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Accepted for/Published in: JMIR Research Protocols

Date Submitted: Jul 1, 2022
Open Peer Review Period: Jul 1, 2022 - Jul 26, 2022
Date Accepted: Sep 21, 2022
(closed for review but you can still tweet)

The final, peer-reviewed published version of this preprint can be found here:

Virtual Reality–Augmented Physiotherapy for Chronic Pain in Youth: Protocol for a Randomized Controlled Trial Enhanced With a Single-Case Experimental Design

Simons LE, Hess CW, Choate ES, Van Orden AR, Tremblay-McGaw AG, Menendez M, Boothroyd DB, Parvathinathan G, Griffin A, Caruso TJ, Stinson J, Weisman A, Liu T, Christensen R, Koeppen K

Virtual Reality–Augmented Physiotherapy for Chronic Pain in Youth: Protocol for a Randomized Controlled Trial Enhanced With a Single-Case Experimental Design

JMIR Res Protoc 2022;11(12):e40705

DOI: 10.2196/40705

PMID: 36508251

PMCID: 9793297

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

Virtual Reality Augmented Physiotherapy for Chronic Pain in Youth: Protocol for a randomized controlled trial enhanced with single case experimental design

  • Laura E Simons; 
  • Courtney Wynne Hess; 
  • Ellison S Choate; 
  • Amanda Rose Van Orden; 
  • Alexandra Georgina Tremblay-McGaw; 
  • Maria Menendez; 
  • Derek B Boothroyd; 
  • Gomathy Parvathinathan; 
  • Anya Griffin; 
  • Thomas Jon Caruso; 
  • Jennifer Stinson; 
  • Amy Weisman; 
  • Tim Liu; 
  • Rachel Christensen; 
  • Kurt Koeppen

ABSTRACT

Background:

Chronic musculoskeletal (MSK) pain is a prominent health concern, resulting in pain-related disability, loss of functioning and high healthcare costs. Physiotherapy rehabilitation is a gold standard treatment for improving functioning in youth with chronic MSK. However, increasing physical activity can feel unattainable for many adolescents due to pain related fear and movement avoidance. Virtual reality (VR) offers an immersive experience that can interrupt the fear-avoidance cycle and improve engagement in physiotherapy. Despite promising initial findings, data are limited and often lack the rigor required to establish VR as an evidence-based treatment for MSK pain.

Objective:

This trial evaluates pain rehabilitation virtual reality (PRVR) for adolescents with MSK pain. This protocol paper outlines the rationale, design, and implementation of a two-group randomized control trial (RCT) enhanced with Single Case Experimental Design (SCED). The objective of this RCT is to test this advancement in VR technology by providing new treatment solutions targeting nonpharmacological movement facilitation.

Methods:

Primary outcomes include physical function and engagement in VR. Secondary outcomes include pain-related fear and treatment adherence.

Results:

Significant breakthroughs for treating MSK pain require mechanistically informed innovative approaches. PRVR provides exposure to progressive challenge, real-time feedback, reinforcement for movement and can include activities difficult to achieve in the real world. It has the added benefits of sustaining patient motivation and adherence while enabling clinicians to use objective benchmarks to influence progression.

Conclusions:

These findings will inform the decision of whether to proceed with a hybrid effectiveness-dissemination trial of PRVR, serving as the basis for potential large-scale implementation of PRVR. Clinical Trial: NCT04636177


 Citation

Please cite as:

Simons LE, Hess CW, Choate ES, Van Orden AR, Tremblay-McGaw AG, Menendez M, Boothroyd DB, Parvathinathan G, Griffin A, Caruso TJ, Stinson J, Weisman A, Liu T, Christensen R, Koeppen K

Virtual Reality–Augmented Physiotherapy for Chronic Pain in Youth: Protocol for a Randomized Controlled Trial Enhanced With a Single-Case Experimental Design

JMIR Res Protoc 2022;11(12):e40705

DOI: 10.2196/40705

PMID: 36508251

PMCID: 9793297

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