A Novel Virtual Reality Technique (Cervigame®) Compared to Conventional Proprioceptive Training to Treat Neck Pain: A Randomized Controlled Trial

Abstract

Background: Despite the potential benefits of virtual reality technology in physical rehabilitation, only a few studies have evaluated the efficacy of this type of treatment in patients with neck pain.Objective: The aim of this study was to compare the effects of virtual reality training (VRT) versus conventional proprioceptive training (CPT) in patients with neck pain.Methods: Forty four participants with nonspecific chronic neck pain were randomly assigned to VRT or CPT in this assessor-blinded clinical trial. A novel videogame called Cervigame® was designed for VRT. It comprises of 50 stages divided into unidirectional and two-directional stages ordered from easy to hard. CPT consisted of eye-follow, gaze stability, eye-head coordination and position and movement sense training. Both groups completed 8 training sessions over 4 weeks. Visual analogue scale score, neck disability index and Y-balance test results were recorded at baseline, immediately after and 5 weeks post-intervention. Mixed repeated measure ANOVA was used to analyze differences between mean values for each variable at an alpha level of 0.05.Results: There were significant improvements in all variables in both groups immediately after and 5 weeks after the intervention. Greater improvements were observed in the visual analogue scale and neck disability index scores in VRT group, and the results for all directions in Y-balance test were similar in both groups. No side effects were reported.Conclusion: Improvements in neck pain and disability were greater in VRT than CPT group. Cervigame® is a potentially practical tool for rehabilitation in patients with neck pain.

Virtual Reality Applications in Chronic Pain Management: Systematic Review and Meta-analysis

“…A television or PC screen was used in the following situations (n=9): support of a group cognitive behavior therapy containing specific content for developing relaxation and mindfulness skills, as an adjunct to the activity pacing component, with education, activity management, and relapse prevention, to induce positive emotions and promote motivation, self-efficacy, and behavior activation [ 48 , 55 , 57 , 58 ]. Other authors used a television or PC screen to practice motor execution by games, such as racing cars using phantom movements and matched random target postures of a virtual arm [ 66 , 77 ], a rabbit attempting to reach carrots and avoid obstacles [ 69 ], or a target-oriented motor control task where hand exercises consisted of reaching out, grasping, transferring, and placing [ 75 ]. In another study, patients with burning mouth syndrome watched their tongues on a computer screen with illusions and performed tongue movements [ 83 ].…”

“…Psychological outcomes, such as kinesiophobia and fear, mood, satisfaction, expectations of pain, pain focus, time spent thinking about pain, self-efficacy, emotions, motivation, stress, catastrophizing, acceptability, global impression of change, ownership, and agency, were measured in 19 studies [ 45 , 48 , 52 , 55 - 59 , 62 - 65 , 67 , 70 - 72 , 74 , 81 , 82 ]. Functional outcomes, including disability, physical comfort, strength, fitness, and sleep, were measured in 15 studies [ 45 , 55 - 57 , 59 , 60 , 62 , 64 , 65 , 69 - 72 , 77 , 82 ]. Functional capacity (evaluated by measuring balance, repetition index, step test, and composite value) was measured in 5 studies [ 56 , 62 , 65 , 69 , 70 ].…”

“…Functional outcomes, including disability, physical comfort, strength, fitness, and sleep, were measured in 15 studies [ 45 , 55 - 57 , 59 , 60 , 62 , 64 , 65 , 69 - 72 , 77 , 82 ]. Functional capacity (evaluated by measuring balance, repetition index, step test, and composite value) was measured in 5 studies [ 56 , 62 , 65 , 69 , 70 ]. Mobility (range of motion) was measured in 4 studies [ 45 , 62 , 71 , 72 ].…”

Eficacia de un tratamiento combinado de terapia manual con realidad mixta en variables motoras y en la modulación del dolor en sujetos con dolor crónico cervical. Ensayo clínico piloto

“…En contraste con los resultados obtenidos, en un reciente estudio de Rezai et al observó mejoras en la discapacidad en pacientes con dolor cervical tras la aplicación de RV mediante un juego controlado por el movimiento de la cabeza. Además, dicha mejora se observó después del tratamiento, y cinco semanas después del mismo (Rezaei et al, 2018). En concordancia con estos autores, Sarig et al también obtuvieron resultados favorables con la aplicación de RV en las variables discapacidad y dolor (Sarig Bahat et al, 2018).…”

A Serious Game for Performing Task-Oriented Cervical Exercises Among Older Adult Patients With Chronic Neck Pain: Development, Suitability, and Crossover Pilot Study

“…On the other hand, the results of this research are not supported by those found in another study that compared nonimmersive VR exercises with proprioceptive training in patients with neck pain, using eight sessions over a period of 4 weeks. That study observed that patients in the VR group improved more in terms of pain and disability than the group that performed proprioceptive exercises [ 49 ].…”