Pain Reduction after Short Exposure to Virtual Reality Environments in People with Spinal Cord Injury.

Mar Cortes,Kathleen Delaney,Jordan Revis,Divija Chopra,David Putrino,Anna Smeragliuolo,Erica Breyman,Zulfi Soomro,Laura Tabacof

doi:10.3390/ijerph18178923

Abstract

Emerging literature suggests that virtual reality (VR) may be a viable therapy for neuropathic pain (NP). This pilot study aimed to investigate the immediate effect of VR in reducing NP in people with spinal cord injury (SCI). Eight individuals with chronic NP after SCI were recruited and underwent consecutive exposure to scenery and somatic virtual environments (VE). The numeric rating scale (NRS) was used to assess pain before and after exposure to each VE. The Immersive Tendencies Questionnaire (ITQ) and Presence Questionnaire (UQO-PQ) were used to investigate the interaction between reported pain relief post-intervention with immersion and presence. There was a significant reduction in pain levels (5.1 ± 0.4, mean ± SEM) after short exposure to the scenery (3.1 ± 0.7, p = 0.04) and somatic VE (3.0 ± 0.7, p = 0.04), with no difference between intervention types (p = 0.56). There was a statistically significant negative correlation between the total ITQ score and the change in NRS after the scenery VR intervention (rs = 0.743, p = 0.035). PQ scores showed no significant correlation with changes in pain following either intervention type. We found that short-term exposure to VR environments results in a reduction in chronic NP intensity in people with SCI.

Highlights

Neuropathic pain (NP) affects 40% to 70% of people with spinal cord injury (SCI) and approximately one-third of those affected describe their pain as severe or excruciating [1,2].It often leads to functional impairments and a decrease in the individual’s quality of life, as about 20% of SCI survivors report that neuropathic pain is more incapacitating than a motor disability [3]
Our pilot study showed a significant reduction in pain levels following short-term exposure to a virtual environment in people with neuropathic after SCI
The significant reductions in numeric rating scale (NRS) pain scores compared to baseline after both the scenery and somatic virtual reality (VR) interventions that were observed in this pilot trial appear to be consistent with the existing literature surrounding VR and chronic pain

Summary

Introduction

Neuropathic pain (NP) affects 40% to 70% of people with spinal cord injury (SCI) and approximately one-third of those affected describe their pain as severe or excruciating [1,2]. It often leads to functional impairments and a decrease in the individual’s quality of life, as about 20% of SCI survivors report that neuropathic pain is more incapacitating than a motor disability [3]. It has been suggested that persistent NP in people with SCI results from increased depersonalization symptoms originating from a mismatch between the sensory input and the cortical sensorimotor representation of the body [5,6]. Though NP is mechanistically well understood from the lens of body representation, treatment options for NP are limited and the efficacy of the current recommended treatment options are modest, with many reported side effects and pharmacological intolerances [10,11,12,13]

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Conclusion