VR rehab eased knee pain and steadied balance, but walking speed did not budge

Knee pain, whether from osteoarthritis or after knee replacement surgery, usually calls for months of rehabilitation exercises, and sticking with them is notoriously difficult. Digital healthcare systems built on virtual and augmented reality promise to make rehab more engaging and easier to deliver, potentially at home. Before clinics and patients invest in headsets and software, though, the fair question is whether these systems actually move the outcomes that matter: pain, balance, joint range of motion and walking ability. This review set out to pool the evidence and answer that directly.

The authors searched Scopus, PubMed, Web of Science and EBSCO for studies published between January 2003 and September 2023 testing digital healthcare interventions in people diagnosed with knee joint pain. Eight papers met the inclusion criteria, together involving 194 men and 279 women. Results were pooled as standardised differences between groups, and the pain analysis was split into subgroups for people with knee osteoarthritis and people recovering from total knee arthroplasty, the surgical replacement of the knee.

Digital rehab significantly improved balance and reduced pain overall. The pain benefit was not evenly spread: osteoarthritis patients showed a large improvement, while the effect in knee replacement patients was smaller and not statistically significant. Two outcomes did not move at all: knee joint range of motion showed no effect whatsoever, and walking velocity was essentially unchanged. In short, the technology helped how patients felt and balanced, but not how far their knees bent or how fast they walked.

This pooled analysis supports the growing use of virtual and augmented reality in musculoskeletal rehab, while drawing a sharper boundary around what it achieves. The split between osteoarthritis and post-surgical patients suggests the technology's value depends heavily on who is using it and why. With only eight studies and varied interventions pooled together, the findings are a promising signal rather than a settled verdict, and head-to-head comparisons against well-delivered conventional rehab remain the key open question.

If knee osteoarthritis pain is part of your life, this is a reason to take digitally delivered rehab seriously as an option worth discussing, since both pain and balance improved in the pooled trials. If your main goals are a stiffer knee bending further or walking faster, these systems showed nothing on either front. And if you are recovering from a knee replacement, the evidence here for extra pain relief specifically is weak, so expectations should stay modest.