Feasibility of attention-based virtual reality interventions in fibromyalgia syndrome: comparing systems, virtual environments and activities.

Background: Fibromyalgia Syndrome (FMS) is highly prevalent with a significant associated morbidity and socioeconomic burden. Effective treatments for FMS remain elusive with pharmacological management (including use of opioids) often proving ineffective. There is a need to develop accessible, innovative management approaches to improve patient care.Virtual reality (VR) interventions have shown evidence of efficacy in the management of acute pain and chronic low back pain, but their feasibility in FMS has not hitherto been explored.

Methods: This feasibility study investigates the use of four different VR systems, four interactive VR activities and two virtual environments in patients with FMS. Acceptability (including adverse effects) and study engagement were the main outcomes investigated. Clinical outcome data on pain and mood were also collected to gather preliminary information for future studies.

Results: The results demonstrated good feasibility across VR systems, activities and virtual environments with high levels of acceptability, low frequency of adverse effects, and positive perceptions of VR in patients with FMS. Reporting of adverse effects (including fatigue) varied across different VR components, with system comfort and virtual environmental design being particularly important.

Conclusions: The findings increase our confidence with respect to the feasibility of using VR in people with FMS, help to inform future randomised controlled trials and emphasise the importance of tailored interventional design for future VR therapeutics.