(380) Preliminary Feasibility of a Graded, Locomotor-Enabled, Whole-Body Virtual Reality Intervention for Individuals with Chronic Low Back Pain

Abstract

Pain-related fear in individuals with chronic low back pain (cLBP) is associated with decreased quality of life and increased disability. Individuals with cLBP and elevated pain-related fear avoid movements perceived as threatening. Virtual reality (VR) can provide graded exposure to fearfully perceived movements, but most VR interventions limit maneuverability to a defined area, and thus limit user experience. We developed six VR gaming modules, in partnership with From the Future Studios ( http://www.ftfstudios.com/ ), to provide progressively challenging physical activities for individuals with cLBP. Users wear a head-mounted display (HTC Vive) while walking on a self-driven treadmill. Users walk, reach, and crouch to accomplish game objectives in VR, like approaching and fighting monsters and crouch-walking beneath obstacles. Unlike typical VR systems, our treadmill-environment allows for unhindered movement and a natural walking experience, not limited by room size or physical obstacles in the room. We assessed the feasibility of using these graded VR walking games as an intervention tool for individuals with cLBP. Participants attended three sessions over a one-week period, experiencing two VR modules per session. Additionally, participants filled out a baseline and follow-up questionnaire and reported their daily pain throughout the study period. 13 participants (8 females) with cLBP were recruited from the local Birmingham area, 12 of whom completed the study (92.3% retention). Participants responded that the VR experience was “enjoyable”, “fun” and “interesting”. Treatment Evaluation Inventory scores (Mean = 30.50, SD=4.93) suggest that participants viewed the VR modules as an acceptable treatment. Pain intensity and kinesiophobia did not increase significantly over the study period (t=0.84, p>0.05 and t=-0.32, p>0.05). These results suggest that graded VR walking challenges can be performed by individuals with cLBP without increasing pain or pain-related fear. Future studies will further explore the treatment effects of our VR walking-environment in individuals with cLBP.