Virtual reality hand therapy: A new tool for nonopioid analgesia for acute procedural pain, hand rehabilitation, and VR embodiment therapy for phantom limb pain

Interacting With Virtual Objects via Embodied Avatar Hands Increases the Illusion of Presence, Increases Distraction, and Modulates VR Analgesia Effectiveness: A Randomized Crossover Trial.

“…Although immersive virtual reality can often help reduce the acute pain of patients during painful medical procedures, some medical procedures are so painful that extra strength VR analgesia may be needed. [14,22,31] The current study measured whether a stronger (more immersive) dose of virtual reality could increase analgesia. Our results indicate that the immersiveness of a VR system can be increased substantially, (e.g., via avatars) with little or no increase in VR side effects, unlike opioids, which show a dose-response increase in side effects (e.g., increased nausea and constipation) with higher doses, and opioid side effects linger for hours after the medical procedure.…”

“…After each brief thermal stimulus, participants indicated how painful they found the stimulus using Graphic Rating Scales (GRS), validated by the measures' strong associations with other measures of pain intensity, as well as through the measure's ability to detect treatment effects, [22,37,38,68,72]. GRS ratings were used to measure "worst pain", "pain unpleasantness", and "time spent thinking about pain" that correspond to three separable components of the pain experience; sensory pain, affective pain, and cognitive pain, respectively.…”

Virtual Reality Analgesia for Children With Large Severe Burn Wounds During Burn Wound Debridement

“…Improvements to the VR system to increase the illusion of presence could make the VR system more immersive, and we predict, can significantly further increase how much pain is reduced. More immersive VR systems with a wider field of view (Hoffman et al, 2006), increased interactivity (Hoffman et al, 2004b;Dahlquist et al, 2007;Wender et al, 2009), eye tracking (Al-Ghamdi et al, 2020), and tactile feedback (Hoffman et al, 1998) may help make VR more effective in the future (Hoffman et al, 2020). In addition, more effective pain medications (McIntyre et al, 2016), and a better understanding of how to integrate pharmacologic and non-pharmacologic analgesics most effectively are important directions for future research.…”

“…Due to the investment of large corporations into mass marketing of VR hardware for entertainment, this technology has recently become more immersive, more affordable, and there is an increasing demand for dissemination of effective treatments (Bailenson, 2018;Frist, 2018;Hoffman et al, 2020). VR has the potential to help improve the medical and psychological outcome of patients undergoing burn wound care, which could reduce reliance on opioids in some patients, and could significantly reduce healthcare costs.…”

“…Immersive virtual reality (VR) is proving to be an unusually effective non-drug pain control technique. VR has been shown to reduce pain and anxiety during burn care (Hoffman et al, 2000a(Hoffman et al, , 2001(Hoffman et al, , 2014Sharar et al, 2007;Carrougher et al, 2009;Soltani et al, 2018), dental procedures (Atzori et al, 2018a), venipuncture (Gold et al, 2006(Gold et al, , 2007Atzori et al, 2018b;Gold and Mahrer, 2018), blunt force trauma (Hoffman et al, 2009), and a number of other painful medical procedures (see Hoffman et al, 2000bHoffman et al, , 2011Hoffman et al, , 2019aHoffman et al, , 2020Keefe et al, 2012;Garrett et al, 2014 for reviews). Several studies have explored the effectiveness of VR pain reduction during burn wound cleaning of burn patients treated for smaller injuries [i.e., <10% Total Body Surface Area (TBSA); (Faber et al, 2013;Garrett et al, 2014;Jeffs et al, 2014;Khadra et al, 2020)].…”