Hanbin Li

Background: Low back pain is one of the most prevalent pain conditions worldwide. Virtual reality–based training has been used for low back pain as a new treatment strategy. Present evidence indicated that the effectiveness of virtual reality–based training for people with chronic low back pain is inconclusive. Objective: This study conducted a meta-analysis to evaluate the immediate- and short-term effects of virtual reality–based training on pain, pain-related fear, and disability in people with chronic low back pain. Methods: We searched the PubMed, Embase, Web of Science, PEDro, CENTRAL, and CINAHL databases from inception until January 2024. Only randomized controlled trials assessing the effects of virtual reality–based training on individuals with chronic low back pain were selected. The outcomes were focused on pain, pain-related fear measured by the Tampa Scale of Kinesiophobia, and disability measured by the Oswestry Disability Index. The immediate term was defined as the immediate period after intervention, and the short term was defined as 3 to 6 months after intervention. The Cochrane Risk of Bias tool and the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach were used to evaluate the quality of the methodology and evidence, respectively. Results: In total, 20 randomized controlled trials involving 1059 patients were eligible for analysis. Virtual reality–based training showed significant improvements in pain (mean difference [MD] –1.43; 95% CI –1.86 to –1.00; I2=95%; P<.001), pain-related fear using the Tampa Scale of Kinesiophobia (MD –5.46; 95% CI –9.40 to 1.52; I2=90%; P=.007), and disability using the Oswestry Disability Index (MD –11.50; 95% CI –20.00 to –3.01; I2=95%; P=.008) in individuals with chronic low back pain immediately after interventions. However, there were no significant differences observed in pain (P=.16), pain-related fear (P=.10), and disability (P=.43) in the short term. Conclusions: These findings indicated that virtual reality–based training can be used effectively for individuals with chronic low back pain in the immediate term, especially to reduce pain, alleviate pain-related fear, and improve disability. However, the short-term benefits need more high-quality trials to be demonstrated. Trial Registration: PROSPERO CRD42021292633; http://tinyurl.com/25mydxpz

BACKGROUND Low back pain is one of the most prevalent pain conditions worldwide. Virtual reality–based training has been used for low back pain as a new treatment strategy. Present evidence indicated that the effectiveness of virtual reality–based training for people with chronic low back pain is inconclusive. OBJECTIVE This study conducted a meta-analysis to evaluate the immediate- and short-term effects of virtual reality–based training on pain, pain-related fear, and disability in people with chronic low back pain. METHODS We searched the PubMed, Embase, Web of Science, PEDro, CENTRAL, and CINAHL databases from inception until January 2024. Only randomized controlled trials assessing the effects of virtual reality–based training on individuals with chronic low back pain were selected. The outcomes were focused on pain, pain-related fear measured by the Tampa Scale of Kinesiophobia, and disability measured by the Oswestry Disability Index. The immediate term was defined as the immediate period after intervention, and the short term was defined as 3 to 6 months after intervention. The Cochrane Risk of Bias tool and the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach were used to evaluate the quality of the methodology and evidence, respectively. RESULTS In total, 20 randomized controlled trials involving 1059 patients were eligible for analysis. Virtual reality–based training showed significant improvements in pain (mean difference [MD] –1.43; 95% CI –1.86 to –1.00; I2=95%; P<.001), pain-related fear using the Tampa Scale of Kinesiophobia (MD –5.46; 95% CI –9.40 to 1.52; I2=90%; P=.007), and disability using the Oswestry Disability Index (MD –11.50; 95% CI –20.00 to –3.01; I2=95%; P=.008) in individuals with chronic low back pain immediately after interventions. However, there were no significant differences observed in pain (P=.16), pain-related fear (P=.10), and disability (P=.43) in the short term. CONCLUSIONS These findings indicated that virtual reality–based training can be used effectively for individuals with chronic low back pain in the immediate term, especially to reduce pain, alleviate pain-related fear, and improve disability. However, the short-term benefits need more high-quality trials to be demonstrated. CLINICALTRIAL PROSPERO CRD42021292633; http://tinyurl.com/25mydxpz

Using a community-based population cross-sectional study, we investigated the validity of an enzymatic method for glycated albumin (GA) measurements and evaluated its utility as a diagnostic tool for diabetes mellitus (DM). In total, 1,211 participants from the city of Harbin, People's Republic of China, were enrolled in the study. A receiver operating characteristic (ROC) analysis for GA, fasting plasma glucose (FPG) and haemoglobin A_1c (HbA_1c) measurements in diagnosed and undiagnosed DM were compared, based on a definition of DM using 1999 WHO criteria. We also estimated the correlation among GA, HbA_1c and other clinical characteristics. Significant and positive correlations of fasting serum GA with FPG (r 50.8097) and HbA_1c (r 50.8976) were found in participants enrolled in the study. ROC analysis for GA predicting undiagnosed DM with a cut-off point of 15.7% was similar to that of FPG and HbA_1c. Therefore, our data indicate that GA is a potential tool for DM diagnosis.