TY - JOUR
T1 - Get Your Head in the Game
T2 - A Replicated Single-Case Experimental Design Evaluating the Effect of a Novel Virtual Reality Intervention in People With Chronic Low Back Pain
AU - MacIntyre, Erin
AU - Sigerseth, Maja
AU - Larsen, Thomas Fiskeseth
AU - Fersum, Kjartan Vibe
AU - Meulders, Michel
AU - Meulders, Ann
AU - Michiels, Bart
AU - Braithwaite, Felicity A.
AU - Stanton, Tasha R.
N1 - Funding Information:
E.M. is supported by the University of South Australia Post Graduate Award (USAPA) and by a National Health & Medical Research Council Project Grant to T.R.S. ( ID1161634 ). F.A.B. is supported by the John Stuart Colville Fellowship (Arthritis South Australia) and has received speaker fees for lectures relating to pain and blinding in clinical trials. T.R.S. is supported by the National Health and Medical Research Council of Australia Career Development Fellowship ( ID1141735 ). T.R.S. receives book royalties and speaker fees for lectures relating to pain and rehabilitation.
Publisher Copyright:
© 2023 United States Association for the Study of Pain, Inc.
PY - 2023/8
Y1 - 2023/8
N2 - Chronic low back pain (CLBP) is a leading cause of disability worldwide. Contemporary treatment of CLBP is suboptimal, with small-moderate effect sizes and high relapse rates. Virtual reality (VR) is an increasingly accessible technology that can improve adherence to exercise programs through gamification. Using VR to facilitate exercise adherence and enjoyment may improve the clinical outcomes. This study aimed to evaluate the effects of a gamified VR graded activity intervention in people with CLBP, using commercially available and bespoke VR programs. A sequentially replicated, multiple-baseline, randomized AB single-case experimental design was undertaken in 10 people with CLBP. Outcomes were assessed daily and included pain intensity (primary) and pain catastrophizing, pain-related fear, and anxiety/worry (secondary). The effect of the intervention on the primary outcome was evaluated using a multilevel-model, nonparametric randomization test. The VR graded activity intervention resulted in a significant reduction in pain intensity (effect estimate = -1.0, standard error =.27, P <.0011) with 4 participants achieving =30% pain reduction (minimum important change). There was a significant effect of the intervention on pain catastrophizing but not pain-related fear or anxiety/worry measures. These findings provide preliminary support for a VR graded activity program to reduce pain in people with CLBP. Perspective: This novel, VR graded activity intervention reduced pain intensity and catastrophizing in people with CLBP. The intervention also had high adherence and enjoyment. Given that this intervention involved 2 freely available VR programs, it can be easily translated into clinical practice.
AB - Chronic low back pain (CLBP) is a leading cause of disability worldwide. Contemporary treatment of CLBP is suboptimal, with small-moderate effect sizes and high relapse rates. Virtual reality (VR) is an increasingly accessible technology that can improve adherence to exercise programs through gamification. Using VR to facilitate exercise adherence and enjoyment may improve the clinical outcomes. This study aimed to evaluate the effects of a gamified VR graded activity intervention in people with CLBP, using commercially available and bespoke VR programs. A sequentially replicated, multiple-baseline, randomized AB single-case experimental design was undertaken in 10 people with CLBP. Outcomes were assessed daily and included pain intensity (primary) and pain catastrophizing, pain-related fear, and anxiety/worry (secondary). The effect of the intervention on the primary outcome was evaluated using a multilevel-model, nonparametric randomization test. The VR graded activity intervention resulted in a significant reduction in pain intensity (effect estimate = -1.0, standard error =.27, P <.0011) with 4 participants achieving =30% pain reduction (minimum important change). There was a significant effect of the intervention on pain catastrophizing but not pain-related fear or anxiety/worry measures. These findings provide preliminary support for a VR graded activity program to reduce pain in people with CLBP. Perspective: This novel, VR graded activity intervention reduced pain intensity and catastrophizing in people with CLBP. The intervention also had high adherence and enjoyment. Given that this intervention involved 2 freely available VR programs, it can be easily translated into clinical practice.
KW - Chronic low back pain
KW - exergaming
KW - graded activity
KW - rehabilitation
KW - virtual reality
U2 - 10.1016/j.jpain.2023.03.013
DO - 10.1016/j.jpain.2023.03.013
M3 - Article
C2 - 37030584
SN - 1526-5900
VL - 24
SP - 1449
EP - 1464
JO - The Journal of Pain
JF - The Journal of Pain
IS - 8
ER -