## 6 Conclusions and Future Directions  
In this article, we explored the challenges in VR terminology and the current state of hardware and software for immersive VR, particularly in the context of its application in musculoskeletal rehabilitation and chronic pain management. We identified considerable confusion in the terminology surrounding VR and related technologies, highlighting the need for authors to clearly define what they include under the term VR and how they interpret it in their studies. To contribute to a clearer understanding of VR, we proposed a framework categorizing VR immersion based on exteroceptive and interoceptive system involvement, as well as the quality and number of senses stimulated, aligning the concept of VR with modern technology. Additionally, we advocated for excluding \"non-immersive VR\" experiences from the VR category and proposed renaming them \"non-immersive fully artificial environments\". While reviewing hardware and software, we identified a lack of solutions specifically tailored for healthcare, emphasizing the need for future development. Current software solutions often fail to leverage VR's full potential mechanisms, such as its impact on kinesiophobia and body image through the use of body illusions or body-swapping techniques, highlighting the need for the development of additional software solutions in the field of musculoskeletal rehabilitation. Future research should prioritize providing detailed descriptions of the technologies and methods used, including clear indications of the type of equipment (e.g., HMD headsets or 2D screens), the nature of the environment (interactive or non-interactive) and the intended purpose of use. These details should ideally be included in the title or abstract of studies to enhance clarity and standardization. Efforts to achieve a consensus on VR terminology should continue, as a standardized approach would greatly benefit the consistency and comparability of future research. Furthermore, the development of VR technologies specifically designed for healthcare should be encouraged, addressing the current gap in solutions tailored to the needs of patients. Such advancements could enable more effective interventions targeting issues like kinesiophobia and altered body perception, which are critical in musculoskeletal rehabilitation and associated chronic pain. Finally, clinical implementation of these findings requires collaborative efforts between researchers, clinicians, and technology developers to ensure that VR systems are not only innovative but also practical, accessible, and aligned with the demands of modern healthcare. In addition to addressing these research and practical gaps, we also highlighted the contributions of key associations in advancing VR in healthcare. These organizations provide valuable resources, facilitate collaboration, and support the integration of VR technologies into clinical practice. By fostering partnerships and prioritizing healthcare-specific VR developments, the field can move closer to realizing the full potential of VR in improving outcomes for patients with musculoskeletal conditions and chronic pain. The following supporting information can be downloaded at [[https://www.mdpi.com/article/10.3390/app15052564/s1](https://www.mdpi.com/article/10.3390/app15052564/s1)]([https://www.mdpi.com/article/10.3390/app15052564/s1](https://www.mdpi.com/article/10.3390/app15052564/s1)): Table S1: Definitions and descriptions of virtual reality in studies on musculoskeletal conditions[PERSON] Table S2: Hardware and software used in studies on immersive virtual reality for musculoskeletal conditions [2; 4; 19; 32; 34; 35; 36; 47; 49; 52; 53; 56; 60; 67; 70; 7  
[PERSON]; [PERSON]; [PERSON]; [PERSON]; [PERSON]; [PERSON]; [PERSON] Cost Effectiveness of Virtual Reality Game Compared to Clinic Based McKenzie Extension Therapy for Chronic Non-Specific Low Back Pain. _Br. J. Pain_**2022**, _16_, 601-609. [CrossRef] [PubMed]
* _[PERSON] et al.