JMIR Publications

ABSTRACT

Background:

Chronic pain has long been a major health burden that has been addressed through numerous forms of pharmacological and non-pharmacological treatment. One of the tenets of modern medicine is to minimize risk while providing efficacy. Because of its non-invasive nature, Virtual Reality provides an attractive platform for potentially developing novel therapeutic modalities.

Objective:

The purpose of the present study was to determine the feasibility of a novel virtual reality-based digital therapeutic for the treatment of chronic pain.

Methods:

An open label study assessed the feasibility of using virtual embodiment in virtual reality to treat chronic pain (Clinicaltrials.gov Identifier: NCT04060875). Twenty-four chronic pain patients were recruited from local pain clinics and completed eight sessions of a novel digital therapeutic that combines virtual embodiment with graded motor imagery to deliver functional rehabilitation exercises over the course of four weeks. Pain intensity as measured by a visual analog scale before and after each virtual embodiment training session was used as a primary outcome measure. Additionally, a battery of patient reported pain questionnaires (Fear and Avoidance Beliefs Questionnaire (FABQ), Oswestry Low Back Pain Disability Questionnaire (ODI), Pain Catastrophizing Scale (PCS), and Patient Health Questionnaire (PHQ-9)) were administered before and after eight sessions of virtual embodiment training as exploratory outcome measures to assess if the measures are appropriate and warrant a larger randomized controlled trial.

Results:

A two-way ANOVA on session x pre vs. post Virtual embodiment training revealed that individual virtual embodiment training sessions significantly reduced the intensity of pain as measured by visual analog scale. Perceived disability due to lower back pain as measured by ODI significantly improved over the four-week course of virtual embodiment regimen. Improvement was also observed on the helplessness subscale of the Pain Catastrophizing Scale.

Conclusions:

The present study provides evidence that functional rehabilitation exercises delivered in virtual reality are safe and may have positive effects on alleviating the symptoms of chronic pain. Additionally, the virtual embodiment intervention may improve perceived disability and helplessness of chronic pain patients after eight sessions. The results support the justification for a larger randomized controlled trial to assess the extent to which virtual embodiment training can exert an effect on symptoms associated with chronic pain. Clinical Trial: Clinicaltrials.gov Identifier: NCT04060875