Virtual reality for management of pain in hospitalized patients: A randomized comparative effectiveness trial
Brennan Spiegel,Garth Fuller,Mayra Lopez,Taylor Dupuy,Benjamin Noah,Amber Howard,Michael Albert,Vartan C. Tashjian,Richard Lam,Joseph C. Ahn,Francis Dailey,Bradley T. Rosen,Mark S. Vrahas,Milton T.M. Little,John M. Garlich,Eldin Dzubur,Waguih William IsHak,Itai Danovitch +17 more
TLDR
Therapeutic virtual reality significantly reduces pain versus an active control condition in hospitalized patients and is most effective for severe pain.Abstract:
Objectives Therapeutic virtual reality (VR) has emerged as an effective, drug-free tool for pain management, but there is a lack of randomized, controlled data evaluating its effectiveness in hospitalized patients. We sought to measure the impact of on-demand VR versus “health and wellness” television programming for pain in hospitalized patients. Methods We performed a prospective, randomized, comparative effectiveness trial in hospitalized patients with an average pain score of ≥3 out of 10 points. Patients in the experimental group received a library of 21 VR experiences administered using the Samsung Gear Oculus headset; control patients viewed specialized television programming to promote health and wellness. Clinical staff followed usual care; study interventions were not protocolized. The primary outcome was patient-reported pain using a numeric rating scale, as recorded by nursing staff during usual care. Pre- and post-intervention pain scores were compared immediately after initial treatment and after 48- and 72-hours. Results There were 120 subjects (61 VR; 59 control). The mean within-subject difference in immediate pre- and post-intervention pain scores was larger in the VR group (-1.72 points; SD 3.56) than in the control group (-0.46 points; SD 3.01); this difference was significant in favor of VR (P < .04). When limited to the subgroup of patients with severe baseline pain (≥7 points), the effect of VR was more pronounced vs. control (-3.04, SD 3.75 vs. -0.93, SD 2.16 points; P = .02). In regression analyses adjusting for pre-intervention pain, time, age, gender, and type of pain, VR yielded a .59 (P = .03) and .56 (P = .04) point incremental reduction in pain versus control during the 48- and 72-hour post-intervention periods, respectively. Conclusions VR significantly reduces pain versus an active control condition in hospitalized patients. VR is most effective for severe pain. Future trials should evaluate standardized order sets that interpose VR as an early non-drug option for analgesia.read more
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An 8-Week Self-Administered At-Home Behavioral Skills-Based Virtual Reality Program for Chronic Low Back Pain: Double-Blind, Randomized, Placebo-Controlled Trial Conducted During COVID-19.
Laura M Garcia,Brandon Birckhead,Parthasarathy Krishnamurthy,Josh Sackman,Ian G Mackey,Robert G Louis,Vafi Salmasi,Todd Maddox,Beth D. Darnall +8 more
TL;DR: In this article, a double-blind, parallel-arm, single-cohort, remote, randomized placebo-controlled trial was conducted for a self-administered behavioral skills-based VR program in community-based individuals with self-reported chronic low back pain during the COVID-19 pandemic.
Journal ArticleDOI
Self-Administered Skills-Based Virtual Reality Intervention for Chronic Pain: Randomized Controlled Pilot Study.
TL;DR: A significant reduction in pain outcomes over the course of the 21-day treatment both within the VR group and compared with an audio-only version suggests that VR has the potential to provide enhanced treatment and greater improvement across a range of pain outcomes.
Journal ArticleDOI
Effects of Virtual Reality versus Exercise on Pain, Functional, Somatosensory and Psychosocial Outcomes in Patients with Non-specific Chronic Neck Pain: A Randomized Clinical Trial
David Morales Tejera,Hector Beltran-Alacreu,Roberto Cano-de-la-Cuerda,Jose Vicente Leon Hernandez,Aitor Martín-Pintado-Zugasti,César Calvo-Lobo,Alfonso Gil-Martínez,Josué Fernández-Carnero +7 more
TL;DR: Kinesiophobia was the only outcome that showed differences between VR and exercise at 3 months, Nevertheless, pain intensity, CPM, TS, ROM, neck disability, pain catastrophizing, fear-avoidance beliefs, PPT and anxiety did not show differences between both interventions.
Journal ArticleDOI
How the nursing profession should adapt for a digital future
TL;DR: Transformation into a digitally enabled profession will maximize the benefits to patient care, write Richard Booth and colleagues as mentioned in this paper, and they propose a model for patient care transformation in the digital health field.
Journal ArticleDOI
Better, Virtually: the Past, Present, and Future of Virtual Reality Cognitive Behavior Therapy
TL;DR: Virtual reality has been used in cognitive behavior therapy since the 1990s and accumulated an impressive evidence base, yet with the recent release of consumer VR platforms came a true paradigm shift in the capabilities and scalability of VR for mental health.
References
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Journal ArticleDOI
Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale
TL;DR: Using a standard outcome across chronic pain studies would greatly enhance the comparability, validity, and clinical applicability of these studies, and the application of these results to future studies may provide a standard definition of clinically important improvement in clinical trials of chronic pain therapies.
Journal ArticleDOI
Core outcome domains for chronic pain clinical trials: IMMPACT recommendations.
Dennis C. Turk,Robert H. Dworkin,Robert R. Allen,Nicholas Bellamy,Nancy A. Brandenburg,Daniel B. Carr,Charles S. Cleeland,Raymond A. Dionne,John T. Farrar,Bradley S. Galer,David J. Hewitt,Alejandro R. Jadad,Nathaniel P. Katz,Lynn D. Kramer,Donald C. Manning,Cynthia McCormick,Michael P. McDermott,Patrick J. McGrath,Steve Quessy,Bob A. Rappaport,James P. Robinson,Mike A. Royal,Lee S. Simon,Joseph W. Stauffer,Wendy M. Stein,Jane Tollett,James Witter +26 more
TL;DR: In this article, the authors provide recommendations for the core outcome domains that should be considered by investigators conducting clinical trials of the efficacy and effectiveness of treatments for chronic pain, and develop a core set of outcome domains would facilitate comparison and pooling of d
Journal ArticleDOI
Topical Review and RecommendationsCore outcome measures for chronic pain clinical trials: IMMPACT recommendations
Robert H. Dworkin,Dennis C. Turk,John T. Farrar,Jennifer A. Haythornthwaite,Mark P. Jensen,Nathaniel P. Katz,Robert D. Kerns,Gerold Stucki,Robert R. Allen,Nicholas Bellamy,Daniel B. Carr,Julie Chandler,Penney Cowan,Raymond A. Dionne,Bradley S. Galer,Sharon Hertz,Alejandro R. Jadad,Lynn D. Kramer,James Witter +18 more
Journal ArticleDOI
Minimal clinically important changes in chronic musculoskeletal pain intensity measured on a numerical rating scale.
TL;DR: The minimal clinically important difference (MCID) of changes in chronic musculoskeletal pain intensity that is most closely associated with improvement on the commonly used and validated measure of the patient's global impression of change (PGIC) is determined.
Journal ArticleDOI
A discussion of cybersickness in virtual environments
TL;DR: A number of the primary factors that contribute to the cause of cybersickness are discussed, three conflicting cybersickenness theories that have been postulated are described, and some possible methods for reducing cyberedickness in VEs are discussed.