Virtual reality-based exercises may reduce pain and improve function in knee osteoarthritis

Exercise Evidence: RCT · n=60 · Randomized controlled trial with 3-week intervention period; pain, function, balance, and quality-of-life measures before and after treatment 2026-07-29

A 60-person randomized controlled trial found that adding non-immersive virtual reality exercises to standard rehabilitation was associated with greater reductions in knee pain, improvements in physical function and balance, and better quality of life compared to conventional therapy alone over 3 weeks.

Researchers enrolled 60 patients with symptomatic knee osteoarthritis in a randomized controlled trial to test whether non-immersive virtual reality-based exercises could enhance outcomes beyond standard rehabilitation alone. Both groups received conventional therapy; one group also completed VR-based exercises over a 3-week period.

Pain was measured on a visual analog scale, disease-specific function via the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and balance and postural stability using the Biodex Balance System. Both groups showed significant improvements across all measures, but the VR-addition group demonstrated greater reductions in pain levels and larger gains in physical function, postural stability, and dynamic balance (p<0.001). Quality of life improved across all subscales of the Short Form-36 in the VR group, with significant time effects observed in every dimension (p<0.001). The study was limited by its short 3-week timeframe; longer follow-up would clarify whether benefits persist. Notably, improvements in role-based physical limitations and mental health did not significantly differ between groups, suggesting VR may target pain and motor control more than psychological aspects.

Takeaway

Adding virtual reality exercise to standard knee osteoarthritis rehabilitation may be linked to faster improvements in pain, physical function, and balance over 3 weeks, though effects beyond this window remain unclear.

The VR group showed clinically meaningful pain reduction on the visual analog scale and superior gains in postural stability measured by the Biodex system's Dynamic Overall Stability Index and Functional Reach scores—suggesting that real-time visual feedback and gamified movement may engage motor learning more effectively than conventional therapy alone. Notably, mental health and role-based physical limitations (subdimensions capturing confidence in returning to work or hobbies) did not improve differently between groups, indicating that pain relief and movement capacity may respond more readily to VR than emotional or social confidence. The mechanism likely involves enhanced proprioceptive feedback and attention through immersive game elements, which may accelerate motor control recovery. This aligns with earlier evidence that VR improves engagement and motivation in rehabilitation. However, the 3-week window is brief; it is unclear whether the advantage persists at 12 weeks or beyond, or whether gains translate to sustained real-world activity. The non-immersive format (less intense than fully immersive headset-based systems) may have accessibility advantages for older adults or those with balance concerns.

Takeaway · Cadence

If you have mild-to-moderate knee osteoarthritis and are doing physical therapy, you might ask your physiotherapist whether adding VR-based exercises—such as interactive balance games or movement-tracking systems—could complement your routine. The short timeframe in this study suggests benefits may emerge within a few weeks, so a trial of 3–4 weeks could help you gauge whether the added engagement and feedback feel helpful. VR may be particularly useful if you find standard exercises repetitive or struggle to maintain balance; the visual feedback can make corrections feel more intuitive. Keep in mind this study did not measure changes in mental health or confidence, so if pain is your main concern, VR looks promising—but addressing mood or return-to-activity confidence may still need other support.

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References

The effectiveness of virtual reality-based exercises in patients with symptomatic knee osteoarthritis: randomized controlled study. — Revista da Associacao Medica Brasileira (1992) (Read the original)

#virtual-reality #knee-osteoarthritis #rehabilitation