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Immediate and Short-Term Effects of Nature-Based Immersive Virtual Reality During Dry Needling: A Single-Blinded Randomized Controlled Trial

Journal
Journal of clinical medicine (Q1)
Published
20 July 2026
Study design
Randomized controlled trial
Evidence level
Level 1, High (CEBM 1b)
Authors
Rodrigo Martín-San Agustín, Alberto Gadea-Blázquez, Elena Millán-Magariños, Adrian Escriche-Escuder, Borja Tronchoni-Crespo, Javier Guerra-Armas
PMID
42513598
DOI
10.3390/jcm15145683

Why clinicians should know about it

Abstract

Objectives: This study aimed to investigate the effects of nature-based immersive virtual reality (IVR) applied during dry needling (DN) on pain experienced during the procedure and on immediate and short-term post-intervention outcomes, compared with traditional DN, with a primary focus on immediate post-intervention pain intensity. Methods: In this single-blinded randomized controlled trial, participants were randomly assigned to the control (DN) or experimental (DN + IVR) group. Eligible participants were healthy individuals with identifiable latent myofascial trigger points (MTPs) in the quadriceps muscles. The primary outcome was pain intensity, measured using a numerical rating scale (NRS), immediately after the intervention. Secondary outcomes included pressure pain threshold (PPT) and pain intensity at follow-up time points (1, 6, and 24 h). Linear mixed-effects models were used to analyze the effects of group, time, and their interactions. Results: A total of 40 participants (control group, n = 21, 21.7 ± 3.1 years, 15 males; experimental group, n = 19, 22.4 ± 3.7 years, 11 males) were included. The DN + IVR group showed significantly lower pain intensity immediately after the intervention than the DN group (p = 0.032). Pain intensity decreased over time in both groups (p < 0.001), with no significant intergroup differences at later time points (all p > 0.05). For PPT, a significant effect of time was observed (p < 0.001), but no significant group × time interaction was observed. Conclusions: Nature-based IVR may reduce immediate procedural pain associated with dry needling, although these effects are not sustained over time. IVR may be a useful non-pharmacological strategy for pain relief during invasive physiotherapy procedures.

Abstract as published, via PubMed.

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For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.