PHYSIOTHERAPY IN A VIRTUAL WORLD: VIRTUAL REALITY IN THE TREATMENT OF CHRONIC PAIN

C. Pollard¹, N. Tuck², D. Bean³

¹Te Whatu Ora, Te Toka Tumai, Health New Zealand, Allied Health, Auckland, New Zealand, ²Auckland University of Auckland, Health and Rehabilitation Research, Auckland, New Zealand, ³Auckland University of Technology, Health and Rehabilitation Research, Auckland, New Zealand

Background: Improving function in people with chronic pain is a primary focus in their management. However, many people with chronic pain find functional activation programs aversive, and dropout rates are high. Virtual Reality (VR) games may make functional activation more fun and novel, promoting greater success with therapy. Yet, many questions remain regarding the application (dosage /type of VR /application techniques) or the acceptability of this form of treatment within a chronic pain population.

Purpose: To describe the potential uses of VR for chronic pain management, provide clinical insight into the application of VR in a clinical setting, and explore the acceptability, feasibility and effectiveness of VR to improve function for people with chronic pain.

Methods: This presentation will draw on the current literature regarding the use of VR for chronic pain management and describe the application of VR in a routine clinical setting. Research data from a randomised controlled pilot study will also be included. In this trial, participants (n=29) were randomly allocated to 6-week of active VR intervention or physiotherapy treatment as usual (TAU). The TAU group completed a 6-week waitlist (WL) preceding treatment, to act as a no treatment control group. VR sessions used commercially available gaming software to encourage movement. Qualitative and quantitative data was collected.

Results: The current literature body is small but expanding, and documents that VR provides benefits including pain relief, altering proprioception and as an adjunct to exercise rehabilitation. Clinical practice insights indicate wider applicability, displaying positive influences to patient’s function and engagement with activity. Pilot study data indicated that although recruitment rates were low in the clinical setting, acceptability was high and the VR group showed greater improvements in activity levels, pain intensity, and pain interference than both the waitlist and TAU groups. Qualitative themes indicated that: VR is an enjoyable alternative to traditional physiotherapy, VR has functional and psychological benefits despite continued pain, and a well-designed VR setup is important.

Conclusions: VR is increasingly popular for chronic pain management. Using commercially available active gaming is highly acceptable in clinical practice and for participants in a clinical trial. VR also produces favourable effects when compared with no treatment or active physiotherapy exercise programmes. These findings combined with current literature indicate that further study into the use of VR for chronic pain management would be necessary.

Implications: VR may provide a useful pain management tool which could be accessed within the clinical setting or within the patient’s own home to increase function in a fun and novel manner. Further research to investigate the efficacy of this approach within a larger population of people with chronic musculoskeletal pain including the long-term impact of this intervention is required.

Funding acknowledgements: Auckland University of Technology research funding was used to purchase activPAL devices. No other funding sources used for pilot study

Keywords:
Chronic pain
Virtual reality
Rehabilitation

Topics:
Pain & pain management
Disability & rehabilitation
Innovative technology: robotics

Did this work require ethics approval? Yes

Institution: New Zealand Ministry of Health

Committee: Health and Disability Ethics Committee

Ethics number: 19/CEN/106