Exploring the Effects of Virtual Reality on Pain Relief and Physical Mobility in Spa-Based Treatment

Objectives: The objective of this prospective, controlled observational study embedded in routine spa care was to evaluate the effectiveness of integrating immersive virtual reality (VR) into a three-week spa-based rehabilitation program to reduce pain and improve physical mobility in adults with chronic musculoskeletal or neurogenic disorders. Methods: In this study, fifty-five adults with chronic musculoskeletal or neurogenic disorders completed a three-week spa regimen combining natural therapies, physiotherapy and rehabilitation. Participants were allocated in a preference- and availability-based manner either to the VR-enhanced group (n = 37), which completed interactive 25 min VR sessions three times per week, or to the control group (n = 18) receiving standard care. Pain was assessed using a 100 mm Visual Analog Scale (VAS) and shoulder-related joint mobility by goniometry before and after the intervention. Wilcoxon signed-rank and Mann-Whitney U tests evaluated within- and between-group differences, with subgroup analyses according to disease duration (≤5 vs. >5 years). Results: Both groups achieved significant post-treatment reductions in VAS pain scores (p < 0.001). The VR group exhibited a greater median decrease in pain compared to controls (p = 0.048), with the largest effect among patients with disease duration ≤ 5 years (p = 0.024). Goniometric measurements demonstrated significant mobility improvements across all tested angles in the VR group (p < 0.001), while improvements in the control group were smaller. Conclusions: VR integrated into spa-based rehabilitation was associated with greater pain reduction and mobility gains than standard care. These preliminary, hypothesis-generating findings require confirmation in larger randomized trials with standardized protocols and long-term follow-up.