Virtual Reality Analgesia for Rehabilitation in Children

描述(由申请者提供)：最常见，但具有挑战性的 需要康复的儿童经历的继发性问题 致残的条件是痛苦。疼痛发生在休息和/或康复时 在慢性情况下(如脑瘫)和 亚急性环境(例如，重复的伤口护理和物理治疗 皮肤烧伤的扩大治疗)。常规药理止痛药 虽然在急性疼痛的儿童中广泛使用和有效的策略， 在这些慢性和亚急性环境中可避免，因为 并发症(如耐受性)和缺乏疗效(发展为中心性 神经病理性疼痛综合征)。这个项目将探索两个非药理的 针对8-20岁儿童的止痛技术，强调1)虚拟 现实(VR)止痛，一项高度创新的技术，最新展示 在这种环境下的功效，以及2)它与催眠的新颖组合。这个 VR和催眠的止痛机制尚不完全清楚，尽管 他们有一个共同的线索，那就是有意识地注意到 环境刺激，使这种认知资源更少地投入到 痛觉。这个项目的目标是开发一个程序，它将 有效研究其镇痛机制，优化临床用药 VR和联合VR/催眠术对残疾儿童疼痛和/或谁 需要康复活动。该项目的具体目标是：1) 建立一个有效的、多学科的小组，能够提出和回答问题 适当的研究问题和切实的结果衡量标准，2)设计和 制作VR硬件和广告软件，并开发必要的VR协议 解决机械问题并执行未来的临床试验，以及3) 进行试验性临床研究，以评估重复治疗的疗效 虚拟现实的应用，并调查其疗效和交互作用 当同时使用VR和催眠时。预期的即刻 该项目的好处包括建立专门的研究团队 和设备，以进行未来的机械研究和临床 VR和VR/催眠试验，以及收集飞行员临床数据以指导 未来的调查。长期利益包括建立 使用VR和/或催眠术的适应症和临床方案 康复引起的和残疾相关的疼痛的治疗 挑战患者群体，更广泛地应用于各种 更易于使用，并具有潜在的经济效益。

DESCRIPTION (provided by applicant): One of the most frequent, yet challenging secondary problems experienced by children who require rehabilitation from disabling conditions is pain. Pain occurs at rest and/or with rehabilitation activities and arises in both chronic settings (e.g., cerebral palsy) and subacute settings (e.g., repetitive wound care and physical therapy during extended treatment of cutaneous burns). Conventional pharmacologic analgesic strategies, although widely used and efficacious in children with acute pain, are avoided in these chronic and subacute settings due to associated complication (e.g. tolerance) and lack of efficacy (development of central neuropathic pain syndromes). This project will explore two non-pharmacologic analgesic techniques for children ages 8-20 years, emphasizing 1) virtual reality (VR) analgesia, a highly innovative technology with newly demonstrated efficacy in such settings, and 2) its novel combination with hypnosis. The analgesic mechanisms of VR and hypnosis are incompletely understood, although they share a common thread distraction of conscious attention from environmental stimuli, leaving less of this cognitive resource to devote to pain perception. The goal of this project is to develop a program that will effectively investigate the analgesic mechanisms and optimize the clinical use of VR and combined VR/hypnosis in disabled children with pain and/or who require rehabilitation activities. The specific aims of the project are 1) to develop an effective, multidisciplinary group capable of posing and answering appropriate study questions with tangible outcome measures, 2) to design and fabricate VR hardware ad software, and develop VR protocols necessary to address mechanistic questions and perform future clinical trials, and 3) to perform pilot clinical studies to assess the efficacy of repetitive application of VR, and to investigate the efficacy of and the interactions between VR and hypnosis when used simultaneously. The anticipated immediate benefits of this project include establishing the specialized research team and equipment necessary to perform future mechanistic studies and clinical trials of VR and VR/hypnosis, as well as collect pilot clinical data to direct future investigations. Long-term benefits include the establishment of indications and clinical protocols for the use of VR and/or hypnosis in the treatment of rehabilitation-induced and disability-related pain in this challenging patient population, with more widespread application to a variety of age groups, greater ease of use, and potential economic benefit.