Virtual Reality Analgesia for Rehabilitation in Children

描述（由申请人提供）：最常见，但具有挑战性的 需要康复的儿童所经历的次要问题， 致残的条件是疼痛。 疼痛发生在休息和/或康复时 活动并在两种慢性环境中产生（例如，脑性瘫痪）和 亚急性环境（例如，反复的伤口护理和物理治疗， 皮肤烧伤的延长治疗）。 常规药物镇痛 尽管这些策略在儿童急性疼痛中广泛使用且有效， 在这些慢性和亚急性环境中避免， 并发症（如耐受性）和缺乏疗效（中枢神经系统疾病的发生） 神经性疼痛综合征）。 该项目将探索两种非药理学 8-20岁儿童的镇痛技术，强调1）虚拟 现实（VR）镇痛，一种高度创新的技术， 在这种情况下的疗效，和2）其与催眠的新组合。 的 VR和催眠的镇痛机制尚不完全清楚，尽管 他们有一个共同点 注意力的分散 环境刺激，留下较少的这种认知资源投入 痛觉 该项目的目标是开发一个程序， 有效研究镇痛机制，优化临床应用 VR和VR/催眠联合应用在有疼痛和/或 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小组，能够提出和回答 适当的研究问题与有形的成果措施，2）设计和 制造VR硬件和软件，并开发必要的VR协议， 解决机制问题并进行未来的临床试验，以及3） 进行试点临床研究，以评估重复 VR的应用，并研究其有效性和相互作用 虚拟现实和催眠的区别 预期的即时 该项目的好处包括建立专业的研究团队， 进行未来机制研究和临床试验所需的设备 VR和VR/催眠的试验，以及收集试点临床数据，以指导 未来的调查。 长期利益包括建立 适应症和临床协议的使用VR和/或催眠在 治疗康复引起的和残疾有关的疼痛， 具有挑战性的患者人群，更广泛地应用于各种 年龄组，更容易使用，和潜在的经济效益。

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.