Pain Rehabilitation Virtual Reality (PRVR): Innovations to Enhance Mobility in the Presence of Pain

Stanford University

Status: Completed

Conditions: Musculoskeletal Pain; Fibromyalgia; Chronic Pain; Virtual Reality

Treatments: Behavioral: Standard Physiotherapy Rehabilitation (SPR); Behavioral: Pain Rehabilitation Virtual Reality (PRVR)

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT04636177

R21AR079140 (U.S. NIH Grant/Contract)

68669

Details and patient eligibility

About

The proposed research is a single arm feasibility trial of pain rehabilitation virtual reality (PRVR) aimed at measuring feasibility, acceptability and utility of VR as well as changes in physical function and fear for adolescents with chronic musculoskeletal pain. The intervention includes standard physiotherapy treatment including functional goal setting and progressive exercise.

Enrollment: 34 patients

Sex: All

Ages: 10 to 17 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• 10 to 17 years old
• Musculoskeletal pain (e.g. localized [back, limb], diffuse) not due to acute trauma (e.g. active sprain or fracture)
• English Language Proficiency

Exclusion criteria

• Significant cognitive impairment (e.g., brain injury)
• Significant medical or psychiatric problem that would interfere (e.g. psychosis, suicidality)
• Presents with a condition that interferes with virtual reality usage (e.g., history of seizure, facial injury precluding safe placement of headset, visual impairment, significant hearing impairment impact ability to follow audio instructions).

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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34 participants in 2 patient groups

Pain Rehabilitation Virtual Reality (PRVR)

Experimental group

Description:

Participants will complete VR in PT to engage participants in a series of immersive games customized to align with individual PT needs delivered over \~6-12 weeks or until clinician believes the patient is done with treatment. Patients in the PRVR arm will be given a structured HEP to practice prescribed exercises at home with integrated VR activities. PRVR participants will be allocated a VR headset for use in PT sessions and with HEP. VR will supplement treatment and be used in session (either in-person or telehealth) and at home as part of their prescribed treatment homework.

Treatment:

Behavioral: Pain Rehabilitation Virtual Reality (PRVR)

Standard Physiotherapy Rehabilitation (SPR)

Active Comparator group

Description:

Sessions are individually-tailored and based on the Guide to Physical Therapy Practice 3.0 consisting of 1) therapeutic exercise, 2) balance and proprioception, 3) strength training, and 4) use of modalities (e.g., heat/cold pack). Patients will be given a structured Home Exercise Program (HEP) with prescribed exercises for home. SPR participants will be allocated a VR headset for recreational use.

Treatment:

Behavioral: Standard Physiotherapy Rehabilitation (SPR)