The influence of an at-home virtual reality intervention on the health-related quality of life of patients with chronic musculoskeletal pain awaiting pain treatment

Background: Chronic musculoskeletal pain (CMP) affects approximately 20% of adults in the Netherlands, significantly impacting quality of life, daily functioning, and mental health. Current treatments often provide limited relief and carry risks such as addiction. Virtual reality (VR) technology has emerged as a potential (adjunctive) treatment modality for CMP, offering immersive experiences that may alter pain perception and improve psychological well-being. This study examined the influence of a four-week, home-based VR intervention, ‘Reducept’, compared to a standard waiting list period without VR intervention, on health-related quality of life (HRQoL) and pain-related outcomes in patients awaiting chronic pain treatment. Methods: This pragmatic, open-label, randomised controlled trial utilised a cluster randomised, two-period, crossover design involving six clusters from four healthcare organisations. Participants in the intervention group used the at-home VR intervention 'Reducept' daily for 10-30 minutes, while the control group followed standard waiting list period procedures without an intervention. Both groups completed questionnaires at baseline and after four weeks, with the primary outcome being HRQoL. Secondary outcomes included pain intensity, pain catastrophising, pain self-efficacy and pain acceptance. Data analysis followed the intention-to-treat principle and utilised linear mixed-model analyses. Results: The four healthcare organisations were randomised, resulting in 30 participants in the intervention group and 22 in the control group, making a total of 52 participants. Complete data fora six participants were missing and these participants were, therefore, excluded from the analysis. For nine participants with partial missing data, the Last Observation Carried Forward method was used. No significant baseline differences were found between groups. Analysis showed no significant differences in HRQoL or secondary outcomes between groups at baseline or after four weeks. Linear mixed-model analyses revealed no significant main effects of treatment, time, or interaction effects for any outcomes over the study period. Conclusion: The four-week VR intervention did not lead to significant improvements in HRQoL or pain-related outcomes compared to standard waiting list procedures. These findings suggest that the short-term duration of the VR intervention may have been insufficient to achieve measurable benefits. Future research should explore the long-term effects of VR and its integration with other treatments to better understand its potential role in managing chronic pain.