785 Post‐stroke Mood and Movement in People With and Without Pain: A Virtual Reality Pilot Study

Management of Central Post-Stroke Pain: Systematic Review and Meta-Analysis

“…From investigation of random-effects meta-analyses, neuromodulation was the most effective treatment with a moderate effect size, followed by physical interventions with moderate effect size, and pharmacological interventions with a small effect size. However, physical studies were limited by high risk of bias and low level of certainty 15,82,95 . Sub-group analysis of rTMS and tDCS found moderate effect sizes, whereas anticonvulsants were found to have a small effect size.…”

“…A comparison of anaesthetic medication found that thiamylal was the most effective treatment when compared with ketamine or morphine. Only one physical study was identified [82] -a VR trial that demonstrated, immediately following treatment, significantly reduced mean VAS pain score and increased pain threshold for cold and heat stimuli. VR has been used in some capacity for post-stroke rehabilitation and chronic pain management, but is rarely used on CPSP patients [1,51,54].…”

“…PGIC was only reported as significant in rTMS [27] and duloxetine studies [57], which might be confounded by the experience of rTMS, and mood stabilising properties of duloxetine. Improvement of allodynia was only reported in Lamotrigine [73], Pregabalin [39] and VR [82] interventions, but allodynia was rarely tested or reported across studies and further research is needed to understand how other interventions impact this symptom. Pregabalin and Lamotrigine effectiveness has been evidenced in literature, but VR is rarely explored for allodynia treatment [54,85,90].…”

“…Across both studies, only 1 person (3.70%) out of 27 experienced side effects from acupuncture who left the study due to itching. Virtual reality [82] was found to significantly increase threshold to cold and heat stimuli. No side effects were reported.…”

“…No physical intervention studies were included in the proportional meta-analysis. Simmonds and Shahrban [82] cross sectional sham controlled within subjects study exposed 12 participants to either "hot world", "snow world", neutral stimuli, or no stimuli. "Hot world" included scenes of volcanoes, "snow world" included snowy mountains, and neutral stimuli consisted of alternating white pillars on a black background.…”