Therapeutic approach using games and virtual reality applications to reduce symptoms of kinesiophobia in patients with chronic low back pain: A literature review
DOI:
https://doi.org/10.70430/rev.cedigma.2025.v3.7.66Keywords:
Virtual Reality (VR); Kinesiophobia; Fear of Movement; Low Back Pain; Chronic back pain (CBP).Abstract
This integrative literature review aimed to understand the scientific evidence and advantages of using electronic movement games and virtual reality-based applications to treat symptoms of kinesiophobia in patients with chronic low back pain. The search for articles was conducted in the Scientific Electronic Library Online (SCIELO), National Library of Medicine (Pubmed), and Virtual Health Library (BVS) databases. In total, 9 articles published in international and national journals were selected, from 2014 to 2024. The studies showed that VR contributes to the reduction of kinesiophobia, pain, and functional disability, promoting greater adherence to treatment through playful and interactive approaches. Positive effects were reported with both immersive and non-immersive VR, with benefits maintained in the short and medium term. Applications with gradual exposure to feared movements have been shown to be effective, especially when combined with conventional therapies or cognitive interventions. The acceptability and usability of VR systems were evaluated as positive by users. VR represents a promising and safe therapeutic approach for the management of CLBP associated with kinesiophobia, offering distraction from pain and favoring the gradual confrontation of the fear of movement. However, due to the heterogeneity of the studies, it is necessary to develop more studies that explore different patient profiles, variations in the types of VR, levels of game intensity, intervention time and investigation of efficacy when associated with another therapeutic approach.
Downloads
References
BORDELEAU, M., et al. (2022). Treatments for kinesiophobia in people with chronic pain: A scoping review. Frontiers in Behavioral Neuroscience, 16, 933483.
BREA-GÓMEZ, B., et al. (2021). Virtual reality in the treatment of adults with chronic low back pain: A systematic review and meta-analysis of randomized clinical trials. International Journal of Environmental Research and Public Health, 18(22), 11806.
ECCLESTON, C., et al. (2022). A prospective, double-blind, pilot, randomized, controlled trial of an “embodied” virtual reality intervention for adults with low back pain. Pain, 163(9), 1700–1715.
FACULDADE DE CIÊNCIAS AGRONÔMICAS (UNESP). Campus de Botucatu. Biblioteca professor Paulo de Carvalho Mattos. Tipos de revisão de literatura. Botucatu; 2015; 2p.
FOWLER, C. A., et al. (2019). A virtual reality intervention for fear of movement for Veterans with chronic pain: protocol for a feasibility study. Pilot and Feasibility Studies, 5(1), 146.
HENNESSY, R. W., et al. (2020). A graded exposure, locomotion-enabled virtual reality app during walking and reaching for individuals with Chronic low back pain: Cohort gaming design. JMIR Serious Games, 8(3), e17799.
HENRÍQUEZ-JURADO, J. M., et al. (2024). Virtual reality-based therapy for chronic low back and neck pain: a systematic review with meta-analysis. EFORT Open Reviews, 9(7), 685–699.
HOTTA, G. H., et al. (2022). Abordagem terapêutica do medo relacionado à dor e da evitação em adultos com dor musculoesquelética crônica: revisão integrativa e roteiro para o clínico. Brazilian Journal Of Pain, 5(1).
LI, R., et al. (2024). Virtual reality-based training in chronic low back pain: Systematic review and meta-analysis of randomized controlled trials. Journal of Medical Internet Research, 26, e45406.
LO, H. H. M., et al. (2024). Immersive and nonimmersive virtual reality-assisted active training in chronic musculoskeletal pain: Systematic review and meta-analysis. Journal of Medical Internet Research, 26, e48787.
NAMBI, G., et al. (2021). Virtual reality or isokinetic training; its effect on pain, kinesiophobia and serum stress hormones in chronic low back pain: A randomized controlled trial. Technology and health care: official journal of the European Society for Engineering and Medicine, 29(1), 155–166.
PEEBLES, A. T., et al. (2022). A virtual reality game suite for graded rehabilitation in patients with low back pain and a high fear of movement: Within-subject comparative study. JMIR Serious Games, 10(1), e32027.
STAMM, O., et al. (2022). Virtual reality exergame for supplementing multimodal pain therapy in older adults with chronic back pain: a randomized controlled pilot study. Virtual Reality, 26(4), 1291–1305.
THEUNISSEN, W. W. E. S., et al. (2020). Timing of anterior cruciate ligament reconstruction and preoperative pain are important predictors for postoperative kinesiophobia. Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA, 28(8), 2502–2510.
THOMAS, J. S., et al. (2016). Feasibility and safety of a virtual reality dodgeball intervention for chronic low back pain: A randomized clinical trial. The Journal of Pain: Official Journal of the American Pain Society, 17(12), 1302–1317.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Emanuel José Fagundes da Silva, Guilherme Tôrres Sobral, João Gabriel Mendonça de Andrade, Lícia Vasconcelos Carvalho da Silva (Autor)
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
- Atribuição — Você deve dar o crédito apropriado , fornecer um link para a licença e indicar se mudanças foram feitas . Você pode fazer isso de qualquer maneira razoável, mas não de nenhuma forma que sugira que o licenciante endossa você ou seu uso.
- Compartilhamento pela mesma licença — Se você remixar, transformar ou criar a partir do material, deverá distribuir suas contribuições sob a mesma licença do original.
- Sem restrições adicionais — Você não pode aplicar termos legais ou medidas tecnológicas que restrinjam legalmente outros de fazer qualquer coisa que a licença permita.
How to Cite
