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Randomized Controlled Trial
. 2020 Apr 22;17(1):55.
doi: 10.1186/s12984-020-00688-0.

Virtual reality distraction induces hypoalgesia in patients with chronic low back pain: a randomized controlled trial

Thomas Matheve  1 , Katleen Bogaerts  2   3 , Annick Timmermans  2
Affiliations
Randomized Controlled Trial

Virtual reality distraction induces hypoalgesia in patients with chronic low back pain: a randomized controlled trial

Thomas Matheve et al. J Neuroeng Rehabil. .

Abstract

Background: Attentional distraction from pain has been shown to be largely ineffective for obtaining a hypoalgesic effect in patients with chronic pain when compared to a control condition. It has been hypothesized that this may be due to the non-engaging types of distraction that have been used so far. Moreover, it is suggested that the hypoalgesic effects of distraction may be attenuated by pain-related cognitions and emotions, as they may increase the attention to pain.

Methods: In this randomized controlled trial, patients with chronic nonspecific low back pain in the intervention group (n = 42) performed a single exercise session with nonimmersive VR games, while those in the control group (n = 42) performed the same exercises without VR games. We investigated whether VR distraction had a hypoalgesic effect during and immediately after the exercises, and whether it reduced the time spent thinking of pain during the exercises. We further explored whether pain-related fear, pain catastrophizing and baseline pain intensity moderated the effects of VR distraction.

Results: VR distraction had a hypoalgesic effect during (Cohen's d = 1.29) and immediately after (Cohen's d = 0.85) the exercises, and it also reduced the time spent thinking of pain (Cohen's d = 1.31). Preliminary exploratory analyses showed that pain-related fear, pain catastrophizing and baseline pain intensity did not moderate the effects of VR distraction.

Conclusions: Large effect sizes of VR distraction induced hypoalgesia were observed. This suggests that nonimmersive VR games can be used when it is deemed important to reduce the pain during exercises in patients with chronic nonspecific low back pain.

Trial registration: NCT02679300. This trial was registered on 10 February 2016.

Keywords: Analgesia; Catastrophizing; Chronic low back pain; Distraction; Gamification; Pain-related fear; Virtual reality.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
a: Participant playing the VR games. b-c: VR games
Fig. 2
Fig. 2
Flowchart of participants
See this image and copyright information in PMC

References

    1. Birnie KA, Chambers CT, Spellman CM. Mechanisms of distraction in acute pain perception and modulation. Pain. 2017;158:1012–1013. doi: 10.1097/j.pain.0000000000000913. - DOI - PubMed
    1. Van Ryckeghem D, Van Damme S, Eccleston C, Crombez G. The efficacy of attentional distraction and sensory monitoring in chronic pain patients: a meta-analysis. Clin Psychol Rev. 2018;59:16–29. doi: 10.1016/j.cpr.2017.10.008. - DOI - PubMed
    1. Boerner KE, Birnie KA, Chambers CT, Taddio A, McMurtry CM, Noel M, Shah V, Pillai Riddell R. Simple psychological interventions for reducing pain from common needle procedures in adults: systematic review of randomized and quasi-randomized controlled trials. Clin J Pain. 2015;31:S90–S98. doi: 10.1097/AJP.0000000000000270. - DOI - PMC - PubMed
    1. Kola S, Walsh JC, Hughes BM, Howard S. Attention focus, trait anxiety and pain perception in patients undergoing colposcopy. Eur J Pain. 2012;16:890–900. doi: 10.1002/j.1532-2149.2011.00068.x. - DOI - PubMed
    1. Verhoeven K, Crombez G, Eccleston C, Van Ryckeghem DM, Morley S, Van Damme S. The role of motivation in distracting attention away from pain: an experimental study. Pain. 2010;149:229–234. doi: 10.1016/j.pain.2010.01.019. - DOI - PubMed

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