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Heartbeat-enhanced immersive virtual reality to treat complex regional pain syndrome.
- Source :
-
Neurology [Neurology] 2018 Jul 31; Vol. 91 (5), pp. e479-e489. Date of Electronic Publication: 2018 Jul 06. - Publication Year :
- 2018
-
Abstract
- Objectives: To develop and test a new immersive digital technology for complex regional pain syndrome (CRPS) that combines principles from mirror therapy and immersive virtual reality and the latest research from multisensory body processing.<br />Methods: In this crossover double-blind study, 24 patients with CRPS and 24 age- and sex-matched healthy controls were immersed in a virtual environment and shown a virtual depiction of their affected limb that was flashing in synchrony (or in asynchrony in the control condition) with their own online detected heartbeat (heartbeat-enhanced virtual reality [HEVR]). The primary outcome measures for pain reduction were subjective pain ratings, force strength, and heart rate variability (HRV).<br />Results: HEVR reduced pain ratings, improved motor limb function, and modulated a physiologic pain marker (HRV). These significant improvements were reliable and highly selective, absent in control HEVR conditions, not observed in healthy controls, and obtained without the application of tactile stimulation (or movement) of the painful limb, using a readily available biological signal (the heartbeat) that is most often not consciously perceived (thus preventing placebo effects).<br />Conclusions: Next to these specific and well-controlled analgesic effects, immersive HEVR allows the application of prolonged and repeated doses of digital therapy, enables the automatized integration with existing pain treatments, and avoids application of painful bodily cues while minimizing the active involvement of the patient and therapist.<br />Classification of Evidence: This study provides Class III evidence that HEVR reduces pain and increases force strength in patients with CRPS.<br /> (© 2018 American Academy of Neurology.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Complex Regional Pain Syndromes physiopathology
Cross-Over Studies
Double-Blind Method
Electrocardiography methods
Female
Humans
Male
Middle Aged
Complex Regional Pain Syndromes diagnosis
Complex Regional Pain Syndromes therapy
Heart Rate physiology
Pain Measurement methods
Virtual Reality Exposure Therapy methods
Subjects
Details
- Language :
- English
- ISSN :
- 1526-632X
- Volume :
- 91
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Neurology
- Publication Type :
- Academic Journal
- Accession number :
- 29980635
- Full Text :
- https://doi.org/10.1212/WNL.0000000000005905