Distraction of attention with the use of virtual reality. Influence of the level of game complexity on the level of experienced pain

2014 ◽  
Vol 45 (4) ◽  
pp. 480-487 ◽  
Author(s):  
Joanna Piskorz ◽  
Marcin Czub
Keyword(s):  
Virtual Reality ◽  
Cold Water ◽  
Cold Pressor Test ◽  
Cold Pressor ◽  
Low Complexity ◽  
Preliminary Evidence ◽  
Pain Tolerance ◽  
High Complexity ◽  
Thermal Pain ◽  
Lower Pain

Abstract : Research done in recent years shows that Virtual Reality (VR) can be an effective tool for distracting attention from pain. The purpose of this study was to test how the complexity of Virtual Environment (VE) influences the experienced intensity of thermal pain stimuli. A within-subjects design experiment was conducted, using cold pressor test for pain stimulation. Research was done on 31 students of Wroclaw Universities. Participants played games created for the purpose of the study, using head mounted displays and movement sensors. Two Virtual Environments differing in the level of complexity and non-VR control condition were used. The order of all conditions was counterbalanced. Participants reported significantly lower pain intensity (Visual Analogue Scale) after playing the high complexity game, compared to the low complexity game. There were also significant differences between non-VR control condition and high complexity game, but not between non-VR and low complexity game. The pain tolerance (measured by time of keeping the hand in cold water) was significantly higher in both VR conditions comparing to non-VR conditions. However, no significant differences between VE’s were found in pain tolerance ratings. Results of this study provide preliminary evidence that game complexity can be related to pain experience during VR interventions.

Influence of memory on experienced pain during Virtual Reality analgesia

2014 ◽  
Vol 12 (4) ◽  
pp. 41-52 ◽  
Author(s):  
Marcin Czub ◽  
Joanna Piskorz ◽  
Mateusz Misiewicz ◽  
Paweł Hodowaniec ◽  
Małgorzata Mrula ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Pain Intensity ◽  
Virtual Environments ◽  
Pain Treatment ◽  
Cold Water ◽  
Cold Pressor Test ◽  
Cold Pressor ◽  
Pain Tolerance ◽  
Intensity Measures ◽  
Pain Stimuli

Abstract Virtual Reality (VR) technology can be applied during pain treatment, acting as an effective distractor from pain stimuli. In our paper we investigate how memory influences experienced intensity of thermal pain stimuli. An experiment (within subject design) was conducted on 35 students from various Wroclaw universities. A cold pressor test was used for pain stimulation. Participants were immersed in customized virtual environments, created for this particular study. The environments differed at the level of memory engagement while playing a game. Pain measures were determined by the length of time participants kept their hands in cold water (pain tolerance), and their pain rating intensity was measured on the VAS scale (pain intensity). Participants were asked to put their hand in a container with cold water and keep it there until the pain became difficult to bear. In both VR conditions participants kept their hands in the cold water significantly longer than in a non-VR (control) condition. Results of pain intensity measures were in conclusive. We did not find any significant differences in effectiveness in the virtual environments that were used.

Differential pain modulation in patients with peripheral neuropathic pain and fibromyalgia

2012 ◽  
Vol 3 (3) ◽  
pp. 116-123 ◽  
Author(s):  
Lise Gormsen ◽  
Flemming W. Bach ◽  
Raben Rosenberg ◽  
Troels S. Jensen
Keyword(s):  
Neuropathic Pain ◽  
Cold Water ◽  
Cold Pressor Test ◽  
Cold Pressor ◽  
Pain Modulation ◽  
Pain Tolerance ◽  
Spontaneous Pain ◽  
Peripheral Neuropathic Pain ◽  
Pressor Test ◽  
Pain Patients

AbstractBackgroundThe definition of neuropathic pain has recently been changed by the International Association for the Study of Pain. This means that conditions such as fibromyalgia cannot, as sometimes discussed, be included in the neuropathic pain conditions. However, fibromyalgia and peripheral neuropathic pain share common clinical features such as spontaneous pain and hypersensitivity to external stimuli. Therefore, it is of interest to directly compare the conditions.Material and methodsIn this study we directly compared the pain modulation in neuropathic pain versus fibromyalgia by recording responses to a cold pressor test in 30 patients with peripheral neuropathic pain, 28 patients with fibromyalgia, and 26 pain-free age-and gender-matched healthy controls. Patients were asked to rate their spontaneous pain on a visual analog scale (VAS (0–100 mm) immediately before and immediately after the cold pressor test. Furthermore the duration (s) of extremity immersion in cold water was used as a measure of the pain tolerance threshold, and the perceived pain intensity at pain tolerance on the VAS was recorded on the extremity in the water after the cold pressor test. In addition, thermal (thermo tester) and mechanical stimuli (pressure algometer) were used to determine sensory detection, pain detection, and pain tolerance thresholds in different body parts. All sensory tests were done by the same examiner, in the same room, and with each subject in a supine position. The sequence of examinations was the following: (1) reaction time, (2) pressure thresholds, (3) thermal thresholds, and (4) cold pressor test. Reaction time was measured to ensure that psychomotoric inhibitions did not influence pain thresholds.ResultsPain modulation induced by a cold pressor test reduced spontaneous pain by 40% on average in neuropathic pain patients, but increased spontaneous pain by 2.6% in fibromyalgia patients. This difference between fibromyalgia and neuropathic pain patients was significant (P < 0.002). Fibromyalgia patients withdrew their extremity from the cold water significantly earlier than neuropathic pain patients and healthy controls; however, they had a higher perceived pain intensity on the VAS than neuropathic pain patients and control subjects. Furthermore, neuropathic pain patients had a localized hypersensitivity to mechanical and thermal stimuli in the affected area of the body. In contrast, fibromyalgia patients displayed a general hypersensitivity to mechanical and thermal stimuli when the stimuli were rated by the VAS, and hypersensitivity to some of the sensory stimuli.ConclusionsThese findings are the first to suggest that a conditioning stimulus evoked by a cold pressor test reduced spontaneous ongoing pain in patients with peripheral neuropathic pain, but not in fibromyalgia patients when directly compared. The current study supports the notion that fibromyalgia and neuropathic pain are distinct pain conditions with separate sensory patterns and dysfunctions in pain-modulating networks. Fibromyalgia should therefore not, as sometimes discussed, be included in NP conditions.ImplicationsOn the basis of the findings, it is of interest to speculate on the underlying mechanisms. The results are consistent with the idea that peripheral neuropathic pain is primarily driven from damaged nerve endings in the periphery, while chronic fibromyalgia pain may be a central disorder with increased activity in pain-facilitating systems.

How does interface influence the level of analgesia when Virtual Reality distraction is used?

2014 ◽  
Vol 12 (1) ◽  
pp. 45-57 ◽  
Author(s):  
Joanna Piskorz ◽  
Marcin Czub ◽  
Katarzyna Urbańska ◽  
Małgorzata Mrula ◽  
Paweł Hodowaniec ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Undergraduate Students ◽  
Cold Water ◽  
Body Movement ◽  
Hand Movement ◽  
Cold Pressor Test ◽  
Analgesic Efficacy ◽  
Cold Pressor ◽  
Rotation Sensor ◽  
Significant Difference

Abstract This study investigates the effectiveness of virtual reality (VR) technology in distracting attention from pain. We tested how body engagement related to navigating the virtual environment (VE) influences the intensity of pain. Two different interfaces were used to play the same VE, and a cold pressor test was used for pain stimulation. A mixed design was used for the experiment. Sixty-six undergraduate students participated. One group navigated the game using a rotation sensor, head tracker and foot pedals (Body Movement Interface). Another group navigated only using their hands (Hand Movement Interface). Objective and subjective measures of pain were collected - the amount of time participants kept their hand in a container with cold water, and the participant’s assessment of the pain intensity on a visual analog scale (VAS). Participants also filled in questionnaires designed to measure feelings of presence in VE and emotional attitudes towards the game. We found no significant difference between the two used interfaces in their analgesic efficacy. In both groups during VR distraction, participants showed significantly higher levels of pain endurance than without VR distraction.

scholarly journals Sound can enhance the analgesic effect of virtual reality

2016 ◽  
Vol 3 (3) ◽  
pp. 150567 ◽  
Author(s):  
Sarah Johnson ◽  
Matthew Coxon
Keyword(s):  
Virtual Reality ◽  
Pain Management ◽  
Cold Water ◽  
Cold Pressor ◽  
Pain Tolerance ◽  
Auditory Information ◽  
Head Mounted Display ◽  
Concurrent Use ◽  
Adult Participants ◽  
The Individual

Virtual reality (VR) technology may serve as an effective non-pharmacological analgesic to aid pain management. During VR distraction, the individual is immersed in a game presented through a head-mounted display (HMD). The technological level of the HMD can vary, as can the use of different input devices and the inclusion of sound. While more technologically advanced designs may lead to more effective pain management the specific roles of individual components within such systems are not yet fully understood. Here, the role of supplementary auditory information was explored owing to its particular ecological relevance. Healthy adult participants took part in a series of cold-pressor trials submerging their hand in cold water for as long as possible. Individual pain tolerances were measured according to the time (in seconds) before the participant withdrew their hand. The concurrent use of a VR game and the inclusion of sound was varied systematically within participants. In keeping with previous literature, the use of a VR game increased pain tolerance across conditions. Highest pain tolerance was recorded when participants were simultaneously exposed to both the VR game and supplementary sound. The simultaneous inclusion of sound may therefore play an important role when designing VR to manage pain.

Pain perception in patients with bipolar disorder and schizophrenia

2007 ◽  
Vol 19 (5) ◽  
pp. 284-290 ◽  
Author(s):  
Levent Atik ◽  
Numan Konuk ◽  
Omer Akay ◽  
Devrim Ozturk ◽  
Ayten Erdogan
Keyword(s):  
Bipolar Disorder ◽  
Pain Perception ◽  
Cold Pressor Test ◽  
Bipolar Disorders ◽  
Cold Pressor ◽  
Study Groups ◽  
Pain Tolerance ◽  
Control Subjects ◽  
Lower Pain ◽  
Healthy Control

Objective:Pain perception is reported to be altered in patients with depression and schizophrenia. However, few studies have investigated the pain perception in patients with bipolar disorders. We therefore aimed to compare pain sensitivity between patients with bipolar disorder, schizophrenia and controls.Methods:Study groups consisted of 30 patients with bipolar disorder, and control groups consisted of 27 patients with schizophrenia and 59 healthy subjects. Pain perception was assessed with cold pressor test (CPT) by exposure to ice-water.Results:Patients with schizophrenia had significantly higher pain thresholds (PTh) than patients with bipolar disorder. There were no differences between the PTh of patients with schizophrenia and healthy control subjects. However, patients with bipolar disorder had significantly lower pain tolerance (PT) in the CPT than patients with schizophrenia and corresponding healthy control subjects.Conclusions:The higher PTh in the schizophrenia group compared with the bipolar group found in this study supports further investigation of a potential difference in the pain perception between patients with schizophrenia and bipolar disorder. Theoretical implications of these findings and possible relevant behavioural and neurochemical mechanisms are discussed.

Effects of Playing Video Games on Pain Response during a Cold Pressor Task

2009 ◽  
Vol 108 (2) ◽  
pp. 439-448 ◽  
Author(s):  
Bryan Raudenbush ◽  
Jerrod Koon ◽  
Trevor Cessna ◽  
Kristin McCombs
Keyword(s):  
Video Games ◽  
Video Game ◽  
Cold Pressor Test ◽  
Cold Pressor ◽  
Pain Tolerance ◽  
Cold Pressor Task ◽  
Video Game Play ◽  
Time Period ◽  
Lower Pain ◽  
Game Condition

Two studies assessed whether playing video games would significantly distract participants from painful stimulation via a cold pressor test. In Study 1, participants (8 men, 22 women, M age= 18.5 yr., SD = 1.3) in an action-oriented game condition tolerated pain for a longer time period and reported lower pain intensity ratings than those in a nonaction-oriented game or a nongame control condition. No differences were found on scores of aggressiveness, competitiveness, or prior video game experience, suggesting that these factors play little role. In Study 2, participants (14 men, 13 women, M age= 19.7 yr., SD= 1.3) engaged in six video game conditions (action, fighting, puzzle, sports, arcade, and boxing) and a nongame control condition. Video game play produced an increase in pulse, which was greatest during the action, fighting, sports, and boxing games. Pain tolerance was greatest during the sports and fighting games. Thus, certain games produce greater distraction, which may have implications for the medical field as an adjunct to pain management.

scholarly journals The peer effect on pain tolerance

2018 ◽  
Vol 18 (3) ◽  
pp. 467-477 ◽  
Author(s):  
Solveig Engebretsen ◽  
Arnoldo Frigessi ◽  
Kenth Engø-Monsen ◽  
Anne-Sofie Furberg ◽  
Audun Stubhaug ◽  
...  
Keyword(s):  
Social Network ◽  
Social Environment ◽  
Cold Pressor Test ◽  
Cold Pressor ◽  
Pain Tolerance ◽  
Potential Candidate ◽  
Peer Effect ◽  
Influence Effect ◽  
The Social ◽  
Average Pain

Abstract Background and aims Twin studies have found that approximately half of the variance in pain tolerance can be explained by genetic factors, while shared family environment has a negligible effect. Hence, a large proportion of the variance in pain tolerance is explained by the (non-shared) unique environment. The social environment beyond the family is a potential candidate for explaining some of the variance in pain tolerance. Numerous individual traits have previously shown to be associated with friendship ties. In this study, we investigate whether pain tolerance is associated with friendship ties. Methods We study the friendship effect on pain tolerance by considering data from the Tromsø Study: Fit Futures I, which contains pain tolerance measurements and social network information for adolescents attending first year of upper secondary school in the Tromsø area in Northern Norway. Pain tolerance was measured with the cold-pressor test (primary outcome), contact heat and pressure algometry. We analyse the data by using statistical methods from social network analysis. Specifically, we compute pairwise correlations in pain tolerance among friends. We also fit network autocorrelation models to the data, where the pain tolerance of an individual is explained by (among other factors) the average pain tolerance of the individual’s friends. Results We find a significant and positive relationship between the pain tolerance of an individual and the pain tolerance of their friends. The estimated effect is that for every 1 s increase in friends’ average cold-pressor tolerance time, the expected cold-pressor pain tolerance of the individual increases by 0.21 s (p-value: 0.0049, sample size n=997). This estimated effect is controlled for sex. The friendship effect remains significant when controlling for potential confounders such as lifestyle factors and test sequence among the students. Further investigating the role of sex on this friendship effect, we only find a significant peer effect of male friends on males, while there is no significant effect of friends’ average pain tolerance on females in stratified analyses. Similar, but somewhat lower estimates were obtained for the other pain modalities. Conclusions We find a positive and significant peer effect in pain tolerance. Hence, there is a significant tendency for students to be friends with others with similar pain tolerance. Sex-stratified analyses show that the only significant effect is the effect of male friends on males. Implications Two different processes can explain the friendship effect in pain tolerance, selection and social transmission. Individuals might select friends directly due to similarity in pain tolerance, or indirectly through similarity in other confounding variables that affect pain tolerance. Alternatively, there is an influence effect among friends either directly in pain tolerance, or indirectly through other variables that affect pain tolerance. If there is indeed a social influence effect in pain tolerance, then the social environment can account for some of the unique environmental variance in pain tolerance. If so, it is possible to therapeutically affect pain tolerance through alteration of the social environment.

scholarly journals Laboratory Personnel Gender and Cold Pressor Apparatus Affect Subjective Pain Reports

2014 ◽  
Vol 19 (1) ◽  
pp. e13-e18 ◽  
Author(s):  
Jacob M Vigil ◽  
Lauren N Rowell ◽  
Joe Alcock ◽  
Randy Maestes
Keyword(s):  
Pain Sensitivity ◽  
Experimental Pain ◽  
Cold Pressor ◽  
Pain Tolerance ◽  
Cold Pain ◽  
Laboratory Personnel ◽  
Subjective Pain ◽  
Lower Pain ◽  
Pain Reporting ◽  
Pain Reports

BACKGROUND: There is no standardized method for cold pressor pain tasks across experiments. Temperature, apparatus and aspects of experimenters vary widely among studies. It is well known that experimental pain tolerance is influenced by setting as well as the sex of the experimenter. It is not known whether other contextual factors influence experimental pain reporting.OBJECTIVES: The present two-part experiment examines whether minimizing and standardizing interactions with laboratory personnel (eg, limiting interaction with participants to consenting and questions and not during the actual pain task) eliminates the influence of examiner characteristics on subjective pain reports and whether using different cold pain apparatus (cooler versus machine) influences reports.METHODS:The present experiment manipulated the gender of the experimenter (male, female and transgender) and the type of cold pressor task (CPT) apparatus (ice cooler versus refrigerated bath circulator). Participants conducted the CPT at one of two pain levels (5°C or 16°C) without an experimenter present.RESULTS:Men and women showed lower pain sensitivity when they were processed by biological male personnel than by biological female personnel before the CPT. Women who interacted with a transgendered researcher likewise reported higher pain sensitivity than women processed by biological male or female researchers. The type of CPT apparatus, despite operating at equivalent temperatures, also influenced subjective pain reports.DISCUSSION: The findings show that even minimal interactions with laboratory personnel who differ in gender, and differences in laboratory materials impact the reliable measurement of pain.CONCLUSION: More standardized protocols for measuring pain across varying research and clinical settings should be developed.

scholarly journals The Confounding Effect of Assessor Ethnicity on Subjective Pain Reporting in Women

2017 ◽  
Vol 11 (1) ◽  
pp. 1-11
Author(s):  
Jacob Miguel Vigil ◽  
Patrick Coulombe ◽  
Lauren Nikki Rowell ◽  
Chance Strenth ◽  
Eric Kruger ◽  
...  
Keyword(s):  
Pain Intensity ◽  
Severe Pain ◽  
Pain Sensitivity ◽  
Cold Pressor ◽  
Pain Tolerance ◽  
Random Effects Models ◽  
Subjective Pain ◽  
Lower Pain ◽  
Pain Reporting ◽  
Hispanic White

The current study examines how subjective pain reporting is influenced by the concordant and discordant nature of the ethnic identities of pain expressers (participants) and pain assessors (experimenters). Three discomfort conditions that varied in stimuli intensity (Study 1: mild pain; Study 2: severe pain), and distraction components (Study 3) were used to assess whether pain intensity and tolerance reporting differ with the ethnic identification of the participant and the experimenter. Specifically, 87 Hispanic and 74 Non-Hispanic White (NHW) women (18–51 yrs., Mage = 20.0, SD = 4.3) underwent a cold pressor pain task (CPT) after engaging in minimal procedural interactions with one of the 22 research experimenters (47% Hispanic, 42% females). The procedural interactions with the experimenters included only consenting and instructions, with no interaction between experimenter and participant during the actual CPT. Random-effects models showed that between the 0% and 18% of the variance in pain sensitivity (intensity and tolerance scores) was attributable to characteristics of the experimenters. Controlling for self-esteem, baseline pain levels, and the gender of the experimenter, Hispanic subjects showed higher pain sensitivity (as marked by lower pain tolerance and higher pain intensity scores) following interactions with an NHW rather than a Hispanic experimenter in response to the most severe pain intensity stimuli. These results question the validity of common findings of ethnic differences in pain sensitivity from studies that have not accounted for the ethnic identity of the pain assessor (and the general communicative nature of pain reporting).

scholarly journals 0233 Pain, Fatigue, and Altered Reactivity to a Repeated Physiological Stressor in Insomnia Patients: An Explanatory-Driven Analysis

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A90-A90
Author(s):  
M R Goldstein ◽  
J K Devine ◽  
R Dang ◽  
B Chatterton ◽  
J Scott-Sutherland ◽  
...  
Keyword(s):  
Cold Water ◽  
Cold Pressor Test ◽  
Cold Pressor ◽  
Comprehensive Treatment ◽  
Spontaneous Pain ◽  
Science Center ◽  
Female Age ◽  
Complex Relationships ◽  
Physiological Stressor ◽  
Pain Testing

Abstract Introduction Fatigue and pain are prominent features of functional impairment in insomnia. This study aimed to better understand behavioral and physiological mechanisms of these complex relationships. Methods 22 participants with insomnia disorder (DSM-5 criteria, 18 female, age 18-49yrs) and 22 good-sleeper controls (19 female, age 18-47yrs) completed two-weeks sleep logs and actigraphy recordings prior to coming to the laboratory for overnight polysomnography and subsequent daytime testing that included questionnaires, three trials of cold pressor test (CPT), and pain testing with blood draws collected throughout. Insomnia diagnosis was determined by a board-certified sleep specialist, and exclusion criteria included psychiatric history within past 6 months, other sleep disorder, significant medical conditions, and any medications within past two weeks with significant effects on inflammation, autonomic function, or other psychotropic effects. For CPT, participants were instructed to immerse hand in ice cold water for at least one minute and rate pain intensity throughout the immersion and 3-minute recovery. Data were analyzed with linear mixed models. Results Per inclusion criteria, PSQI scores were differed between groups (insomnia: 10.2±2.7, range 7–16; control: 1.9±1.3, range 0–5; p&lt;.001). Insomnia consistently reported higher daily fatigue ratings compared to controls (p&lt;.001), as well as higher spontaneous pain globally and across several specific domains (p’s: .007-.03). In response to CPT, groups did not differ in their initial tolerance (i.e. immersion duration, p=.41) or intensity ratings during immersion (p=.88), however insomnia showed blunted recovery in intensity ratings (p&lt;.01). Control participants then showed an ability to habituate to repeated CPT by increasing immersion duration, whereas insomnia slightly decreased in tolerance across trials (Group effect: p&lt;.05). Conclusion These data indicate that habituation to and acute recovery from pain is deteriorated in chronic insomnia, which may be a key contributor to maintained pathophysiology over time and mechanism to target with comprehensive treatment. Support Merck Inc. MISP# 51971 (investigator-initiated), NIH/National Center for Research Resources UL1-RR02758 and M01-RR01032 to the Harvard Clinical and Translational Science Center.

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