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Pain

Virtual Reality – A Multimodal Approach to Pain Management

In today’s dive, we examine a significant study that showcases the potential of Virtual Reality (VR) in conjunction with Cognitive Behavioral Therapy (CBT) for managing chronic pain.

“Remote cognitive behavioral therapy utilizing an in-home virtual reality toolkit (Vx Therapy) reduces pain, anxiety, and depression in patients with chronic cervical and lumbar spondylytic pain: A potential alternative to opioids in multimodal pain management” by Matthew J. McGirt et al.

Full Article: https://pubmed.ncbi.nlm.nih.gov/38033880/

Key Insights:

Vx Therapy: This approach combines VR with cognitive behavioral therapy, offering a non-invasive, non-pharmacological option for pain management.
Significant Improvements: Patients reported significant reductions in pain intensity, anxiety, and depression levels.
Sustained Benefits: VR acutely reduced pain by an average of 33% and anxiety by 46%, with the duration of pain relief increasing over time.

Methodological Approach:

The research included 145 patients in a 14-week program combining VR with cognitive behavioral therapy.
The program involved weekly encounters with a trained therapist and daily VR sessions with 50 modules.
Pain, anxiety, and depression were measured using PROMIS (Patient-Reported Outcomes Measurement Information System) at baseline and after the program.
VR’s immediate effect on pain and anxiety was quantified, showing significant reductions lasting several hours post-use.

Critical Observations:

Immediate vs. Long-Term Efficacy: While the study shows immediate and sustained relief, the long-term effectiveness of VR therapy, particularly post-treatment, remains an area for further research.
Integration Challenges: The integration of VR with traditional therapy represents a significant advancement, yet it also poses challenges in terms of standardization of protocols and ensuring consistent therapeutic outcomes across diverse patient populations.
Generalizability: The study’s results, while promising, may not be universally applicable given the specific patient cohort and treatment conditions. Further studies are needed to validate these findings in broader and more diverse populations.

Ethical and Practical Considerations:

Accessibility and Cost: The use of Vx Therapy, while non-invasive and non-pharmacological, could be impacted by the cost and current availability of VR technology. Addressing these factors is essential for ensuring wider accessibility, particularly in settings with limited resources.
Patient Adaptability and Support: The home-based nature of this therapy is advantageous for patient comfort and convenience. However, it also highlights the need for user-friendly VR systems and adequate support mechanisms to assist patients, especially those less familiar with technology.
Data Privacy and Security: As with any remote therapy, the implementation of VR solutions must include strong data privacy and security measures. This is critical to protect sensitive patient information and maintain the integrity of the therapeutic process.

Quelle:

https://vrforhealth.com/2023/12/02/🔍-sundayresearchdive-virtual-reality-a-multimodal-approach-to-pain-management/

4. Dezember 2023 0 comment

Examples

AppliedVR Secures $29M Funding to Pursue FDA Approval for VR Pain Management Tech

AppliedVR, a virtual reality pain management startup, today announced it has secured $29 million in funding, something it aims to use in pursuit of FDA approval for its cognitive behavioral therapy-based pain management tech.

The Series A financing round includes F-Prime Capital, JAZZ Venture Partners, Sway Ventures, GSR Ventures, Magnetic Ventures, and Cedars-Sinai, bringing its total funds raised to date to $35 million.

Founded in 2015 in LA, the company is also hoping to use its latest funding round to conduct more payer pilots, develop its product pipeline, and build out its clinical, marketing and sales teams.

Based on cognitive behavioral therapies and mindfulness training, the company’s EaseVRx solution recently received Breakthrough Device Designation from the FDA for treatment-resistant fibromyalgia and chronic intractable lower back pain, something that is typically treated by prescribing opioids.

“Chronic pain is one of the most common medical conditions in the world, yet it still is incredibly debilitating to patients, costly to the system and complex to treat,” said Matthew Stoudt, co-founder and CEO of AppliedVR. “While our mission has always been to demonstrate that VR can be a powerful analgesic in any setting, the COVID-19 pandemic has created a surge in demand for digital medicines like VR that can be delivered safely to patients in their own homes.”

AppliedVR has worked with over 200 healthcare provider organizations across the globe, including Geisinger, Cleveland Clinic, and the University of California at San Francisco (UCSF). The company says in a press statement that its program has been used to help “more than 60,000 patients to manage their expectations of pain.”

Quelle:

1. April 2021 0 comment

Examples

FDA Designates First VR Device For Chronic Pain

AppliedVR, a Los Angeles-based virtual reality company, has announced that its EaseVRx headset has received Breakthrough Device Designation from the Food and Drug Administration for treating fibromyalgia and chronic intractable lower back pain.

EaseVRx is the first virtual reality (VR) device to get a Breakthrough Designation from the FDA for treating a chronic pain condition. The designation speeds up the development and review of new medical devices that treat life-threatening or irreversibly debilitating diseases or conditions. It could also speed up insurance coverage of VR therapy for chronic pain.

“AppliedVR is the most evidence-backed VR platform on the market, and today’s FDA designation demonstrates that health experts across the spectrum recognize the therapeutic potential of VR as a viable treatment for pain,” Matthew Stoudt, CEO and co-founder of AppliedVR, said in a statement.

“Now, with the COVID-19 pandemic severely disrupting Americans’ ability to get in-person care safely, we’re looking forward to getting EaseVRx into the hands of people suffering from pain. Providers believe in it, patients want it, and payers are coming around to it.”

AppliedVR funded a recent clinical trial that showed VR therapy can be self-administered at home to treat chronic pain. Patients living with fibromyalgia or chronic lower back pain were given VR headsets and instructed to watch at least one virtual reality program daily for 21 days.

The programs immerse users in a “virtual” environment where they can swim with dolphins, play games or enjoy beautiful scenery. The goal is to help patients learn how to manage their pain and other symptoms by distracting them and making their pain seem less important

At the end of the study, 84 percent of the patients reported they were satisfied with VR therapy. Their pain intensity was reduced an average of 30 percent. Physical activity, mood, sleep and stress levels also improved.

“Virtual reality is a promising skills-based behavioral medicine that has been shown to have high patient engagement and satisfaction,” said Beth Darnall, PhD, AppliedVR’s chief science advisor. “However, chronic pain patients to date have had very limited access to it, so we’re excited to continue working with the FDA to develop our platform and get it into the market faster.”

PNN columnist Madora Pennington, who lives with chronic pain from Ehlers-Danlos Syndrome, recently reviewed one of AppliedVR’s headsets. She said watching VR programs helped calm and relax her.

“The benefits of VR therapy continued for me after the sessions ended. When pain or panic about pain began to set in, I found it drifts away rather than latching onto me like it used to,” Madora wrote. “After a couple weeks of VR, during a visit to physical therapist, I noticed I was no longer afraid of her touching my neck and back, and actually enjoyed it.”

AppliedVR’s technology is currently being used in hundreds of hospitals, but devices are not expected to be available for home use until next year. The company is working with Geisinger Health and Cleveland Clinic on two studies to see if VR therapy can be used as an opioid-sparing tool for acute and chronic pain.

Quelle:

https://www.vrroom.buzz/vr-news/health-fitness/fda-designates-first-vr-device-chronic-pain

3. November 2020 0 comment

Examples

SoCal Patients Use Imagination To Control Pain With VR

Teresa Lipot enjoys swimming as a way to connect with nature.

Unfortunately, a medical condition has rendered the 62-year-old woman unable to go in the water for the past several years.

The same medical condition also causes Lipot chronic pain.

Virtual reality technology, or VR, recently introduced by Hoag Hospital in Newport Beach has allowed Lipot to experience an underwater swim in the ocean while reducing pain and stress at the same time.

Hoag, which in 2015 introduced VR technology in operating rooms, has begun using the technology with patients to reach areas of the brain that affect sensations such as pain, said Dr. Robert Louis, chair of neurosurgery.

Hoag is one of the first hospitals in the nation to offer this VR treatment outside of clinical trial settings. The hospital is seeing positive results, Louis said.

“It decreases the person’s thinking and worrying about the pain,” Louis said. “It decreases the emotional unpleasantness of the pain, as well as the physical sensation of the pain.

“We can see that all on functional MRIs,” he said. “When you see the before and after, it’s amazing.”

While in the hospital in May, two nurses introduced Lipot to the technology, which involves wearing a headset nearly identical to those used by gamers.

“I was more than happy to try it,” Lipot said. “I would probably equate it to very affordable hypnotherapy.”

In 2018, Cedar-Sinai Health Systems in Los Angeles conducted a study involving 120 subjects. “VR significantly reduces pain versus an active control condition in hospitalized patients,” the study found. “VR is most effective for severe pain.”

On a scale of one to 10, with 10 being the worst pain, pain can be reduced by five points through the use of VR experiences, Louis said.

With such significant reductions in pain, there is less need to use opioids to help reduce pain – thereby reducing the possibly of opioid addiction.

“We’re hearing some patients with a pain score going from an eight to a three,” Louis said. “If you start off with a pain score of eight, the normal prescription would be for morphine or fentanyl. When you have a pain score of three, the normal prescription is Tylenol.

“Each time we can lower the dose of opioids, we can prevent maybe one more person from becoming addicted,” Louis added. “We’re losing 50,000 a year in the US to opioid overdoses.

While a significant number of patients have experienced a “substantial reduction in pain,” the technology doesn’t work on everyone, Louis said.

Some of the new VR technology used by Hoag involves educational video games that center around how pain works, Louis said.

“Understanding pain is one of the key features,” he said.

In another VR program, patients wearing a headset are shown dead tree. They are instructed to take long, deep breaths as a microphone that records the depth of the breaths. As the patient’s breathing relaxes, the tree begins to grow and blossom and come back to life.

Lipot calls swimming her “happy place,” but hasn’t been able to enjoy the therapeutic activity for 10 years.

When she made eye contact with a whale in the VR setting, she found herself “literally crying.”

“I was really pleased that I was able to experience swimming under the water,” Lipot said, “without swimming under water.”

Quelle:

https://www.vrroom.buzz/vr-news/health-fitness/socal-patients-use-imagination-control-pain-vr

Foto:

Dr. Robert Louis, a neurosurgeon at Hoag Hospital in Newport Beach, takes notes while demonstrating new virtual reality headset to a patient. The technology, which allows patients to immerse themselves in a variety of experiences, is being used to help reduce stress and severe pain. (Courtesy of Hoag Hospital)

3. Juli 2020 0 comment