Title : Immersive virtual reality: A new direction in the management of neuropathic pain in spinal cord injury
Abstract:
Objectives:
- Main: To study the reduction in neuropathic pain using immersive virtual reality as a modality.
- Secondary: To evaluate the presence of depersonalization in persons with spinal cord injury who have neuropathic pain and the effect of virtual reality on it.
Trial design: Double blinded, Randomized controlled trial.
Setting: Rehabilitation center of a tertiary care teaching Hospital in South India.
Participants: 52 persons with spinal cord injury (SCI) ASIA A, B and C who had neuropathic pain score of 12 or more on LANSS scale and who were on stable pharmacological treatment. Randomized using computer generated block randomization.
Methods: The intervention group was given immersive VR environment exposure in the form of virtual wheelchair propulsion, cycling, and walking on a VR head-mounted display, for 15 minutes per session, 2 sessions per day, 5 days a week, for 2 weeks. The control group was shown 2D animated films for the same period, in the same device.
Outcome measures:
- Visual Analog Scale (VAS) for neuropathic pain
- Cambridge Depersonalization Scale (CDS) for depersonalization.
Result: 43 patients completed the study (intervention - 23; control – 19). VAS showed statistically significant improvement in both groups (p<0.005). However, the reduction in pain was two times greater in intervention than the control. CDS showed statistically significant improvement with immersive VR intervention group (p=0.003)
Conclusion: Immersive VR is a potent nonpharmacological, non-invasive modality for management of neuropathic pain in spinal cord injury (SCI) with minimal adverse effects, portability, ease of use and customization. It improves embodiment and enables ownership in paraplegics. Thereby immersive VR may help in improving quality of life in SCI population.
Keywords: Spinal cord injuries, paraplegia, neuralgia, depersonalization, virtual reality, rehabilitation
Audience Take Away Note:
- Immersive Virtual reality (VR) is a new and rapidly developing technology. The possibilities of application of VR in the medical field are limitless. This study will provide insight into the role of virtual reality (VR) in neuropathic pain management in persons with Spinal Cord Injury.
- Provide in-depth understanding about the scientific basis of immersive VR in pain management.
- Help to understand the duration of the effect of immersive VR in pain management.
- The audience can incorporate and improve this idea of immersive VR in their various research.
- Provide newer directions in the non-invasive management of chronic pain.
