Virtual Reality Technology Design and Its Applications in Preventing and/or Managing Paediatric Chronic Pain: A Scoping Review

BACKGROUND AND OBJECTIVE: Virtual reality (VR) has emerged as a novel non-pharmacological intervention tool, offering immersive environments for pain management and prevention. Despite growing literature on its efficacy, key design elements for effective VR interventions for paediatric chronic pain (CP) remain unclear. Therefore, this scoping review aimed to explore VR design strategies for managing and/or preventing paediatric CP. DATABASES AND DATA TREATMENT: Following the JBI methodology and PRISMA-ScR guidelines, a comprehensive search was conducted across five major databases: PsycINFO, Medline, Central, Scopus, and Embase, complemented by Google Scholar. Eligible studies were systematically screened and analysed. RESULTS: Twenty studies were included. Several objectives were highlighted. Identified objectives ranged from simple distraction without additional therapeutic goals to more structured skill-development aims, such as fostering relaxation skills or supporting the transfer of pain management strategies to daily life. Between these two extremes, VR was often used to distract the user while simultaneously pursuing another specific therapeutic objective, such as inducing relaxation or promoting movement. VR was also applied for mirror therapy. To support these objectives, a wide variety of virtual environments (VEs) were implemented, some integrating biofeedback. These VEs were grouped into four main categories: relaxing environments, gamified movement-based environments, simulation of everyday settings, and avatar-based interactive environments. CONCLUSION: These findings informed an adaptation of an existing holistic framework for paediatric VR-based pain interventions, originally developed in the context of acute pain, to paediatric CP. This adapted model integrates intervention objectives, moderators, and implementation barriers to guide the selection and development of VR-based interventions in this context. SIGNIFICANCE STATEMENT: This scoping review examines the range of VR design strategies and their applications in paediatric CP. An adapted holistic framework is proposed to guide the selection and development of VR interventions for this population. Given the rapid growth and emerging nature of this research field, a structured classification of VR designs is essential to support interpretation, replication, and comparison across studies.