Effectiveness of Virtual Reality-based Rehabilitation Combined with Conventional Therapy in Reducing Pain and Improving Function in Knee Osteoarthritis: An Observational Pilot Study

Background: Knee osteoarthritis (KOA) is a leading cause of disability worldwide, with a high prevalence in India.Conventional rehabilitation is effective but often limited by low adherence and engagement.Virtual reality-based rehabilitation (VRBR) offers immersive, interactive environments that may enhance motivation, reduce pain perception, and improve function.Objective: To evaluate the preliminary effectiveness of VRBR combined with conventional therapy in reducing pain and improving functional outcomes in patients with KOA. Materials and methods: A pilot study was conducted at the Government Institute of Rehabilitation Medicine (GIRM), Chennai (January-April 2025) on 30 patients with primary KOA [Kellgren-Lawrence (K-L) grades II-IV].All received conventional physiotherapy along with 4-10 sessions of immersive VR therapy, with pain and function assessed using visual analog scale (VAS) and Western Ontario and McMaster universities osteoarthritis index (WOMAC), and correlations examined for session count and radiographic severity.Results: Significant improvements were observed in pain (VAS: 6.56 1.79 to 2.30 1.39, p < 0.001) and function (WOMAC: 39.1 8.53 to 18.1 7.80, p < 0.001).No significant correlation was found between the number of VR sessions and changes in VAS (p = 0.917) or WOMAC (p = 0.299).A moderate positive correlation was identified between VR session outcomes and radiographic OA grade ( = 0.507, p = 0.004). Conclusion:Virtual reality-based rehabilitation combined with conventional therapy significantly reduced pain and improved function in patients with KOA.While benefits were not linked to session frequency, radiographic severity showed a moderate influence on outcomes.These findings support VRBR as a feasible adjunct to conventional rehabilitation, warranting further validation through larger, multicenter randomized trials.