Virtual reality system for cancer patients' shoulder pain and psychosocial impact

虚拟现实系统治疗癌症患者的肩部疼痛和社会心理影响

• 批准号: 8199644
• 负责人: Grigore C BURDEA
• 金额: $ 21.4万
• 依托单位: BRIGHT CLOUD INTERNATIONAL CORPORATION
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-01 至 2015-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8199644
• 关键词: Absence of pain sensation; Activities of Daily Living; Acute; Address; Adherence; Adult; Advanced Malignant Neoplasm; Adverse effects; Affect; Aluminum; American; Analgesics; Anxiety; Articular Range of Motion; Behavioral; Biosensor; Brief Pain Inventory; Burn injury; Cancer Patient; Carbon; Caring; Centers for Disease Control and Prevention (U.S.); Child; Childhood; Client; Clinic; Clinical; Cognition; Cognitive; Cognitive Therapy; Computer Systems; Computer software; Custom; Data; Data Analyses; Data Storage and Retrieval; Databases; Development; Devices; Distress; Doctor of Philosophy; Elderly; Evaluation; Exercise; Feasibility Studies; Female; Force of Gravity; Forearm; Friction; Future; Goals; Health Care Costs; Health Services Accessibility; Impairment; Improve Access; Institutional Review Boards; Intake; International; Intervention; Investigation; Java; Lead; Learning; Left; Life; Limb structure; Malignant Neoplasms; Manuals; Maps; Mastectomy; Measures; Memorial Sloan-Kettering Cancer Center; Memory; Mental Depression; Methods; Mind; Modification; Monitor; Motivation; Motor; Movement; Nursing Homes; Operative Surgical Procedures; Opioid; Outcome; Outpatients; Pain; Pain management; Palliative Care; Participant; Patient Care; Patient Monitoring; Patients; Pharmaceutical Preparations; Phase; Physicians; Play; Population; Positive Reinforcements; Prevalence; Protocols documentation; Provider; Psychologist; Publishing; Quality of life; Questionnaires; Randomized Controlled Trials; Recruitment Activity; Rehabilitation device; Rehabilitation therapy; Reporting; Resistance; Running; Sampling; Secure; Shoulder; Shoulder Pain; Sleep Disorders; Slide; Small Business Innovation Research Grant; Societies; Solutions; Structure; Surface; Syndrome; System; Technology; Testing; Therapeutic; Time; Training; Training Programs; United States National Institutes of Health; Universities; Upper Extremity; Video Games; Vision; Woman; anticancer treatment; arm; base; breast surgery; cancer type; chemotherapy; chronic pain; chronic shoulder pain; combat; computerized; design and construction; disability; distraction; dosage; executive function; eye hand coordination; grasp; improved; innovation; malignant breast neoplasm; novel; palliative; patient population; point of care; prototype; psychologic; psychosocial; rehabilitation technology; relating to nervous system; research and development; response; simulation; social; usability; virtual; virtual reality; volunteer; web-accessible; wound

DESCRIPTION (provided by applicant): It is hypothesized that it is possible to use virtual reality such that it simultaneously: 1) provides non-medication analgesia for women with chronic shoulder pain following breast surgery; 2) improves their upper extremity strength/range of movement; and 3) improves their emotive state and quality of life. This implements "a healthy mind in a healthy body" single-point-of-care approach. The long-term objective of the project is to develop a combined therapy that is superior to separately doing physical and cognitive/behavioral therapies as non-medication palliative pain care interventions. The purpose of the present investigation is to develop and feasibility test the prototype BrightArm II system integrated with dual-arm, adaptable virtual reality games, such that the patient receives gravity-gradated assistance/resistance for gentle shoulder training. This system should accommodate low-functioning patients with chronic pain and weakness in their shoulder following breast surgery, patients for whom off-the-shelf active video games are not practical. SPECIFIC AIMS The first aim is to develop the BrightArm II system for improving arm/shoulder motion range, shoulder strength, endurance, grasp strength, memory, focusing, executive function and psycho-social correlates to shoulder pain due to cancer. The second aim is to evaluate the feasibility and acceptance of the prototype for women with chronic pain due to mastectomy, through an 8-week combined physical, cognitive and emotive therapy while simultaneously monitoring pain medication intake and activities of daily living. METHODS 1) Construct the BrightArm II system by creating a vision-tracked rehabilitation table that tilts to allow assistance/resistance to either arm and can track both arms simultaneously; 2) Develop rehabilitation game software for virtual analgesia with simulations training of the physical, cognitive and emotive aspects of chronic shoulder pain. These games will automatically adapt to arm range, grip strength and patient level of distress; 3) Develop a secure web-accessible database module for game data storage and analysis. Data will be sampled transparently in real time during play and uploaded to Bright Cloud International Corp blade server; 4) Usability study with 4 adult women without disability to uncover technical problems; 5) Feasibility study with 6 adult women with chronic shoulder pain following breast surgery to remove cancer, participating in a 8-week training program on the BrightArm II system. Subjects will be evaluated for physical and cognitive/emotive function using standardized tests pre-, mid- and post-training. Additional measures will be medication intake, and patients subjective reports of pain level, system usefulness, and independence in daily activities. This project will develop a new device and therapeutic method for virtual analgesia, arm rehabilitation and cognition/emotive therapy in an integrated way providing a single-point-of-care solution. The same approach can be extended to other patient populations with chronic shoulder pain, and to pediatric care. PUBLIC HEALTH RELEVANCE: A product that simultaneously reduces women's chronic shoulder pain, improves their arm strength and reach, and combats depression following mastectomy improves their quality of life/participation, and reduces health care costs. By integrating dual-arm physical rehabilitation for shoulder/arm/grasp reach and strength with motivating custom video games, the product improves access to health care by facilitating a single-point team-care therapy. The ability of the product to also be used in the future in acute post-surgery rehabilitation further reduces health care costs by accelerating return to productive life.

描述（由申请人提供）：假设可以使用虚拟现实，使其同时：1）为乳房手术后患有慢性肩痛的女性提供非药物镇痛； 2）提高上肢力量/活动范围； 3）改善他们的情绪状态和生活质量。这实现了“健康身体中的健康思想”的单点护理方法。该项目的长期目标是开发一种联合疗法，作为非药物姑息性疼痛护理干预措施，优于单独进行物理和认知/行为疗法。本研究的目的是开发与双臂、适应性虚拟现实游戏集成的 BrightArm II 原型系统并进行可行性测试，以便患者接受重力分级的辅助/阻力，以进行温和的肩部训练。该系统应该适合乳房手术后患有慢性肩部疼痛和无力的功能低下患者，对于这些患者来说，现成的主动视频游戏不实用。具体目标 第一个目标是开发 BrightArm II 系统，以改善手臂/肩部运动范围、肩部力量、耐力、抓握力量、记忆力、注意力、执行功能以及与癌症引起的肩部疼痛相关的社会心理。第二个目标是通过为期 8 周的身体、认知和情感综合治疗，同时监测止痛药物的摄入量和日常生活活动，评估原型对于因乳房切除术而患有慢性疼痛的女性的可行性和接受度。方法 1) 通过创建视觉跟踪康复台构建 BrightArm II 系统，该康复台可倾斜以允许对任一手臂提供帮助/阻力，并可同时跟踪双臂； 2）开发虚拟镇痛康复游戏软件，对慢性肩痛的身体、认知和情感方面进行模拟训练。这些游戏会自动适应手臂范围、握力和患者的痛苦程度； 3) 开发一个安全的可通过网络访问的数据库模块，用于游戏数据存储和分析。数据将在游戏过程中实时透明采样并上传至明云国际刀片服务器； 4) 对 4 名无残疾的成年女性进行可用性研究，以发现技术问题； 5) 对 6 名在乳腺癌切除手术后患有慢性肩痛的成年女性进行可行性研究，她们参加了为期 8 周的 BrightArm II 系统培训计划。将使用训练前、训练中和训练后的标准化测试来评估受试者的身体和认知/情感功能。其他指标包括药物摄入量、患者对疼痛程度、系统有效性和日常活动独立性的主观报告。该项目将开发一种新的设备和治疗方法，用于虚拟镇痛、手臂康复和认知/情绪治疗，以综合方式提供单点护理解决方案。同样的方法可以扩展到其他患有慢性肩痛的患者群体以及儿科护理。 公共健康相关性：一种产品可以同时减轻女性的慢性肩部疼痛，提高她们的手臂力量和伸展范围，并对抗乳房切除术后的抑郁症，提高她们的生活质量/参与度，并降低医疗保健成本。通过将肩部/手臂/抓握范围和力量的双臂物理康复与激励性定制视频游戏相结合，该产品通过促进单点团队护理治疗来改善获得医疗保健的机会。该产品未来还可用于急性术后康复，加速恢复生产生活，进一步降低医疗成本。