Illusion-enhanced Virtual Reality Exercise for Neck Pain A Replicated Single Case Series

Daniel S. Harvie; Ross T. Smith; G. Lorimer Moseley; Ann Meulders; Bart Michiels; Michele Sterling

doi:10.1097/AJP.0000000000000780

Illusion-enhanced Virtual Reality Exercise for Neck Pain A Replicated Single Case Series

Daniel S. Harvie^*, Ross T. Smith, G. Lorimer Moseley, Ann Meulders, Bart Michiels, Michele Sterling

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

OBJECTIVES: Body illusions have shown promise in treating some chronic pain conditions. We hypothesized that neck exercises performed in virtual reality (VR) with visual feedback of rotation amplified would reduce persistent neck pain.
METHODS: In a multiple-baseline replicated single case series, 8 blinded individuals with persistent neck pain completed a 4-phase intervention (initial n=12, 4 dropouts): (1) "baseline"; (2) "VR" during which participants performed rotation exercises in VR with no manipulation of visual feedback; (3) "VR enhanced" during which identical exercises were performed but visual feedback overstated the range of motion being performed; (4) "follow-up." Primary outcomes were twice-daily measures of pain-free range of motion and pain intensity. During the baseline and follow-up phases, measures were taken but no intervention took place.
RESULTS: No differences in primary outcomes were found between VR and baseline, VR enhanced and VR, or VR enhanced and follow-up.
DISCUSSION: Our hypothesis, that neck exercises performed in VR with visual feedback of rotation amplified, would reduce persistent neck pain was not supported. Possible explanations and future directions are discussed.

Original language	English
Pages (from-to)	101-109
Number of pages	9
Journal	Clinical Journal of Pain
Volume	36
Issue number	2
DOIs	https://doi.org/10.1097/AJP.0000000000000780
Publication status	Published - Feb 2020

Keywords

chronic pain
neck pain
persistent pain
virtual reality
illusion
cortical representation
cortical reorganization
brain training
whiplash-associated disorder
exercise therapy
MIRROR VISUAL FEEDBACK
GRADED MOTOR IMAGERY
OF-THE-ART
BACK-PAIN
NONCONSCIOUS ACTIVATION
PSYCHOMETRIC PROPERTIES
TREATMENT MODALITIES
HAND LOCALIZATION
DISABILITY-INDEX
MOVEMENT

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10.1097/AJP.0000000000000780

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Cite this

@article{8cb92c9976db4d468199b69669621d73,

title = "Illusion-enhanced Virtual Reality Exercise for Neck Pain A Replicated Single Case Series",

abstract = "OBJECTIVES: Body illusions have shown promise in treating some chronic pain conditions. We hypothesized that neck exercises performed in virtual reality (VR) with visual feedback of rotation amplified would reduce persistent neck pain.METHODS: In a multiple-baseline replicated single case series, 8 blinded individuals with persistent neck pain completed a 4-phase intervention (initial n=12, 4 dropouts): (1) {"}baseline{"}; (2) {"}VR{"} during which participants performed rotation exercises in VR with no manipulation of visual feedback; (3) {"}VR enhanced{"} during which identical exercises were performed but visual feedback overstated the range of motion being performed; (4) {"}follow-up.{"} Primary outcomes were twice-daily measures of pain-free range of motion and pain intensity. During the baseline and follow-up phases, measures were taken but no intervention took place.RESULTS: No differences in primary outcomes were found between VR and baseline, VR enhanced and VR, or VR enhanced and follow-up.DISCUSSION: Our hypothesis, that neck exercises performed in VR with visual feedback of rotation amplified, would reduce persistent neck pain was not supported. Possible explanations and future directions are discussed.",

keywords = "chronic pain, neck pain, persistent pain, virtual reality, illusion, cortical representation, cortical reorganization, brain training, whiplash-associated disorder, exercise therapy, MIRROR VISUAL FEEDBACK, GRADED MOTOR IMAGERY, OF-THE-ART, BACK-PAIN, NONCONSCIOUS ACTIVATION, PSYCHOMETRIC PROPERTIES, TREATMENT MODALITIES, HAND LOCALIZATION, DISABILITY-INDEX, MOVEMENT",

author = "Harvie, {Daniel S.} and Smith, {Ross T.} and Moseley, {G. Lorimer} and Ann Meulders and Bart Michiels and Michele Sterling",

note = "Funding Information: This project was supported by the Physiotherapy Research Foundation grant and a Griffith University and University of South Australia Collaboration Grant, Gold Coast, Australia. D.S.H. was supported by an Early Career Research Fellowship from the National Health and Medical Research Council of Australia. G.L.M. was supported by a Principal Research Fellowship from the National Health and Medical Research Council of Australia. In the last 5 years, G.L.M. has received support from: Seqirus, Kaiser Permanente, Workers{\textquoteright} Compensation Boards in Australia, Europe and North America, AIA Australia, the International Olympic Com-mittee, Port Adelaide Football Club and Arsenal Football Club. Pro-fessional and scientific bodies have reimbursed him for travel costs related to the presentation of research on pain at scientific conferences/symposia. He has received speaker fees for lectures on pain and rehabilitation. He receives book royalties from NOIgroup publications (Adelaide, Australia), Dancing Giraffe Press (Canberra, Australia) & OPTP (Minneapolis, Minnesota, USA). D.S.H. and R.T.S. are exploring opportunities to create and commercialize therapeutic applications of virtual reality. The contribution of A.M. was supported by a Senior Research Fellowship of the Research Foundation Flanders (FWO-Vlaanderen), Belgium, (grant ID 12E3717N) and by a Vidi grant from the Netherlands Organization for Scientific Research (NWO), The Netherlands (grant ID 452-17-002). The contribution of B.M. was supported by a project grant of the Research Foundation Flanders (FWO-Vlaanderen), Belgium, (grant ID G059314N). Publisher Copyright: {\textcopyright} 2019 Wolters Kluwer Health, Inc. All rights reserved.",

year = "2020",

month = feb,

doi = "10.1097/AJP.0000000000000780",

language = "English",

volume = "36",

pages = "101--109",

journal = "Clinical Journal of Pain",

issn = "0749-8047",

publisher = "LIPPINCOTT WILLIAMS & WILKINS",

number = "2",

}

TY - JOUR

T1 - Illusion-enhanced Virtual Reality Exercise for Neck Pain A Replicated Single Case Series

AU - Harvie, Daniel S.

AU - Smith, Ross T.

AU - Moseley, G. Lorimer

AU - Meulders, Ann

AU - Michiels, Bart

AU - Sterling, Michele

N1 - Funding Information: This project was supported by the Physiotherapy Research Foundation grant and a Griffith University and University of South Australia Collaboration Grant, Gold Coast, Australia. D.S.H. was supported by an Early Career Research Fellowship from the National Health and Medical Research Council of Australia. G.L.M. was supported by a Principal Research Fellowship from the National Health and Medical Research Council of Australia. In the last 5 years, G.L.M. has received support from: Seqirus, Kaiser Permanente, Workers’ Compensation Boards in Australia, Europe and North America, AIA Australia, the International Olympic Com-mittee, Port Adelaide Football Club and Arsenal Football Club. Pro-fessional and scientific bodies have reimbursed him for travel costs related to the presentation of research on pain at scientific conferences/symposia. He has received speaker fees for lectures on pain and rehabilitation. He receives book royalties from NOIgroup publications (Adelaide, Australia), Dancing Giraffe Press (Canberra, Australia) & OPTP (Minneapolis, Minnesota, USA). D.S.H. and R.T.S. are exploring opportunities to create and commercialize therapeutic applications of virtual reality. The contribution of A.M. was supported by a Senior Research Fellowship of the Research Foundation Flanders (FWO-Vlaanderen), Belgium, (grant ID 12E3717N) and by a Vidi grant from the Netherlands Organization for Scientific Research (NWO), The Netherlands (grant ID 452-17-002). The contribution of B.M. was supported by a project grant of the Research Foundation Flanders (FWO-Vlaanderen), Belgium, (grant ID G059314N). Publisher Copyright: © 2019 Wolters Kluwer Health, Inc. All rights reserved.

PY - 2020/2

Y1 - 2020/2

N2 - OBJECTIVES: Body illusions have shown promise in treating some chronic pain conditions. We hypothesized that neck exercises performed in virtual reality (VR) with visual feedback of rotation amplified would reduce persistent neck pain.METHODS: In a multiple-baseline replicated single case series, 8 blinded individuals with persistent neck pain completed a 4-phase intervention (initial n=12, 4 dropouts): (1) "baseline"; (2) "VR" during which participants performed rotation exercises in VR with no manipulation of visual feedback; (3) "VR enhanced" during which identical exercises were performed but visual feedback overstated the range of motion being performed; (4) "follow-up." Primary outcomes were twice-daily measures of pain-free range of motion and pain intensity. During the baseline and follow-up phases, measures were taken but no intervention took place.RESULTS: No differences in primary outcomes were found between VR and baseline, VR enhanced and VR, or VR enhanced and follow-up.DISCUSSION: Our hypothesis, that neck exercises performed in VR with visual feedback of rotation amplified, would reduce persistent neck pain was not supported. Possible explanations and future directions are discussed.

AB - OBJECTIVES: Body illusions have shown promise in treating some chronic pain conditions. We hypothesized that neck exercises performed in virtual reality (VR) with visual feedback of rotation amplified would reduce persistent neck pain.METHODS: In a multiple-baseline replicated single case series, 8 blinded individuals with persistent neck pain completed a 4-phase intervention (initial n=12, 4 dropouts): (1) "baseline"; (2) "VR" during which participants performed rotation exercises in VR with no manipulation of visual feedback; (3) "VR enhanced" during which identical exercises were performed but visual feedback overstated the range of motion being performed; (4) "follow-up." Primary outcomes were twice-daily measures of pain-free range of motion and pain intensity. During the baseline and follow-up phases, measures were taken but no intervention took place.RESULTS: No differences in primary outcomes were found between VR and baseline, VR enhanced and VR, or VR enhanced and follow-up.DISCUSSION: Our hypothesis, that neck exercises performed in VR with visual feedback of rotation amplified, would reduce persistent neck pain was not supported. Possible explanations and future directions are discussed.

KW - chronic pain

KW - neck pain

KW - persistent pain

KW - virtual reality

KW - illusion

KW - cortical representation

KW - cortical reorganization

KW - brain training

KW - whiplash-associated disorder

KW - exercise therapy

KW - MIRROR VISUAL FEEDBACK

KW - GRADED MOTOR IMAGERY

KW - OF-THE-ART

KW - BACK-PAIN

KW - NONCONSCIOUS ACTIVATION

KW - PSYCHOMETRIC PROPERTIES

KW - TREATMENT MODALITIES

KW - HAND LOCALIZATION

KW - DISABILITY-INDEX

KW - MOVEMENT

U2 - 10.1097/AJP.0000000000000780

DO - 10.1097/AJP.0000000000000780

M3 - Article

C2 - 31714324

SN - 0749-8047

VL - 36

SP - 101

EP - 109

JO - Clinical Journal of Pain

JF - Clinical Journal of Pain

IS - 2

ER -