Virtual Reality Distraction Induces Hypoalgesia in Patients with Chronic Nonspecific Low Back Pain

Taibang CHEN; Jing WANG; Di DU; Xiaoqing HE; Wenbao ZHOU

doi:10.12259/j.issn.2095-610X.S20220910

Volume 43 Issue 9

Sep. 2022

Turn off MathJax

Article Contents

Article Navigation > Journal of Kunming Medical University > 2022 > 43(9): 59-65

Taibang CHEN, Jing WANG, Di DU, Xiaoqing HE, Wenbao ZHOU. Virtual Reality Distraction Induces Hypoalgesia in Patients with Chronic Nonspecific Low Back Pain[J]. Journal of Kunming Medical University, 2022, 43(9): 59-65. doi: 10.12259/j.issn.2095-610X.S20220910

Citation:

Taibang CHEN, Jing WANG, Di DU, Xiaoqing HE, Wenbao ZHOU. Virtual Reality Distraction Induces Hypoalgesia in Patients with Chronic Nonspecific Low Back Pain[J]. Journal of Kunming Medical University, 2022, 43(9): 59-65. doi: 10.12259/j.issn.2095-610X.S20220910

Citation:

PDF( 1012 KB)

Virtual Reality Distraction Induces Hypoalgesia in Patients with Chronic Nonspecific Low Back Pain

doi: 10.12259/j.issn.2095-610X.S20220910

Institute of Trauma and Orthopedics，The 920th Hospital of Joint Logistics Support Force of PLA，Kunming Yunnan 650032，China

Received Date: 2022-06-24
Available Online: 2022-09-07
Publish Date: 2022-09-29

Abstract

Abstract

Purpose To investigate whether a virtual reality game can reduce the chronic nonspecific low back pain and help patients recover. Methods In this randomized controlled trial, the patients with the chronic nonspecific low back pain were taken as the experimental group （n = 40） and underwent a period of exercise in an immersive virtual reality game, while those performed the same exercises without VR games were taken as the control group （n = 40） so as to investigate whether VR distraction had a hypoalgesia effect during and immediately after the exercises, and whether it reduced the time spent thinking of pain during the exercises. Thereafter, we further explored whether pain-related fear, pain catastrophizing and baseline pain intensity moderated the effects of VR distraction. Results The results of repeated measures analysis of variance showed that the pain intensity among the patients of the experimental group was the main effect, and time and pain intensity had an interactive effect. The time to think about pain during the exercise was significantly less than that of the control group （Experimental group M = 32.26, SD = 12.32; Control group M = 51.21, SD = 17.18; t80 = 5.80, P < 0.0001）, both had an analgesic effect during the exercise （Cohen’s d = 0.86） and after the exercise （Cohen’s d = 0.46）. The results of analysis of variance showed that fear of pain, catastrophic pain, and initial pain intensity all have the main effects, but there was no interaction on thinking time （all p values > 0.05）, and it was believed that it did not affect the distracting analgesic effect of virtual reality. Conclusion Virtual reality is effective in distracting attention and inducing pain reduction and it indicates that immersive virtual reality games can be used to relieve the pain of patients with chronic non-specific low back pain during the exercise and help them recover their health.
- Virtual reality,
- Distraction,
- Nonspecific low back pain,
- Immersive

FullText(HTML)

References(37)

References

[1]	Birnie K A,Chambers C T,Spellman C M. Mechanisms of distraction in acute pain perception and modulation[J]. Pain,2017,158(6):1012-1013. doi: 10.1097/j.pain.0000000000000913
[2]	Van Ryckeghem D,Van Damme S,Eccleston C,et al. The efficacy of attentional distraction and sensory monitoring in chronic pain patients:A meta-analysis[J]. Clin Psychol Rev,2018,59(12):16-29.
[3]	Boerner K E,Birnie K A,Chambers C T,et al. Simple psychological interventions for reducing pain from common needle procedures in adults:Systematic review of randomized and quasi-randomized controlled trials[J]. Clin J Pain,2015,31(10):S90-98.
[4]	Kola S,Walsh J C,Hughes B M,et al. Attention focus,trait anxiety and pain perception in patients undergoing colposcopy[J]. Eur J Pain,2012,16(6):890-900. doi: 10.1002/j.1532-2149.2011.00068.x
[5]	Verhoeven K,Crombez G,Eccleston C,et al. The role of motivation in distracting attention away from pain:An experimental study[J]. Pain,2010,149(2):229-234. doi: 10.1016/j.pain.2010.01.019
[6]	Indovina P,Barone D,Gallo L,et al. Virtual reality as a distraction intervention to relieve pain and distress during medical procedures:A comprehensive literature review[J]. Clin J Pain,2018,34(9):858-877. doi: 10.1097/AJP.0000000000000599
[7]	Todd J,Van Ryckeghem D M L,Sharpe L,et al. Attentional bias to pain-related information:A meta-analysis of dot-probe studies[J]. Health Psychol Rev,2018,12(4):419-436. doi: 10.1080/17437199.2018.1521729
[8]	Crombez G,Van Ryckeghem D M,Eccleston C,et al. Attentional bias to pain-related information:A meta-analysis[J]. Pain,2013,154(4):497-510. doi: 10.1016/j.pain.2012.11.013
[9]	Van Ryckeghem D,Rost S,Kissi A,et al. Task interference and distraction efficacy in patients with fibromyalgia:An experimental investigation[J]. Pain,2018,159(6):1119-1126. doi: 10.1097/j.pain.0000000000001196
[10]	Schreiber K L,Campbell C,Martel M O,et al. Distraction analgesia in chronic pain patients:The impact of catastrophizing[J]. Anesthesiology,2014,121(6):1292-1301. doi: 10.1097/ALN.0000000000000465
[11]	Goubert L,Crombez G,Eccleston C,et al. Distraction from chronic pain during a pain-inducing activity is associated with greater post-activity pain[J]. Pain,2004,110(2):220-227.
[12]	Buck R,Morley S. A daily process design study of attentional pain control strategies in the self-management of cancer pain[J]. Eur J Pain,2006,10(5):385-398. doi: 10.1016/j.ejpain.2005.04.001
[13]	Hadjistavropoulos H D,Hadjistavropoulos T,Quine A. Health anxiety moderates the effects of distraction versus attention to pain[J]. Behav Res Ther,2000,38(5):425-438.
[14]	Van Damme S, Crombez G. A motivational perspective on coping with pain. In: Motivational perspectives on chronic pain[M]. New York: Oxford University Press, 2018: 445–478.
[15]	Van Damme S,Legrain V,Vogt J,et al. Keeping pain in mind:A motivational account of attention to pain[J]. Neurosci Biobehav Rev,2010,34(3):204-213.
[16]	Scheffler M,Koranyi S,Meissner W,et al. Efficacy of on pharmacological interventions for procedural pain relief in adults undergoing burn wound care:A systematic review and meta-analysis of randomized controlled trials[J]. Burns,2018,44(5):1709-1720.
[17]	Chan E,Foster S,Sambell R,Leong P. Clinical efficacy of virtual reality for acute procedural pain management:A systematic review and meta-analysis[J]. PLoS One,2018,13(7):1301-1313.
[18]	Andersson G B. Epidemiological features of chronic low-back pain[J]. Lancet,1999,354(79):581-585.
[19]	Matheve T,Claes G,Olivieri E,Timmermans A. Timmermans A. Serious gaming to support exercise therapy for patients with chronic nonspecific low Back pain:A feasibility study[J]. Games Health J,2018,7(5):262-720.
[20]	Hodges P W, Van Dillen L R, McGill S M, et al. Integrated clinical approach to motor control interventions in low back and pelvic pain. In: Hodges PW, Cholewicki J, Van dieen JH, editors. Spinal control: The rehabilitation of back pain state of the art and science[M]. 1st edition. London: Churchill Livingstone, 2013: 243–309.
[21]	Chapman J R,Norvell D C,Hermsmeyer J T,et al. Evaluating common outcomes for measuring treatment success for chronic low back pain[J]. Spine (Phila Pa,1976),2011,36(3):S54-68.
[22]	Chiarotto A,Maxwell L J,Ostelo R W,et al. Measurement properties of visual analogue scale,numeric rating scale,and pain severity subscale of the brief pain inventory in patients with low back pain:A systematic review[J]. J Pain,2018,20(3):245-263.
[23]	Roland M,Morris R. A study of the natural history of back pain. Part I:development of a reliable and sensitive measure of disability in low-back pain[J]. Spine (Phila Pa,1976),1983,8(7):141-144.
[24]	Sullivan M J,Bishop F L,Pivik J. The pain catastrophizing scale:Development and validation[J]. Psychol Assess,1995,7(12):524-532.
[25]	Van Damme S,Crombez G,Bijttebier P,et al. A confirmatory factor analysis of the pain Catastrophizing scale:Invariant factor structure across clinical and non-clinical populations[J]. Pain,2002,96(8):319-324.
[26]	Vlaeyen J W,Kole-Snijders A M,Boeren R G,et al. Fear of movement/ (re)injury in chronic low back pain and its relation to behavioral performance[J]. Pain,1995,62(6):363-372.
[27]	Schrooten M G,Van Damme S,Crombez G,et al. Non pain goal pursuit inhibits attentional bias to pain[J]. Pain,2012,153(6):1180-1186. doi: 10.1016/j.pain.2012.01.025
[28]	Van Damme S,Crombez G,Eccleston C. Disengagement from pain:The role of catastrophic thinking about pain[J]. Pain,2004,107(2):70-76.
[29]	Goubert L,Crombez G,Van Damme S. The role of neuroticism,pain catastrophizing and pain-related fear in vigilance to pain:A structural equations approach[J]. Pain,2004,107(5):234-241.
[30]	Campbell C M,Witmer K,Simango M,et al. Catastrophizing delays the analgesic effect of distraction[J]. Pain,2010,149(2):202-207. doi: 10.1016/j.pain.2009.11.012
[31]	Roelofs J,Peters M L,Van der Zijden M,et al. Does fear of pain moderate the effects of sensory focusing and distraction on cold pressor pain in pain-free individuals?[J]. J Pain,2004,5(5):250-256. doi: 10.1016/j.jpain.2004.04.001
[32]	Vlaeyen J,Morley S,Crombez G. The experimental analysis of the interruptive,interfering,and identity-distorting effects of chronic pain[J]. Behav Res Ther,2016,86(3):23-34.
[33]	Crombez G,Lauwerier E,Goubert L,et al. Goal pursuit in individuals with chronic pain:A personal project analysis[J]. Front Psychol,2016,28(7):966-972.
[34]	Vlaeyen J W S,Maher C G,Wiech K,et al. Low back pain[J]. Nat Rev Dis Primers,2018,4(2):52-55.
[35]	Mannion A F,Helbling D,Pulkovski N,et al. Spinal segmental stabilization exercises for chronic low back pain:Programme adherence and its influence on clinical outcome[J]. Eur Spine J,2009,18(12):1881-1891. doi: 10.1007/s00586-009-1093-7
[36]	Palazzo C,Klinger E,Dorner V,et al. Barriers to home-based exercise program adherence with chronic low back pain:Patient expectations regarding new technologies[J]. Ann Phys Rehabil Med,2016,59(2):107-113. doi: 10.1016/j.rehab.2016.01.009
[37]	Bunzli S,Smith A,Watkins R,et al. What do people who score highly on the tampa scale of kinesiophobia really believe?A mixed methods investigation in people with chronic nonspecific low back pain[J]. Clin J Pain,2015,31(7):621-632. doi: 10.1097/AJP.0000000000000143

Relative Articles(20)

Relative Articles

[1]	You LI, Heng DING, Liang CUI, Yuanxi ZHAO, Enyu ZHAN, Xingguo LI. The Analysis of the Therapeutic Effect of Intervertebral Foramen Endoscopy on Single Segment Non-specific Lumbar Intervertebral Space Infection. Journal of Kunming Medical University, 2024, 45(5): 94-102. doi: 10.12259/j.issn.2095-610X.S20240515
[2]	Xuan XU, Moxian CHEN, Guanglei LIU, Xiao XU, Changliang LUO, Ya ZHOU. Correlation between Attention and Motor Function in Children with Spastic Hemiplegia. Journal of Kunming Medical University, 2022, 43(3): 44-49. doi: 10.12259/j.issn.2095-610X.S20220319
[3]	Song-qin LV, Xi-ruo SUN, Shan HUANG, Li-ping XV, Juan ZHANG, Yi-na WANG, Xiao-fei LI, Yong-rui YANG. The Application Value of Dry Fluorescent Luminescence in The Diagnosis and Treatment of HBV Infection. Journal of Kunming Medical University, 2021, 42(8): 65-70. doi: 10.12259/j.issn.2095-610X.S20210812
[4]	Hong-ling SHI, Yu LI, Ting-juan ZHANG, Lei YANG, Bai-jing LIU, Feng-yun YANG, Yu-yun ZHAO, Ke-rong CHEN, Li-rong BI, Xiao-yu LI, Jia-pu WANG. Application of Innovative Teaching of “TBL，Workshop” in the Teaching of Speech Therapy. Journal of Kunming Medical University, 2021, 42(7): 157-160. doi: 10.12259/j.issn.2095-610X.S20210726
[5]	Li Zeng Ming , Bao Wen Li . . Journal of Kunming Medical University, 2020, 41(01): 137-140.
[6]	Qing Qing , Sun Chun Yi , Li Dai Zhu , Huang Ya Juan , Xu Chang Jun , Liu Yang , Zhou Hong Lin . . Journal of Kunming Medical University, 2019, 40(08): 34-37.
[7]	Lei Wen , Wu Wen Juan , Li Zhen Kun , Li Jing , Yang Mei Juan , Dong Zhao Xing . Participatory Teaching Class for MBBS Students. Journal of Kunming Medical University, 2018, 39(05): 138-140.
[8]	An Yuan . Effect of Blood Purification on Septic Encephalopathy Neuron-specific Enolase. Journal of Kunming Medical University,
[9]	Huang Zeng Jie . Species Specificity of Male Human's 29 Y-SNP Loci. Journal of Kunming Medical University,
[10]	Qiu Jian Wu . . Journal of Kunming Medical University,
[11]	Gu Wan Gang . . Journal of Kunming Medical University,
[12]	Shen Hong . . Journal of Kunming Medical University,
[13]	Yu Jing . . Journal of Kunming Medical University,
[14]	Yang Yin Feng . . Journal of Kunming Medical University,
[15]	Gu Wan Gang . . Journal of Kunming Medical University,
[16]	Gu Wan Gang . . Journal of Kunming Medical University,
[17]	Wang Jian . . Journal of Kunming Medical University,
[18]	Chen Shi Gui . . Journal of Kunming Medical University, 2012, 33(05): 159-160.
[19]	. Establishment and Evaluation of A Modified Piggyback Orthotopic Liver Transplantation Model. Journal of Kunming Medical University,
[20]	Zhu Hong . . Journal of Kunming Medical University,