain, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and muscle strength. Meta-analysis was conducted using RevMan (version 5.4) and Stata (version 14.0). The bias risk of included studies was assessed using the Cochrane RoB 2.0 tool, while the quality of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach.ResultsThis meta-analysis and systematic review included nine studies involving 456 KOA patients. The results indicated that VR exercise significantly improved pain scores (SMD, −1.53; 95% CI: −2.50 to −0.55; p = 0.002), WOMAC total score (MD, −14.79; 95% CI: −28.26 to −1.33; p = 0.03), WOMAC pain score (MD, −0.93; 95% CI: −1.52 to −0.34; p = 0.002), knee extensor strength (SMD, 0.51; 95% CI: 0.14 to 0.87; p = 0.006), and knee flexor strength (SMD, 0.65; 95% CI: 0.28 to 1.01; p = 0.0005), but not significantly for WOMAC stiffness (MD, −0.01; 95% CI: −1.21 to 1.19; p = 0.99) and physical function (MD, −0.35; 95% CI: −0.79 to −0.09; p = 0.12).ConclusionVR exercise significantly alleviates pain, enhances muscle strength and WOMAC total score in KOA patients, but improvements in joint stiffness and physical function are not significant. However, the current number of studies is limited, necessitating further research to expand on the present findings.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024540061, identifier CRD42024540061

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“…No significant differences regarding limb loading, balance, ROM, and functional tests were found [26]. A VR training protocol has shown beneficial improvement compared to sensory-motor training in post-traumatic knee osteoarthritis (KOA) after ACL injury, concerning not only pain and function but also inflammatory biomarkers without effect on bone morphogenic proteins [27]. Two RCTs using VR training after total knee replacement (TKR) showed no superiority over conventional rehabilitation regarding improvement of outcomes with a possible better effect on global proprioception [28,29].…”

Section: Complex Regional Pain Syndrome (Crps)mentioning

confidence: 99%

Clinical Applications of Virtual Reality in Musculoskeletal Rehabilitation: A Scoping Review

Chaplin,

Karatzios,

Benaim

2023

Healthcare

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(1) Background: VR is based on a virtual world that creates sounds effects and videos that replace the real environment. Arising literature shows VR efficacy in the field of neurological rehabilitation (NR) and that its use is also taking a place in musculoskeletal rehabilitation (MSR), as a treatment of various disorders that cause disability and chronic pain. (2) Aim: We discuss the role of VR in MSR, presenting its use and development on acute and chronic musculoskeletal disorders, based on the most recent literature. (3) Design and Methods: Literature searches were conducted in the databases Pubmed and Medline up to 30 September 2023. The PRISMA-Scr Checklist was followed. (4) Results: A total of 51 records were included. The analysed studies were conducted within a variety of populations, musculoskeletal disorders, settings, and VR technologies. Only a few studies could statistically affirm the efficacy of VR in MSR, as mentioned for the rehabilitation of the upper limb. Nevertheless, the observed trend is an improvement of the global perceived effect compared to traditional rehabilitation. (5) Conclusion: VR allows for the personalisation of treatment with an adaptable treatment platform, which may improve the participation of the patient and increase acceptability and adherence to long-term rehabilitation programs. We provide recommendations and suggestions for future research and use of VR in musculoskeletal rehabilitation.

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Comparative effects of virtual reality training and sensory motor training on bone morphogenic proteins and inflammatory biomarkers in post-traumatic osteoarthritis

Cited by 15 publications

References 28 publications

Virtual Reality Therapy for the Management of Chronic Spinal Pain: Systematic Review and Meta-Analysis

Virtual Reality Therapy for the Management of Chronic Spinal Pain: Systematic Review and Meta-Analysis

Efficacy of virtual reality exercise in knee osteoarthritis rehabilitation: a systematic review and meta-analysis

Clinical Applications of Virtual Reality in Musculoskeletal Rehabilitation: A Scoping Review

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