JMIR Publications

ABSTRACT

Background:

Complex Regional Pain Syndrome (CRPS) is a rare and severe chronic pain condition, with effective treatment options not established for many patients. The underlying pathophysiology is still unclear, but there is a growing appreciation for the role of central mechanisms which have formed the basis for brain based therapies such as transcranial magnetic stimulation and mirror visual feedback (MVF). MVF has been deployed in the treatment of Complex Regional Pain Syndrome (CRPS) using both conventional mirrors and virtual reality (VR).

Objective:

To further investigate the use of virtual reality (VR) in the treatment of unilateral upper limb Complex Regional Pain Syndrome (CRPS) patients. Virtual reality has the potential advantage of more flexible and more motivating tasks, as well as the option of tracking patient improvement through the use of movement data.

Methods:

We describe the development, acceptability, feasibility, and usability of an open-source virtual reality program mirror visual feedback module designed to be used with consumer virtual reality systems for the treatment of Complex Regional Pain Syndrome. The development team was an interdisciplinary group of physical therapists, pain researchers, and virtual reality researchers. Patients recruited from a pain clinic completed 4-5 visits each to trial the system and assessed their experiences in pre- and post-treatment questionnaires.

Results:

Nine of nine (100%) of participants were able to use the system for three, four or five trials each. Zero participants quit any trial due to cybersickness. Nine of nine (100%) of participants reported interest in using the module in the future. We did not find a statistically significant effect on participants’ self-reported average pain scores.

Conclusions:

We propose that this module could be a useful starting point for modification and testing for other researchers. We share modifications to make this module usable with standalone headsets and finger tracking. Next steps include adapting this module for at-home use, or for use with participants with lower-limb pain.