Introduction: In recent years, the effectiveness of virtual reality exercise in orthopedic patients and for the treatment of pain conditions has been increasingly researched. Chronic lower back pain often leads to avoiding certain activities for fear that they would increase pain levels. Virtual reality exercise is thought to reduce pain through diverting the patient's attention from pain and making exercise more interesting. Purpose: To review the existing research on the effectiveness of virtual reality exercise in patients with lower back pain. Methods: We searched for research articles in the PubMed, CINAHL and PEDro databases. Results: Based on the criteria, we included seven studies published between 2013 and 2021, with PEDro scores between 5 and 8 and a total of 433 subjects with either subacute or chronic lower back pain. In four studies virtual reality exercise was found to be more effective in reducing the intensity of lower back pain than control treatments. In three studies it was also found to be effective in improving well-being and mood of the subjects. Conclusion: Virtual reality exercise is an effective single or complementary therapy for the reduction of pain intensity and improvement of well-being and mood in patients with subacute or chronic pain. To reduce the intensity of pain, virtual reality exercise should be performed for at least four weeks, with an exercise frequency of 3-4 times a week and an individual session lasting 30-40 minutes. Virtual reality exercise could also be effective in reducing the need for pain medications, improving the performance of certain sports activities (running, jumping), and improving the patients pain self-efficacy. Additional studies with uniform measurement tools, comparable exercise programs, types of virtual reality and evaluation of long-term effects could provide clearer findings about the effectiveness of virtual reality exercise in patients with lower back pain.
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