Virtual Reality as a Clinical Tool for Pain Management

Pourmand, Ali; Davis, Steven; Marchak, Alex; Whiteside, Tess; Sikka, Neal

doi:10.1007/s11916-018-0708-2

Cited by 225 publications

(148 citation statements)

References 25 publications

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“…It has also show to be effective for posttraumatic stress disorder . Over the past decade, VR has also been associated with an improvement in acute pain symptoms . To the best of our knowledge, no studies to this date have examined the feasibility or effectiveness of VR in an outpatient rheumatology setting.…”

Section: Discussionmentioning

confidence: 99%

Virtual Reality–Based Biofeedback and Guided Meditation in Rheumatology: A Pilot Study

Venuturupalli

Chu²,

Vicari³

et al. 2019

ACR Open Rheumatology

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Objective. As technology continues to improve, it plays an increasingly vital role in the practice of medicine. This study aimed to assess the feasibility of the implementation of virtual reality (VR) in a rheumatology clinic as a platform to administer guided meditation and biofeedback as a means of reducing chronic pain.Methods. Twenty participants were recruited from a rheumatology clinic. These participants included adults with physician-diagnosed autoimmune disorders who were on a stable regimen of medication and had a score of at least 5 on the pain Visual Analog Scale (VAS) for a minimum of 4 days during the prior 30 days. VAS, part of most composite outcome measurements in rheumatology, is an instrument used to assess pain that consists of a straight line with the endpoints ranging from "no pain at all" and "pain as bad as it could be." Patients were randomized into two groups that differed in the order in which they experienced the two VR modules. One module consisted of a guided meditation (GM) environment, whereas the other module consisted of a respiratory biofeedback (BFD) environment. Data on pain and anxiety levels were gathered before, during, and after the two modules.Results. The three most common diagnoses among participants were rheumatoid arthiritis (RA), lupus, and fibromyalgia. There was a significant reduction in VAS scores after BFD and GM (P values = 0.01 and 0.04, respectively). There was a significant reduction in Facial Anxiety Scale after the GM compared with the BFD (P values = 0.02 and 0.08, respectively).Conclusion. This novel study demonstrated that VR could be a feasible solution for the management of pain and anxiety in rheumatology patients. Further trials with varying treatment exposures and durations are required to solidify the viability of VR as a treatment option in rheumatology clinics.

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Section: Discussionmentioning

confidence: 99%

Virtual Reality–Based Biofeedback and Guided Meditation in Rheumatology: A Pilot Study

Venuturupalli

Chu²,

Vicari³

et al. 2019

ACR Open Rheumatology

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“…It is thought that in order to draw the attention away from the pain, the competing stimulus should be sufficiently engaging [19]. In this respect, interactive virtual reality (VR) games may prove to be a promising tool [20][21][22][23][24], as they are typically considered to be motivating [25].…”

Section: Introductionmentioning

confidence: 99%

Virtual reality distraction induces hypoalgesia in patients with chronic low back pain: a randomized controlled trial

Matheve

Bogaerts

Timmermans

2020

J NeuroEngineering Rehabil

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Background: Attentional distraction from pain has been shown to be largely ineffective for obtaining a hypoalgesic effect in patients with chronic pain when compared to a control condition. It has been hypothesized that this may be due to the non-engaging types of distraction that have been used so far. Moreover, it is suggested that the hypoalgesic effects of distraction may be attenuated by pain-related cognitions and emotions, as they may increase the attention to pain. Methods: In this randomized controlled trial, patients with chronic nonspecific low back pain in the intervention group (n = 42) performed a single exercise session with nonimmersive VR games, while those in the control group (n = 42) performed the same exercises without VR games. We investigated whether VR distraction had a hypoalgesic effect during and immediately after the exercises, and whether it reduced the time spent thinking of pain during the exercises. We further explored whether pain-related fear, pain catastrophizing and baseline pain intensity moderated the effects of VR distraction. Results: VR distraction had a hypoalgesic effect during (Cohen's d = 1.29) and immediately after (Cohen's d = 0.85) the exercises, and it also reduced the time spent thinking of pain (Cohen's d = 1.31). Preliminary exploratory analyses showed that pain-related fear, pain catastrophizing and baseline pain intensity did not moderate the effects of VR distraction. Conclusions: Large effect sizes of VR distraction induced hypoalgesia were observed. This suggests that nonimmersive VR games can be used when it is deemed important to reduce the pain during exercises in patients with chronic nonspecific low back pain.

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“…There have been several other studies that demonstrate a sedation or analgesic sparing effect of IVR [7][8][9][10][11]. Further efforts have also been made to commercialize IVR, with little high-quality evidence of effectiveness [12].…”

Section: Introductionmentioning

confidence: 99%

Effects of immersive virtual reality therapy on intravenous patient-controlled sedation during orthopaedic surgery under regional anesthesia: A randomized controlled trial

2020

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Background Immersive virtual reality (IVR) is a form of distraction therapy that has shown potential as an analgesia and sedation sparing agent. This study assessed the effect of IVR on the selfadministered sedation requirements of patients undergoing joint replacement surgery under regional anesthesia in a single center. Methods and findings This study was a single-center, randomized control trial at St Vincent's Hospital in Melbourne, Australia. Fifty patients undergoing elective total knee and total hip arthroplasty were randomized to IVR and Propofol patient-controlled sedation (PCS) or propofol PCS alone. The primary outcome measure was intra-operative propofol use. Secondary outcomes included pattern of propofol use over time, use of adjunct analgesia, unmet propofol demand, and patient satisfaction survey scores. Of 50 total patients, 25 received IVR in conjunction with PCS, and 25 received PCS alone. All patients received adjunct analgesia from the treating Anesthesiologist. Median propofol use/hour over the entire procedure in the control group was 40 (11.1, 93.9) mg/hour compared with 45 (0, 94.7) mg/hour in the IVR group (p = 0.90). There were no differences in patterns of propofol use over the course of each procedure. Adjusting for various baseline characteristics did not change the results. Postoperative satisfaction scores were equivalent in both groups. The VR intervention was well tolerated by all patients, with no report of major side effects. Key limitations were relatively small sample size, the non-blinded nature of the study, and use of adjunct analgesia. Conclusions In patients receiving joint replacement surgery under regional anesthesia with PCS, IVR was well tolerated but did not decrease the overall sedation requirement.

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Virtual Reality as a Clinical Tool for Pain Management

Cited by 225 publications

References 25 publications

Virtual Reality–Based Biofeedback and Guided Meditation in Rheumatology: A Pilot Study

Virtual Reality–Based Biofeedback and Guided Meditation in Rheumatology: A Pilot Study

Virtual reality distraction induces hypoalgesia in patients with chronic low back pain: a randomized controlled trial

Effects of immersive virtual reality therapy on intravenous patient-controlled sedation during orthopaedic surgery under regional anesthesia: A randomized controlled trial

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