"A new tool for my toolbox": physiotherapists' perceptions on therapeutic virtual reality for chronic low back pain – a qualitative descriptive study

Objective Therapeutic virtual reality (VR) is an emerging intervention in physiotherapy for patients with chronic low back pain (CLBP). However, broad adoption of VR by physiotherapists (PTs) is slow. This is possibly due to PT's negative perceptions on and attitudes towards the added value of VR in physiotherapy for patients with CLBP. The aim of this study was to explore these perceptions and attitudes. Methods We performed a qualitative descriptive study using semi-structured interviews. The study sample included eleven primary care PTs with a median age of 35 years (range: 28–58). Participating PTs had at least one year of experience using VR for the treatment of patients with CLBP, after which they continued using VR or stopped using it. The interviews were transcribed verbatim and inductively analyzed using reflexive thematic analysis. Results Analysis of the interviews identified four overarching themes: (i) therapeutic VR is perceived as non-threatening to the PT's role; (ii) VR has distinctive qualities that complement the PT's toolbox; (iii) contrasting attitudes towards the added value of therapeutic VR for CLBP; and (iv) PTs need specific skills, positive attitudes and knowledge to administer therapeutic VR. Conclusion The study results showed that VR was perceived as a valuable and non-threatening innovation for physiotherapy in patients with CLBP, that fits the hands-off and coaching role of PTs. Therapeutic VR seems promising in physiotherapy for patients with CLBP, but further adoption depends on breaking practical and systemic barriers. Also, more education is needed to train PTs to effectively administer VR.