The short-term effects of head-mounted virtual-reality on neuropathic pain intensity in people with spinal cord injury pain: a randomised cross-over pilot study
The short-term effects of head-mounted virtual-reality on neuropathic pain intensity in people with spinal cord injury pain: a randomised cross-over pilot study
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DOI：
10.1038/s41393-020-00569-2
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发表时间：
2020-10-19
期刊：
影响因子：
2.2
通讯作者：
Siddall, Philip J.
中科院分区：
文献类型：
--
作者：
Austin, Philip D.;Craig, Ashley;Siddall, Philip J.
研究设计受试者内随机交叉试验。目的确定与使用2D屏幕设备相比，市售3D头戴式（HMD）虚拟现实（VR）设备是否能显著减少脊髓损伤（SCI）患者的神经性疼痛。设置格林威治医院，悉尼，澳大利亚。方法16名患有SCI和慢性神经性疼痛的男性参与了一项单次随机交叉试验。我们比较了3D HMD VR和2D屏幕应用程序对SCI神经性疼痛强度和感知存在水平的影响。结果与2D屏幕应用相比，3D HMD VR后受试者报告的疼痛强度显著降低（1.9 +/- SD 1.8vs3.4 +/- SD 1.6，95%CI：1.5，P < 0.0001）。与2D屏幕相比，参与者报告3D HMD VR的感知存在水平显著更高（49.6 +/- SD 8.9 vs 32.8 +/- SD 11.1，平均95% CI：16.6，P < 0.0001）。无论两种情况的随机顺序如何，感知存在的增加与疼痛强度显著降低相关（平均95%CI：0.06，P = 0.005）。使用3D HMD VR减轻疼痛的效应量为0.80。结论我们认为3D HMD VR可以为SCI患者提供神经病理性疼痛缓解。考虑到缺乏晕机和容易访问，我们建议沉浸式VR可能是当前药物治疗的一个有用的辅助手段。需要进一步的研究来证明VR可以有效地长期减少SCI疼痛。
Study design Within-subject, randomised cross-over trial. Objectives To determine whether a commercially available 3D head-mounted (HMD) virtual reality (VR) device results in significant reductions in neuropathic pain compared to using a 2D screen device in people with spinal cord injury (SCI). Setting Greenwich Hospital, Sydney, Australia. Methods Sixteen men with established SCI and chronic neuropathic pain participated in a single-session randomised cross-over trial. We compared the effects of 3D HMD VR and a 2D screen application on SCI neuropathic pain intensity and levels of perceived presence. Results Participants reported significantly lower pain intensity after 3D HMD VR compared to 2D screen application (1.9 +/- SD 1.8 versus 3.4 +/- SD 1.6, mean 95% CI: 1.5,P < 0.0001). Participants reported significantly higher perceived levels of presence with the 3D HMD VR compared to 2D screen of (49.6 +/- SD 8.9 versus 32.8 +/- SD 11.1, mean 95% CI: 16.6,P < 0.0001). Increased perceived presence was associated with significantly lower pain intensity regardless of randomised sequencing of the two conditions (mean 95% CI: 0.06,P = 0.005). Effect size for pain reduction using 3D HMD VR was 0.80. Conclusions We suggest that 3D HMD VR may provide neuropathic pain relief for people with SCI. Given the lack of cybersickness and ease of access, we propose that immersive VR could be a helpful adjunct to current pharmacotherapy. Further research is required to show that VR can be effective for more long-term reductions in SCI pain.