The effect of virtual reality (VR) used as a distraction method in pain response

2011 ◽  
Vol 26 (S2) ◽  
pp. 996-996
Author(s):  
K. Cabas-Hoyos ◽  
J. Gutiérrez-Maldonado ◽  
D. Loreto-Quijada ◽  
O. Gutiérrez-Martínez ◽  
C. Peñaloza-Salazar
Keyword(s):  
Pain Intensity ◽  
Self Efficacy ◽  
Cold Pressor Test ◽  
Cognitive Strategies ◽  
Experimental Pain ◽  
Time Estimation ◽  
Cold Pressor ◽  
Limited Attention ◽  
Experimental Conditions

IntroductionCognitive strategies have received considerable attention in the field of pain management, together with more traditional approaches based on physical interventions and behavior modification. Distraction is a technique that lately has been often studied.Distraction is based on an individual's limited attention capacity; it diminishes attention aimed to a painful stimulus with a subsequent pain reduction (Wismeijer & Vingerhoets, 2005).ObjectiveTo study the effect of VR as a distraction technique in an experimental pain task.Method37 healthy participants were induced pain through two consecutive immersions using the cold-pressor test. All participants went through two experimental conditions: VR and black screen. The order of conditions was counterbalanced and a design of repetitive measures was used.A virtual environment “Surreal World” was developed based on distraction techniques designed to surprise participants. The effect of VR as a distraction technique was evaluated using objective measures of pain (threshold, tolerance, pain intensity and time estimation) and other cognitive measures (self-efficacy and catastrophic thinking in vivo).ResultsVR significantly decreased tolerance and pain intensity, influenced participants to underestimate the length of immersion. A higher self-efficacy in VR and a lower rumination and helplessness were registered in the pain experience. Thus, VR may help improve the efficacy of cognitive strategies.PerspectivesThe study shows the relevance of VR as an adjunctive method in the treatment of acute pain and allows studying its efficacy in patients with chronic pain.

FC09-02 - Efficacy of distraction by means of virtual reality in the control and reduction of pain using the cold-pressor test

2011 ◽  
Vol 26 (S2) ◽  
pp. 1859-1859
Author(s):  
J. Gutiérrez-Maldonado ◽  
K. Cabas-Hoyos ◽  
O. Gutiérre Martínez ◽  
D. Loreto-Quijada ◽  
C. Peñaloza-Salazar
Keyword(s):  
Pain Intensity ◽  
Pain Perception ◽  
Pain Treatment ◽  
Cold Pressor Test ◽  
Time Estimation ◽  
Cold Pressor ◽  
Experimental Conditions ◽  
Pressor Test ◽  
Reduction Of Pain ◽  
Healthy Participants

IntroductionAttention plays an important rol in pain perception. Focusing attention in pain intensifies the painful experience whereas distraction may decrease its subjective sensation (Eccleston & Crombez, 1999).The purpose of the two studies is to establish the efficacy of distraction by means of VR in the control and reduction of pain using the cold-pressor test. In both studies threshold, tolerance, perceived pain intensity and time estimation were measured.Study 137 healthy participants were induced pain in two consecutive immersions using the cold-pressor test. The experiment was counterbalanced and all participants went through two experimental conditions: VR (stereoscopic screen) and black screen. A virtual environment “Surreal World” was designed based on distraction of attention techniques. Results showed that VR significantly increased threshold and tolerance, diminished pain intensity and perception of time.Study 235 healthy participants underwent two consecutive immersions using cold pressor: VR (using the updated version of Surreal World and 3D laptops) and black screen. VR significantly increased the threshold and tolerance, whereas variations in the estimation of time were barely significant.Differences in the results of the two studies could be accounted for by the immersive effect of the stereoscopic screen. Findings are discussed in relation to previous studies on VR and pain. Results support VR as an adjunctive method in pain treatment and allow proving its efficacy in patients with chronic pain.

scholarly journals An initial exploration of in vivo hair cortisol responses to a brief pain stressor: latency, localization and independence effects

2009 ◽  
pp. 757-761
Author(s):  
CF Sharpley ◽  
KG Kauter ◽  
JR McFarlane
Keyword(s):  
Hpa Axis ◽  
Cold Pressor Test ◽  
Cold Pressor ◽  
Hair Follicles ◽  
Repeated Measurements ◽  
Single Observation ◽  
Target Organs ◽  
Cortisol Responses

Cortisol is secreted by the central hypothalamo-pituitary-adrenal axis and affects many target organs and tissues, particularly in response to stressor demands and infection. Recent data reporting cortisol synthesis in hair follicles have shown the existence of a parallel “peripheral” HPA-axis. However, although there is evidence from in vitro studies and single-observation comparisons between groups that cortisol from hair follicles reflects endocrine changes associated with stressor demands, there are no reports to date of repeated measurements of in vivo cortisol responsivity in hair to transitory stressors. This issue was investigated with three males who underwent 1 min cold pressor test (CP). Cortisol response in hair to stressor demand appears to be (a) swift but transitory, (b) localized to the site of the demand and (c) independent of central HPA-axis activity.

scholarly journals Classification of Game Demand and the Presence of Experimental Pain Using Functional Near-Infrared Spectroscopy

2021 ◽  
Vol 2 ◽  
Author(s):  
Stephen H. Fairclough ◽  
Chelsea Dobbins ◽  
Kellyann Stamp
Keyword(s):  
Infrared Spectroscopy ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Cold Pressor Test ◽  
Experimental Pain ◽  
Cold Pressor ◽  
Pain Tolerance ◽  
Support Vector ◽  
Test Protocol ◽  
Functional Near Infrared Spectroscopy

Pain tolerance can be increased by the introduction of an active distraction, such as a computer game. This effect has been found to be moderated by game demand, i.e., increased game demand = higher pain tolerance. A study was performed to classify the level of game demand and the presence of pain using implicit measures from functional Near-InfraRed Spectroscopy (fNIRS) and heart rate features from an electrocardiogram (ECG). Twenty participants played a racing game that was configured to induce low (Easy) or high (Hard) levels of demand. Both Easy and Hard levels of game demand were played with or without the presence of experimental pain using the cold pressor test protocol. Eight channels of fNIRS data were recorded from a montage of frontal and central-parietal sites located on the midline. Features were generated from these data, a subset of which were selected for classification using the RELIEFF method. Classifiers for game demand (Easy vs. Hard) and pain (pain vs. no-pain) were developed using five methods: Support Vector Machine (SVM), k-Nearest Neighbour (kNN), Naive Bayes (NB) and Random Forest (RF). These models were validated using a ten fold cross-validation procedure. The SVM approach using features derived from fNIRS was the only method that classified game demand at higher than chance levels (accuracy = 0.66, F1 = 0.68). It was not possible to classify pain vs. no-pain at higher than chance level. The results demonstrate the viability of utilising fNIRS data to classify levels of game demand and the difficulty of classifying pain when another task is present.

Pain sensations to the cold pressor test in normally menstruating women: comparison with men and relation to menstrual phase and serum sex steroid levels

2007 ◽  
Vol 293 (4) ◽  
pp. R1711-R1716 ◽  
Author(s):  
Kent Stening ◽  
Olle Eriksson ◽  
LisKarin Wahren ◽  
Göran Berg ◽  
Mats Hammar ◽  
...  
Keyword(s):  
Pain Intensity ◽  
Luteal Phase ◽  
Pain Threshold ◽  
Cold Pressor Test ◽  
Cold Pressor ◽  
Test Session ◽  
Gonadal Hormones ◽  
Follicular Phase ◽  
Pressor Test ◽  
Late Luteal Phase

The role of gonadal hormones on pain sensations was investigated in normally menstruating women ( n = 16) using the cold pressor test. Tolerance time, pain threshold, and pain intensity were examined once a week during a 4-wk period, and serum concentrations of 17β-estradiol and progesterone were determined at each test session, which were classified into the early follicular phase, late follicular phase, early luteal phase, and late luteal phase, as determined by the first day of menses and the actual hormone levels recorded. A group of men ( n = 10) of the same age interval was examined for comparison. The data show that pain threshold was reduced during the late luteal phase compared with the late follicular phase, and hormone analyses showed significant positive correlation between the progesterone concentration and lowered pain threshold and increasing pain intensity. Hormone analysis also showed an interaction between S-estradiol and S-progesterone on pain intensity, demonstrating that the increased perceived pain intensity that was associated with high progesterone concentrations was significantly reduced with increasing levels of estradiol. While no statistically significant sex differences in pain measurements were found, women displayed much more pronounced, and statistically significant, session-to-session effects than men, with increased pain threshold and decreased pain intensity with each test session. Hence, these data suggest that the changes in the serum concentration of gonadal hormones that occur during the menstrual cycle influence pain sensations elicited by noxious tonic cold stimulation and show that adaptation to the cold pressor test may be sex dependent.

scholarly journals Muscle stretching – the potential role of endogenous pain inhibitory modulation on stretch tolerance

2019 ◽  
Vol 19 (2) ◽  
pp. 415-422 ◽  
Author(s):  
Morten Pallisgaard Støve ◽  
Rogerio Pessoto Hirata ◽  
Thorvaldur Skuli Palsson
Keyword(s):  
Range Of Motion ◽  
Cold Pressor Test ◽  
Experimental Pain ◽  
Cold Pressor ◽  
Knee Extension ◽  
Painful Stimulus ◽  
Control Group ◽  
Inhibitory System ◽  
Pain Group ◽  
Resistive Torque

Abstract Background and aims The effect of stretching on joint range of motion is well documented and is primarily related to changes in the tolerance to stretch, but the mechanisms underlying this change are still largely unknown. The aim of this study was to investigate the influence of a remote, painful stimulus on stretch tolerance. Methods Thirty-four healthy male subjects were recruited and randomly assigned to an experimental pain group (n=17) or a control group (n=17). Passive knee extension range of motion, the activity of hamstring muscles and passive resistive torque were measured with subjects in a seated position. Three consecutive measures were performed with a 5-min interval between. A static stretch protocol was utilized in both groups to examine the effect of stretching and differences in stretch tolerance between groups. Following this, the pain-group performed a cold pressor test which is known to engage the endogenous pain inhibitory system after which measurements were repeated. Results A significant increase in knee extension range of motion was found in the pain group compared with controls (ANCOVA: p<0.05). No difference was found in muscle activity or passive resistive torque between groups (ANCOVA p>0.091). Conclusions Passive knee extension range of motion following stretching increased when following a distant, painful stimulus, potentially engaging the endogenous pain inhibitory systems. Current findings indicate a link between increased tolerance to stretch and endogenous pain inhibition. Implications The current findings may have implications for clinical practice as they indicate that a distant painful stimulus can influence range of motion in healthy individuals. This implies that the modulation of pain has significance for the efficacy of stretching which is important knowledge when prescribing stretching as part of rehabilitation.

scholarly journals A 5-HT Antagonist (UP 26-91) versus Codeine and Placebo in a Human Experimental Pain Study

2000 ◽  
Vol 5 (2) ◽  
pp. 135-140 ◽  
Author(s):  
Lars Arendt-Nielsen ◽  
Poul Pedersen ◽  
Lars Poulsen ◽  
Ole Kæseler Andersen ◽  
Peter Bjerring ◽  
...  
Keyword(s):  
Serotonin Receptor ◽  
Pain Threshold ◽  
Statistical Significance ◽  
Cold Pressor Test ◽  
Experimental Pain ◽  
Cold Pressor ◽  
Double Blind ◽  
Stimulus Response ◽  
Pressor Test ◽  
Pain Models

BACKGROUND: This double-blind, randomized, crossover study compared the potential analgesic effect of the serotonin receptor antagonist UP 26-91 (50 mg, 150 mg and 300 mg) with that of codeine (100 mg) and placebo by use of different human experimental pain models.SUBJECTS AND METHODS: In experiment 1, pain detection and tolerance thresholds to heat, pressure and pain ratings during the cold pressor test were measured. In experiment 2, the pain threshold to single and repetitive (temporal summation) electrical sural nerve stimulation, and the pain intensity on a visual analogue scale to supra pain threshold electrical stimulation (stimulus-response-function) were measured. Tests were performed before, and 1, 2 and 6 h after drug administration.RESULTS: UP 26-91 did not show a marked effect on the experimental pain tests. Most of the variables tended to show a better effect from codeine than from placebo, but statistical significance for peak pain was only reached during the cold pressor test (P=0.011).CONCLUSIONS: In the present doses, the serotonin antagonist UP 26-91 had no effect on the experimental pain models applied.

Influence of sympathetic tone on mechanical properties of muscular arteries in humans

1995 ◽  
Vol 268 (2) ◽  
pp. H794-H801 ◽  
Author(s):  
R. Joannides ◽  
V. Richard ◽  
N. Moore ◽  
M. Godin ◽  
C. Thuillez
Keyword(s):  
Mechanical Properties ◽  
Arterial Pressure ◽  
Muscle Tone ◽  
Arterial Compliance ◽  
Cold Pressor Test ◽  
Animal Experiments ◽  
Cold Pressor ◽  
Internal Diameter ◽  
Wall Stiffness

Although smooth muscle tone is a key determinant of mechanical properties of arteries in animal experiments, it has not yet been studied in humans because of technical limitations. To assess the influence of tone on arterial properties in humans and to emphasize the interest of calculation at specific stress, we used echo tracking and photoplethysmographic measurement of arterial pressure to study radial arterial mechanics during a cold pressor test (CPT) in 12 healthy volunteers (28 +/- 2 yr). During CPT, mean arterial pressure rose from 83 +/- 3 to 106 +/- 5 mmHg (P < 0.05), internal diameter decreased from 2.75 +/- 0.15 to 2.54 +/- 0.14 mm (P < 0.05), and wall thickness increased from 0.576 +/- 0.027 to 0.634 +/- 0.029 mm (P < 0.05). At a specific pressure (105 mmHg), midwall stress and incremental modulus decreased whereas arterial compliance increased. The incremental modulus of elasticity and compliance were fitted as functions of pressure and of midwall stress. CPT decreased the modulus about equally at all wall stresses measured. The modulus decreased and the compliance increased at every level of pressure measured. At all levels of midwall stress, the compliance was decreased. Thus acute sympathetic stimulation induced by CPT decreases the wall stiffness of human arteries in vivo. This may be explained by an unloading of stiffer wall components during active arterial constriction.

scholarly journals The Effects of Mindful Attention on Cold Pressor Pain in Children

2013 ◽  
Vol 18 (1) ◽  
pp. 39-45 ◽  
Author(s):  
Mark Petter ◽  
Christine T Chambers ◽  
Jill MacLaren Chorney
Keyword(s):  
Pain Intensity ◽  
Acute Pain ◽  
Coping Style ◽  
Guided Imagery ◽  
Experimental Pain ◽  
Cold Pressor ◽  
Pain Tolerance ◽  
Trait Mindfulness ◽  
Cold Pressor Task ◽  
Mindful Attention

BACKGROUND: Typical interventions for acute pain in children attempt to reduce pain by directing attention away from pain. Conversely, mindfulness involves devoting attention to one’s experience in an accepting and nonjudgmental way. However, the effect that instructing children to mindfully devote attention to acute pain has on pain outcomes is unknown.OBJECTIVES: To examine whether mindful attention can help children attend to pain without increasing pain intensity or decreasing pain tolerance; to compare the effects of mindful attention with a well-established intervention designed to take attention away from pain (guided imagery); and to test whether baseline coping style or trait mindfulness alter the effects of these interventions.METHODS: A total of 82 children (10 to 14 years of age) completed measures of coping style and trait mindfulness. Participants then received either mindful attention or guided imagery instructions designed to direct attention toward or away from pain, respectively, before participating in a cold pressor task.RESULTS: The mindful attention group reported more awareness of the physical sensations of pain and thoughts about those sensations. Overall, there were no between-group differences in measures of pain intensity or pain tolerance during the cold pressor task, and no evidence of an interaction between baseline characteristics of the child and experimental condition.CONCLUSIONS: Mindful attention was successful in helping children focus attention on experimental pain without increasing pain intensity or decreasing tolerance compared with a well-established intervention for acute pain reduction.

scholarly journals Pregabalin Has Analgesic, Ventilatory, and Cognitive Effects in Combination with Remifentanil

2016 ◽  
Vol 124 (1) ◽  
pp. 141-149 ◽  
Author(s):  
Marianne Myhre ◽  
Lien My Diep ◽  
Audun Stubhaug
Keyword(s):  
Pain Score ◽  
Cold Pressor Test ◽  
Experimental Pain ◽  
Cold Pressor ◽  
Analgesic Effects ◽  
Rapid Information Processing ◽  
End Tidal ◽  
Double Blinded ◽  
Dose Dependent ◽  
Higher Doses

Abstract Background Pregabalin is widely used perioperatively. The authors explored the effects of pregabalin, remifentanil, and their combination on experimental pain, ventilatory, and cognitive function. Methods In a randomized, double-blinded crossover study, 12 volunteers received (1) pregabalin + placebo, (2) placebo + remifentanil, (3) pregabalin + remifentanil, and (4) placebo + placebo. Pregabalin 150 mg/placebo was administered twice orally. After baseline, remifentanil/placebo was given as effect-site target-controlled infusion (TCI): 0.6, 1.2, and 2.4 ng/ml. Pain during cold pressor test was scored on visual analog scale (0 to 100 mm). Ventilation was measured by spirometry and cognition tested with Color-Word Interference and Rapid Information Processing tests. Results Pain intensity after placebo was (mean) 72 mm (95% CI, 62 to 83). Pregabalin reduced pain score by −10 mm (−14 to −7, P &lt; 0.001). Remifentanil had dose-dependent analgesic effect, reducing pain score by −47 mm (−54 to −39, P &lt; 0.001) on highest TCI level, whereas pregabalin + remifentanil exerted additive effect, reducing pain score by −57 mm (−64 to −50, P &lt; 0.001). Respiratory depression was potentiated by adding pregabalin to remifentanil; end-tidal carbon dioxide was 39.3 mmHg (37.2 to 41.3) with placebo, increased 1.8 mmHg (−0.9 to 4.6, P = 0.4) with pregabalin, 10.1 mmHg (4.9 to 15.4, P &lt; 0.001) with remifentanil, and 16.4 mmHg (11.3 to 21.5, P &lt; 0.001) with pregabalin + remifentanil on highest TCI level. The combination pregabalin + remifentanil, but not either drug alone, adversely affected all cognitive tests. Conclusions The combination of pregabalin and remifentanil had additive analgesic effects, pregabalin potentiated remifentanil ventilatory depression, and the combination adversely affected cognition. These results question the clinical benefit of the combination compared with higher doses of opioids.

scholarly journals Influence of Cognitive Orientation and Attentional Focus on Pain Perception

2021 ◽  
Vol 18 (13) ◽  
pp. 7176
Author(s):  
Pierluigi Diotaiuti ◽  
Stefano Corrado ◽  
Stefania Mancone ◽  
Lavinia Falese ◽  
Angelo Rodio ◽  
...  
Keyword(s):  
Learned Helplessness ◽  
Self Efficacy ◽  
Pain Perception ◽  
Cold Pressor Test ◽  
Cold Pressor ◽  
Attentional Focus ◽  
Pressor Test ◽  
Perceived Pain ◽  
Positive Effect

Background. Recently, a growing interest has emerged in the role of attention and hypervigilance in the experience of pain. Shifting attention away from pain seems likely to reduce the perception of pain itself. Objectives. The present study has been designed to test the following overall hypotheses: (1) disposition to catastrophize, self-efficacy perceived in pain resistance (task self-efficacy), previous experiences concerning the tolerance of physical pain, and degree of impulsiveness are significant predictors of the decision to abandon a painful test such as the cold pressor test (CPT); (2) the manipulation of the attentive focus (internal or external) can influence the level of perceived pain. Methods. Effects of the manipulation of attentional focus (internal and external) on pain perception and response of trial abandonment were evaluated in a sample of university students (n = 246) subjected to the cold pressor test. Results. A significant effect (p < 0.05) was found through a test–retest comparison on the final level of perceived pain among subjects who had received instruction to externalize the focus of their attention (mixed factorial analysis of variance), but no significance was observed with respect to the decision to abandon the experiment. A general explanatory model of the abandonment behavior demonstrating overall good fit measurements was tested too. Conclusion. The abandonment of tests has been shown to be predicted mainly by catastrophic attitude. Attentive impulsiveness showed a further positive effect on catastrophic attitude. Perceived self-efficacy in the tolerance of pain limited learned helplessness, which in turn positively influenced catastrophizing.

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