Cluster-Randomised Controlled Trial of At-Home Virtual Reality for People With Chronic Musculoskeletal Pain on the Waiting List

IF 3.5 2区 医学 Q1 ANESTHESIOLOGY
Syl Slatman, Lieke Heesink, Reinoud Achterkamp, José Broeks, Bram Lemans, Nelson Monteiro de Oliveira, Leonie Brinckate-Oolbekkink, Diede Paarlberg, Heleen Reinders-Messelink, Remko ter Riet, Marjolein Stegeman, Jesper Knoop, Monique Tabak
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Abstract

Background

Virtual reality (VR) has been introduced as a novel intervention in chronic musculoskeletal pain (CMP) rehabilitation. However, much remains unknown about the effectiveness of VR for CMP. The aim of this study was to examine the effectiveness of VR in daily life versus no treatment for people with CMP who were on a waiting list to receive secondary pain treatment.

Methods

This study employed a cluster-randomised, controlled design. The intervention group received a novel VR application that offers pain education and pain management techniques. This home-based, stand-alone, immersive VR intervention was advised to be used daily for four weeks. The control group received no treatment. Primary outcome measure was health-related quality of life at four weeks; secondary outcome measures included various pain-related variables (e.g., pain self-efficacy). Intervention effectiveness was analysed using linear mixed models.

Results

Fifty-three participants were included in this trial (mean age: 55.5 (SD: 15)) of which 70% were women. No significant between-group differences were found at four weeks on physical (mean difference (95% CI): 0.039 (−2.810 to 2.889), p = 0.978) or mental (3.590 (−1.640 to 8.819), p = 0.172) health-related quality of life or any of the secondary outcome measures.

Discussion

The pain education VR intervention showed no effect in improving outcomes for people with CMP who were on a waiting list, compared to a no-intervention control group. Future research should investigate for which patients, settings, and timing this VR intervention could be beneficial.

Significance Statement

Prior research showed that VR could be beneficial for people with CMP. However, the results of this study showed that VR is ineffective as stand-alone therapy for people with CMP who were on a waiting list to receive secondary pain treatment.

Abstract Image

在等待名单上的慢性肌肉骨骼疼痛患者的家庭虚拟现实的集群随机对照试验
虚拟现实(VR)作为一种新的干预手段被引入慢性肌肉骨骼疼痛(CMP)康复中。然而,关于VR治疗CMP的有效性仍有许多未知之处。本研究的目的是检查VR在日常生活中的有效性,而不是等待接受继发性疼痛治疗的CMP患者没有治疗。方法采用整群随机对照设计。干预组接受了一种新颖的VR应用程序,该应用程序提供疼痛教育和疼痛管理技术。这种基于家庭的、独立的、沉浸式的虚拟现实干预被建议每天使用四周。对照组不进行任何治疗。主要结局指标是四周时与健康相关的生活质量;次要结果测量包括各种疼痛相关变量(如疼痛自我效能)。采用线性混合模型分析干预效果。结果本试验纳入53例受试者,平均年龄55.5岁(SD: 15),其中70%为女性。四周时,两组间在身体(平均差异(95% CI): 0.039(- 2.810至2.889),p = 0.978)或精神(3.590(- 1.640至8.819),与健康相关的生活质量或任何次要结局指标方面均无显著差异。与无干预对照组相比,疼痛教育VR干预在改善等候名单上的CMP患者的预后方面没有效果。未来的研究应该调查这种虚拟现实干预对哪些患者、环境和时间有益。先前的研究表明,VR可能对CMP患者有益。然而,这项研究的结果表明,对于等待接受二次疼痛治疗的CMP患者,VR作为单独治疗无效。
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来源期刊
European Journal of Pain
European Journal of Pain 医学-临床神经学
CiteScore
7.50
自引率
5.60%
发文量
163
审稿时长
4-8 weeks
期刊介绍: European Journal of Pain (EJP) publishes clinical and basic science research papers relevant to all aspects of pain and its management, including specialties such as anaesthesia, dentistry, neurology and neurosurgery, orthopaedics, palliative care, pharmacology, physiology, psychiatry, psychology and rehabilitation; socio-economic aspects of pain are also covered. Regular sections in the journal are as follows: • Editorials and Commentaries • Position Papers and Guidelines • Reviews • Original Articles • Letters • Bookshelf The journal particularly welcomes clinical trials, which are published on an occasional basis. Research articles are published under the following subject headings: • Neurobiology • Neurology • Experimental Pharmacology • Clinical Pharmacology • Psychology • Behavioural Therapy • Epidemiology • Cancer Pain • Acute Pain • Clinical Trials.
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