scholarly journals A Graded Exposure, Locomotion-Enabled Virtual Reality App During Walking and Reaching for Individuals With Chronic Low Back Pain: Cohort Gaming Design (Preprint)

2020 ◽  
Author(s):  
Rebecca White Hennessy ◽  
Deanna Rumble ◽  
Mike Christian ◽  
David A Brown ◽  
Zina Trost
Keyword(s):  
Virtual Reality ◽  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Perceived Exertion ◽  
Rating Of Perceived Exertion ◽  
Low Back ◽  
Progressive Movement ◽  
System Usability Scale ◽  
Graded Exposure

BACKGROUND Chronic low back pain (cLBP) can interfere with daily activities, and individuals with elevated pain-related fear (also known as kinesiophobia or the fear of injury due to movement) can develop worse long-term disability. Graded exposure (GEXP) protocols use successive participation in avoided activities to help individuals overcome fearful movement appraisals and encourage activity. We sought to develop a series of GEXP virtual reality (VR) walking and reaching scenarios to increase the exposure and engagement of people with high kinesiophobia and cLBP. OBJECTIVE This study aims to (1) determine GEXP content validity of the VR application and (2) determine the feasibility of individuals with cLBP performing locomotion-enabled physical activities. METHODS We recruited 13 individuals with cLBP and high pain-related fear to experience six VR modules, which provide progressive movement exposure over three sessions in a 1 week period. At session 1, participants ranked each module by likelihood to avoid and assigned an expected pain and concern for harming their back rating to each module. Participants provided a rating of perceived exertion (RPE) after experiencing each module. To test feasibility, we administered the system usability scale (SUS) and treatment evaluation inventory (TEI) following the final session. In addition, we measured pain and pain-related fear at baseline and follow-up. RESULTS The 12 participants who completed the study period assigned higher avoidance (<i>P</i>=.002), expected pain (<i>P</i>=.002), and expected concern (<i>P</i>=.002) for session 3 modules compared with session 1 modules. RPE significantly increased from session 1 (mean 14.8, SD 2.3) to session 3 (mean 16.8, SD 2.2; <i>P</i>=.009). The VR application showed positive feasibility for individuals with cLBP through acceptable SUS (mean 76.7, SD 13.0) and TEI (mean 32.5, SD 4.9) scores. Neither pain (<i>P</i>=.20) nor pain-related fear (<i>P</i>=.58) changed significantly across sessions. CONCLUSIONS The GEXP VR modules provided progressive exposure to physical challenges, and participants found the VR application acceptable and usable as a potential treatment option. Furthermore, the lack of significant change for pain and pain-related fear reflects that participants were able to complete the modules safely.

scholarly journals A Graded Exposure, Locomotion-Enabled Virtual Reality App During Walking and Reaching for Individuals With Chronic Low Back Pain: Cohort Gaming Design

10.2196/17799 ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. e17799
Author(s):  
Rebecca White Hennessy ◽  
Deanna Rumble ◽  
Mike Christian ◽  
David A Brown ◽  
Zina Trost
Keyword(s):  
Virtual Reality ◽  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Perceived Exertion ◽  
Rating Of Perceived Exertion ◽  
Low Back ◽  
Progressive Movement ◽  
System Usability Scale ◽  
Graded Exposure

Background Chronic low back pain (cLBP) can interfere with daily activities, and individuals with elevated pain-related fear (also known as kinesiophobia or the fear of injury due to movement) can develop worse long-term disability. Graded exposure (GEXP) protocols use successive participation in avoided activities to help individuals overcome fearful movement appraisals and encourage activity. We sought to develop a series of GEXP virtual reality (VR) walking and reaching scenarios to increase the exposure and engagement of people with high kinesiophobia and cLBP. Objective This study aims to (1) determine GEXP content validity of the VR application and (2) determine the feasibility of individuals with cLBP performing locomotion-enabled physical activities. Methods We recruited 13 individuals with cLBP and high pain-related fear to experience six VR modules, which provide progressive movement exposure over three sessions in a 1 week period. At session 1, participants ranked each module by likelihood to avoid and assigned an expected pain and concern for harming their back rating to each module. Participants provided a rating of perceived exertion (RPE) after experiencing each module. To test feasibility, we administered the system usability scale (SUS) and treatment evaluation inventory (TEI) following the final session. In addition, we measured pain and pain-related fear at baseline and follow-up. Results The 12 participants who completed the study period assigned higher avoidance (P=.002), expected pain (P=.002), and expected concern (P=.002) for session 3 modules compared with session 1 modules. RPE significantly increased from session 1 (mean 14.8, SD 2.3) to session 3 (mean 16.8, SD 2.2; P=.009). The VR application showed positive feasibility for individuals with cLBP through acceptable SUS (mean 76.7, SD 13.0) and TEI (mean 32.5, SD 4.9) scores. Neither pain (P=.20) nor pain-related fear (P=.58) changed significantly across sessions. Conclusions The GEXP VR modules provided progressive exposure to physical challenges, and participants found the VR application acceptable and usable as a potential treatment option. Furthermore, the lack of significant change for pain and pain-related fear reflects that participants were able to complete the modules safely.

scholarly journals Embodiment in Virtual Reality for the Treatment of Chronic Low Back Pain: A Case Series

2020 ◽  
Vol Volume 13 ◽  
pp. 3131-3137
Author(s):  
Michael S Trujillo ◽  
Anthony F Alvarez ◽  
Lincoln Nguyen ◽  
James Petros
Keyword(s):  
Virtual Reality ◽  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Case Series ◽  
Low Back

scholarly journals Correction: Self-Administered Behavioral Skills-Based At-Home Virtual Reality Therapy for Chronic Low Back Pain: Protocol for a Randomized Controlled Trial

10.2196/27652 ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. e27652
Author(s):  
Laura M Garcia ◽  
Beth D Darnall ◽  
Parthasarathy Krishnamurthy ◽  
Ian G Mackey ◽  
Josh Sackman ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Virtual Reality ◽  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Controlled Trial ◽  
Reality Therapy ◽  
Low Back ◽  
Behavioral Skills ◽  
Randomized Controlled

Radiological (Magnetic Resonance Image and Ultrasound) and biochemical effects of virtual reality training on balance training in football players with chronic low back pain: A randomized controlled study

2020 ◽  
pp. 1-9
Author(s):  
Gopal Nambi ◽  
Walid Kamal Abdelbasset ◽  
Bader A. Alqahatani
Keyword(s):  
Virtual Reality ◽  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Controlled Study ◽  
Football Players ◽  
Low Back ◽  
Virtual Reality Training ◽  
Cross Sectional ◽  
Muscle Cross Sectional Area

BACKGROUND: Virtual reality training is commonly used for balance problems in neurological conditions with the use of visual and auditory biofeedback. The knowledge about the effective implementation of this training in chronic low back pain is lacking. OBJECTIVE: The objective of this study is to find the radiological and biochemical effects of virtual reality training in football players with chronic low back pain. METHODS: A randomized, single-blinded controlled study was conducted on 36 participants. The first group received virtual reality training (VRT; n= 12), the second group received combined physical rehabilitation (CPR; n= 12), and the third group (control group; n= 12) received conventional training exercises for four weeks. Radiological (muscle cross-sectional area and muscle thickness) and biochemical (CRP, TNF-α, IL-2, IL-4, IL-6) values were measured at baseline and after four weeks. RESULTS: Four weeks following training, the VRT group showed more significant changes in the muscle cross-sectional area than the CPR and control groups (p⩽ 0.001). Biochemical measures such as CRP, TNF-α, IL-2, IL-4, and IL-6 also showed significant improvement in the VRT group compared to the other two groups (p⩽ 0.001). CONCLUSION: The results show that virtual reality training has positive effects on the radiological and biochemical aspects in university football players with chronic low back pain.

scholarly journals Virtual Reality in the Treatment of Adults with Chronic Low Back Pain: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

2021 ◽  
Vol 18 (22) ◽  
pp. 11806
Author(s):  
Beatriz Brea-Gómez ◽  
Irene Torres-Sánchez ◽  
Araceli Ortiz-Rubio ◽  
Andrés Calvache-Mateo ◽  
Irene Cabrera-Martos ◽  
...  
Keyword(s):  
Systematic Review ◽  
Virtual Reality ◽  
Low Back Pain ◽  
Back Pain ◽  
Pain Intensity ◽  
Chronic Low Back Pain ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Low Back

Virtual reality (VR) can present advantages in the treatment of chronic low back pain. The objective of this systematic review and meta-analysis was to analyze the effectiveness of VR in chronic low back pain. This review was designed according to PRISMA and registered in PROSPERO (CRD42020222129). Four databases (PubMed, Cinahl, Scopus, Web of Science) were searched up to August 2021. Inclusion criteria were defined following PICOS recommendations. Methodological quality was assessed with the Downs and Black scale and the risk of bias with the Cochrane Risk of Bias Assessment Tool. Fourteen studies were included in the systematic review and eleven in the meta-analysis. Significant differences were found in favor of VR compared to no VR in pain intensity postintervention (11 trials; n = 569; SMD = −1.92; 95% CI = −2.73, −1.11; p < 0.00001) and followup (4 trials; n = 240; SDM = −6.34; 95% CI = −9.12, −3.56; p < 0.00001); and kinesiophobia postintervention (3 trials; n = 192; MD = −8.96; 95% CI = −17.52, −0.40; p = 0.04) and followup (2 trials; n = 149; MD = −12.04; 95% CI = −20.58, −3.49; p = 0.006). No significant differences were found in disability. In conclusion, VR can significantly reduce pain intensity and kinesiophobia in patients with chronic low back pain after the intervention and at followup. However, high heterogeneity exists and can influence the consistency of the results.

Short-Term Psychological and Hormonal Effects of Virtual Reality Training on Chronic Low Back Pain in Soccer Players

2020 ◽  
pp. 1-10
Author(s):  
Gopal Nambi ◽  
Walid Kamal Abdelbasset ◽  
Saud F. Alsubaie ◽  
Ayman K. Saleh ◽  
Anju Verma ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Adrenocorticotropic Hormone ◽  
Soccer Players ◽  
Model Assessment ◽  
Low Back ◽  
Homeostatic Model Assessment ◽  
Homeostatic Model

Objective: To find the short-term psychological and hormonal effects of virtual reality training on chronic low back pain in American soccer players. Design, Setting, Participants: The 3-block random sampling method was used on 54 university American soccer players with chronic low back pain, and they were allocated into 3 groups: virtual reality training (VRT; n = 18), combined physical rehabilitation (n = 18), and control (n = 18) groups at University Hospital. They underwent different balance training exercises for 4 weeks. The participants and the therapist who is assessing the outcomes were blinded. Psychological (pain intensity and kinesiophobia) and hormonal (glucose, insulin, Homeostatic Model Assessment of Insulin Resistance, growth hormone, prolactin, adrenocorticotropic hormone, and cortisol) values were measured at baseline, after 4 weeks, and after 6 months. Results: The baseline demographic, psychological, and hormonal data between the VRT, combined physical rehabilitation, and control groups show no statistical difference (P ≥ .05). Four weeks following training, the VRT group shows more significant changes in pain intensity and kinesiophobia than the combined physical rehabilitation and control groups (P < .001), and the improvement was noted in the 6-month follow-up. All the hormonal variables (glucose, insulin, growth hormone, prolactin, adrenocorticotropic hormone, and cortisol) show significant changes at 4-week training (P < .001), except for the Homeostatic Model Assessment of Insulin Resistance (P = .075) between the 3 groups. At 6-month follow-up glucose, prolactin, adrenocorticotropic hormone, and cortisol show more significant difference in the VRT group than the other 2 groups (P < .001). At the same time, insulin (P = .694), Homeostatic Model Assessment of Insulin Resistance (P = .272), and growth hormone (P = .145) failed to show significant changes between the groups. Conclusion: Training through virtual reality is an effective treatment program when compared with conventional exercise training programs from a psychological and hormonal analysis perspective in American soccer players with chronic low back pain.

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