Virtual reality for spinal cord injury-associated neuropathic pain: Systematic review

Chi, Bradley; Chau, Brian; Yeo, Elizabeth; Ta, Phillip

doi:10.1016/j.rehab.2018.09.006

Cited by 71 publications

(55 citation statements)

References 70 publications

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“…Chronic pain is common in older adults, limiting independence, physical movement, and social activity [ 53 , 72 ]. Although more knowledge is needed about VR interventions to reduce or manage pain in older adults, VR has been used extensively in other age groups, and there is scientific evidence that VR can reduce the pain that is experienced [ 73 , 74 ]. VR exposure therapy interventions have been applied to reduce extreme fears such as phobias [ 73 - 75 ].…”

Section: Discussionmentioning

confidence: 99%

“…Although more knowledge is needed about VR interventions to reduce or manage pain in older adults, VR has been used extensively in other age groups, and there is scientific evidence that VR can reduce the pain that is experienced [ 73 , 74 ]. VR exposure therapy interventions have been applied to reduce extreme fears such as phobias [ 73 - 75 ]. After a fall or similar accident, older adults often suffer from extreme fear of falling, which could be very limiting to staying physically active [ 76 ].…”

Section: Discussionmentioning

confidence: 99%

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The Role of Virtual Reality in Improving Health Outcomes for Community-Dwelling Older Adults: Systematic Review

et al. 2020

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Background Virtual reality (VR) delivered through immersive headsets creates an opportunity to deliver interventions to improve physical, mental, and psychosocial health outcomes. VR app studies with older adults have primarily focused on rehabilitation and physical function including gait, balance, fall prevention, pain management, and cognition. Several systematic reviews have previously been conducted, but much of the extant literature is focused on rehabilitation or other institutional settings, and little is known about the effectiveness of VR apps using immersive headsets to target health outcomes among community-dwelling older adults. Objective The objective of this review was to evaluate the effectiveness of VR apps delivered using commercially available immersive headsets to improve physical, mental, or psychosocial health outcomes in community-dwelling older adults. Methods Peer-reviewed publications that included community-dwelling older adults aged ≥60 years residing in residential aged care settings and nursing homes were included. This systematic review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology for systematic reviews of effectiveness evidence. The title of this review was registered with JBI, and the systematic review protocol was registered with the International Prospective Register of Systematic Reviews. Results In total, 7 studies that specifically included community-dwelling older adults were included in this review. VR apps using a head-mounted display led to improvements in a number of health outcomes, including pain management, posture, cognitive functioning specifically related to Alzheimer disease, and a decreased risk of falls. A total of 6 studies reported a statistically significant difference post VR intervention, and 1 study reported an improvement in cognitive function to reduce navigational errors. Only one study reported on the usability and acceptability of the interventions delivered through VR. While one study used a distraction mechanism for pain management, none of the studies used gaming technology to promote enjoyment. Conclusions Interventions to improve health outcomes through VR have demonstrated potential; however, the ability to synthesize findings by primary outcome for the older adult population is not possible. A number of factors, especially related to frailty, usability, and acceptability, also need to be explored before more substantial recommendations on the effectiveness of VR interventions for older adults can be made. Trial Registration PROSPERO CRD42019143504; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=143504

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Role of Virtual Reality in Improving Health Outcomes for Community-Dwelling Older Adults: Systematic Review

et al. 2020

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“…Several mobile apps and video games (Table S1) received approval, or clearance, from the Food and Drug Administration (FDA) using software as a medical device (SaMD) regulatory mechanism (7,8). There are also increased interests in developing mobile apps for people living with chronic pain (9)(10)(11)(12)(13)(14)(15)(16) and epilepsy (6,(17)(18)(19).…”

Section: Introductionmentioning

confidence: 99%

Music-Enhanced Analgesia and Antiseizure Activities in Animal Models of Pain and Epilepsy: Toward Preclinical Studies Supporting Development of Digital Therapeutics and Their Combinations With Pharmaceutical Drugs

Metcalf

Huntsman

Garcia³

et al. 2019

Front. Neurol.

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Digital therapeutics (software as a medical device) and mobile health (mHealth) technologies offer a means to deliver behavioral, psychosocial, disease self-management and music-based interventions to improve therapy outcomes for chronic diseases, including pain and epilepsy. To explore new translational opportunities in developing digital therapeutics for neurological disorders, and their integration with pharmacotherapies, we examined analgesic and antiseizure effects of specific musical compositions in mouse models of pain and epilepsy. The music playlist was created based on the modular progression of Mozart compositions for which reduction of seizures and epileptiform discharges were previously reported in people with epilepsy. Our results indicated that music-treated mice exhibited significant analgesia and reduction of paw edema in the carrageenan model of inflammatory pain. Among analgesic drugs tested (ibuprofen, cannabidiol (CBD), levetiracetam, and the galanin analog NAX 5055), music intervention significantly decreased paw withdrawal latency difference in ibuprofen-treated mice and reduced paw edema in combination with CBD or NAX 5055. To the best of our knowledge, this is the first animal study on music-enhanced antinociceptive activity of analgesic drugs. In the plantar incision model of surgical pain, music-pretreated mice had significant reduction of mechanical allodynia. In the corneal kindling model of epilepsy, the cumulative seizure burden following kindling acquisition was lower in animals exposed to music. The music-treated group also exhibited significantly improved survival, warranting further research on music interventions for preventing Sudden Unexpected Death in Epilepsy (SUDEP). We propose a working Metcalf et al. Music-Enhanced Analgesic and Antiseizure Activities model of how musical elements such as rhythm, sequences, phrases and punctuation found in K.448 and K.545 may exert responses via parasympathetic nervous system and the hypothalamic-pituitary-adrenal (HPA) axis. Based on our findings, we discuss: (1) how enriched environment (EE) can serve as a preclinical surrogate for testing combinations of non-pharmacological modalities and drugs for the treatment of pain and other chronic diseases, and (2) a new paradigm for preclinical and clinical development of therapies leading to drug-device combination products for neurological disorders, depression and cancer. In summary, our present results encourage translational research on integrating non-pharmacological and pharmacological interventions for pain and epilepsy using digital therapeutics.

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“…VR offers a non-invasive and non-pharmaceutical alternative for patients with SCIrelated NP and unpleasant phantom sensations. For instance, virtual walking exercises [41][42][43], which can be performed in a domestic environment for those suffering from severe mobility impairment, may improve certain aspects of NP. Enhancing the patients′ ability to imagine themselves walking has an analgesic effect upon them, ranging from pre-post sessions to three months post-treatment.…”

Section: Vr As Therapy For Pain In Patients With Scimentioning

confidence: 99%

“…Enhancing the patients′ ability to imagine themselves walking has an analgesic effect upon them, ranging from pre-post sessions to three months post-treatment. Relief has been recorded in some patients for the level of associated unpleasantness and for certain sensory qualities of that pain [41,43]. However, the factors that make these treatments effective in reducing general pain severity remain unknown.…”

Section: Vr As Therapy For Pain In Patients With Scimentioning

confidence: 99%

Go Virtual to Get Real: Virtual Reality as a Resource for Spinal Cord Treatment

Leemhuis

Esposito

Gennaro

et al. 2021

IJERPH

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Increasingly, refined virtual reality (VR) techniques allow for the simultaneous and coherent stimulation of multiple sensory and motor domains. In some clinical interventions, such as those related to spinal cord injuries (SCIs), the impact of VR on people′s multisensory perception, movements, attitudes, and even modulations of socio-cognitive aspects of their behavior may influence every phase of their rehabilitation treatment, from the acute to chronic stages. This work describes the potential advantages of using first-person-perspective VR to treat SCIs and its implications for manipulating sensory-motor feedback to alter body signals. By situating a patient with SCI in a virtual environment, sensorial perceptions and motor intention can be enriched into a more coherent bodily experience that also promotes processes of neural regeneration and plasticity. In addition to the great potential of research, the most significant areas of interest concern is managing neuropathic pain, motor rehabilitation, and psychological well-being.

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Virtual reality for spinal cord injury-associated neuropathic pain: Systematic review

Cited by 71 publications

References 70 publications

The Role of Virtual Reality in Improving Health Outcomes for Community-Dwelling Older Adults: Systematic Review

The Role of Virtual Reality in Improving Health Outcomes for Community-Dwelling Older Adults: Systematic Review

Music-Enhanced Analgesia and Antiseizure Activities in Animal Models of Pain and Epilepsy: Toward Preclinical Studies Supporting Development of Digital Therapeutics and Their Combinations With Pharmaceutical Drugs

Go Virtual to Get Real: Virtual Reality as a Resource for Spinal Cord Treatment

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