A Virtual Reality System Combined with Biofeedback for Treating Pediatric Chronic Headache—A Pilot Study

Shiri, Shimon; Feintuch, Uri; Weiss, Nilly; Pustilnik, Alex; Geffen, Tal; Kay, Barrie; Meiner, Zeev; Berger, Itai

doi:10.1111/pme.12083

Cited by 95 publications

(59 citation statements)

References 37 publications

(38 reference statements)

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“…Request permissions from permissions@acm.org. VR has also proven to be an effective method to reduce perceived pain during burn wound care [12]. Hoffman et al designed a series of distraction-based VR studies in which patients reported up to 50% reduction in perceived pain.…”

Section: Related Workmentioning

confidence: 97%

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The Virtual Meditative Walk

Gromala

Tong

Choo

et al. 2015

Proceedings of the 33rd Annual ACM Conference on Human Factors in Computing Systems

147

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Because the nature of chronic pain is complex, pharmacological analgesics are often not enough to achieve an ideal treatment plan. Virtual Reality (VR) technologies have emerged within medical research in recent years for treating acute pain, and proved to be an effective strategy based on pain distraction. This paper describes a VR system designed for chronic pain patients. The system incorporates biofeedback sensors, an immersive virtual environment, and stereoscopic sound titled the "Virtual Meditative Walk" (VMW). It was designed to enable chronic pain patients to learn Mindfulness-based stress reduction (MBSR), a form of meditation. By providing real-time visual and sonic feedback, VMW enables patients to learn how to manage their pain. A proof-of-concept user study was conducted to investigate the effectiveness of the VR system with chronic pain patients in clinical settings. Results show that the VMW was more effective in reducing perceived pain compared to the non-VR control condition.

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Section: Related Workmentioning

confidence: 97%

“…In 2013, Shiri et al created a VE and biofeedback system to treat pediatric headaches [12]. They obtained galvanic skin response (GSR) levels of patients with chronic headaches over ten sessions, each lasting 30 minutes.…”

Section: Related Workmentioning

confidence: 99%

The Virtual Meditative Walk

Gromala

Tong

Choo

et al. 2015

Proceedings of the 33rd Annual ACM Conference on Human Factors in Computing Systems

147

View full text Add to dashboard Cite

show abstract

“…In addition, totally immersive VR was shown to have greater benefit in pain reduction . ‐ As immersive VR technology improves, VR is being utilized as a complementary therapy for persistent, chronic pain rather than solely for acute pain . On the basis of these data and our recognition that novel complementary therapies are required to improve pain management in patients with SCD, we aimed to conduct a feasibility study of immersive VR therapy in patients hospitalized for vaso‐occlusive pain.…”

Section: Introductionmentioning

confidence: 99%

Virtual reality as complementary pain therapy in hospitalized patients with sickle cell disease

Agrawal

Robertson²,

Litwin

et al. 2018

Pediatric Blood & Cancer

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Objective Due to incomplete management of vaso‐occlusive pain episodes (VOE) in patients with sickle cell disease (SCD), we sought to determine if immersive VR would be feasible for inpatients. Secondarily, we hypothesized that a single VR session would improve the VOE pain experience. Procedures Consecutive patients with SCD eight years and older admitted for VOE were offered one 15‐minute VR session, utilizing a relaxing underwater world specifically created for pediatric patients and to minimize potential simulator side effects. Safety and acceptability were evaluated with a brief survey before and after the session. Pain was evaluated utilizing the validated adolescent pediatric pain tool (APPT). Survey data and pain scores were analyzed using Wilcoxon signed‐rank test as the data were nonnormally distributed. Results Thirty patients, 21 female, with a median age of 16 years were enrolled, the majority having hemoglobin SS disease. The VR session had no reported side effects; all patients requested VR again in the future. Median pain intensity (pre‐VR 7.3 [interquartile range, IQR, 6.1, 8.8], post‐VR 5.8 [4.7, 7.9]), number of affected body areas (pre‐VR 3.0 [2.0, 7.8], post‐VR 2.0 [0, 4.8]), and qualitative measures including sensory, affective, evaluative, and temporal pain domains were all statistically reduced (i.e., P ≤0.01). Conclusions VR therapy was feasible in a cohort of patients with SCD admitted for VOE. In addition to standard therapies, VR may help reduce the pain experience with SCD VOE. Further study is required to determine the impact of VR therapy on opioid usage and length of stay in hospital.

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“…A number of reports along these lines have already been published, one example being experiments involving VR hypnosis. 23,24 In the introduction to this paper, we mentioned other examples 10,11 in which VR has been used for purposes other than pain distraction, and these could be particularly useful in the clinical context. What makes the intervention described here especially interesting and innovative is that it is designed to change cognitive variables (i.e., self-efficacy and catastrophizing) that have been shown to be very important in the context of chronic pain problems.…”

Section: Discussionmentioning

confidence: 99%

Differential Effects of Two Virtual Reality Interventions: Distraction Versus Pain Control

Loreto-Quijada

Gutiérrez-Maldonado²,

Nieto³

et al. 2014

Cyberpsychology, Behavior, and Social Networking

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There is evidence that virtual reality (VR) pain distraction is effective at improving pain-related outcomes. However, more research is needed to investigate VR environments with other pain-related goals. The main aim of this study was to compare the differential effects of two VR environments on a set of pain-related and cognitive variables during a cold pressor experiment. One of these environments aimed to distract attention away from pain (VRD), whereas the other was designed to enhance pain control (VRC). Participants were 77 psychology students, who were randomly assigned to one of the following three conditions during the cold pressor experiment: (a) VRD, (b) VRC, or (c) Non-VR (control condition). Data were collected regarding both pain-related variables (intensity, tolerance, threshold, time perception, and pain sensitivity range) and cognitive variables (self-efficacy and catastrophizing). Results showed that in comparison with the control condition, the VRC intervention significantly increased pain tolerance, the pain sensitivity range, and the degree of time underestimation. It also increased self-efficacy in tolerating pain and led to a reduction in reported helplessness. The VRD intervention significantly increased the pain threshold and pain tolerance in comparison with the control condition, but it did not affect any of the cognitive variables. Overall, the intervention designed to enhance control seems to have a greater effect on the cognitive variables assessed. Although these results need to be replicated in further studies, the findings suggest that the VRC intervention has considerable potential in terms of increasing self-efficacy and modifying the negative thoughts that commonly accompany pain problems.

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A Virtual Reality System Combined with Biofeedback for Treating Pediatric Chronic Headache—A Pilot Study

Abstract: This novel system, combining biofeedback and virtual reality, is feasible for pediatric use. Randomized controlled studies in larger populations are needed in order to determine the utility of the system in reducing headache, improving daily functioning, and elevating quality of life.

Cited by 95 publications

References 37 publications

The Virtual Meditative Walk

The Virtual Meditative Walk

Virtual reality as complementary pain therapy in hospitalized patients with sickle cell disease

Differential Effects of Two Virtual Reality Interventions: Distraction Versus Pain Control

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