Evaluating the Impact of 6-Week Gamified Virtual Reality Rehabilitation Program on Pain, Function, and Balance in Knee Osteoarthritis: A Randomized Controlled Trial

Objective: This study aimed to evaluate the effects of a gamified virtual reality (VR) rehabilitation program, using immersive VR combined with conventional conventional physical therapy (CPT), on pain, functional mobility, disability, and balance in individuals with knee osteoarthritis (OA). Methods: A randomized controlled trial was conducted on 90 volunteered participants diagnosed with knee OA, equally divided into VR and control groups. VR group received VR + CPT, while the control group received only CPT. Outcome measures included Visual Analog Scale (VAS) for pain, 6-minute walk test (6MWT) for function, Western Ontario and McMaster Universities Arthritis Index (WOMAC) for disability, and the Berg Balance Scale (BBS) for balance. Participants underwent three sessions per week for 6 weeks. Assessments were performed at baseline, after 3 weeks, and after 7 weeks (postintervention). The level of significance was set at P ≤ 0.05. Results: The VR group demonstrated greater improvements than the control group, including a 38.6% reduction in pain compared with 26.3% in the control group, and a 39.9% increase in 6MWT distance compared with 19.4% in the control group. WOMAC improved substantially in the VR group (57.9%) compared with the control group (25%). Pain reduction became significantly greater in the VR group in the third week. Significant between-group differences at postintervention ( P < 0.001) were observed for VAS, 6MWT, and WOMAC. Both groups demonstrated significant within-group improvements in balance; however, no significant between-group difference was found for BBS ( P = 0.090). Conclusion: Integrating a gamified VR rehabilitation program alongside CPT significantly reduces pain and improves mobility and knee function in individuals with knee OA. The findings support using VR as an effective adjunct to traditional physiotherapy, improving engagement and clinical outcomes.