Effects of Immersive Virtual Reality Exercise on Quality of Life, Cognitive Function, and Psychological Symptoms in Individuals With Fibromyalgia

Plain-language summary

Fibromyalgia is considered a condition of unknown etiology, affecting approximately 2-5% of the population in developed countries, predominantly women, and is most commonly diagnosed between the ages of 40 and 50. Its main characteristic is the presence of widespread musculoskeletal pain. Although the most frequently reported symptoms include multiple tender points, fatigue, and cognitive dysfunction, this syndrome is also commonly associated with anxiety, depression, and pain catastrophizing. In Chile, fibromyalgia accounts for up to 26.7% of private rheumatology consultations, with a similar scenario observed in the city of Concepción. This highlights the need to implement innovative therapeutic strategies that allow patients to practice motor and cognitive skills in various contexts, including occupational and domestic environments. In this regard, virtual reality has emerged as a promising tool for this population, as it provides a controlled virtual environment where patients can engage in different therapeutic techniques, moving beyond conventional treatment approaches. Through this approach, interventions may include relaxation exercises, cognitive-behavioral therapy, and adapted physical activities. Such interaction may improve cognitive function, reduce symptoms of anxiety, decrease pain perception associated with the condition, and enhance overall quality of life. This study aims to evaluate the effectiveness of a physiotherapy intervention combined with immersive virtual reality on quality of life, cognitive function, and psychological symptoms in patients diagnosed with fibromyalgia. This study corresponds to a randomized controlled crossover clinical trial in which participants will be randomly assigned to one of two groups: Group A will initiate the intervention with physical exercise using immersive virtual reality, while Group B will begin with physical exercise without virtual reality support (control condition). After completing the first intervention period, a crossover will be performed, such that Group A will continue with exercise without virtual reality and Group B will receive the immersive virtual reality intervention. In this way, all participants will experience both exercise modalities, allowing for both within- and between-subject comparisons. A washout period will be included between phases to minimize potential carryover effects. Each group will consist of 21 participants recruited from the Kinesiology Center of Universidad San Sebastián. Cognitive function will be assessed using the Montreal Cognitive Assessment (MoCA), psychological variables will be evaluated using the Depression Anxiety Stress Scales (DASS-21), and quality of life will be measured using the Fibromyalgia Impact Questionnaire-Revised (FIQ-R). All outcomes will be assessed at baseline and after each intervention phase.

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