RESUMEN
Virtual Reality (VR) has been shown to effectively reduce pain in patients with various pain conditions. However, questions arise on the use of VR in multimodal postsurgical pain management. Optimizing VR for pain management requires an understanding of intervention- and context-specific factors, based on patients' needs and expectations after major surgery. This substudy is part of a randomized controlled trial investigating the effects of three VR interventions as an add-on, self-administered treatment for postsurgical pain. Semi-structured interviews were conducted to evaluate VR effects, software, hardware, prescriptions, and factors affecting the implementation of VR. Experiences across interventions were compared to identify relevant factors for successful implementation. Patients benefitted from self-administered VR in postsurgical pain management in various aspects and without serious drawbacks. Participants preferred an intuitive, 3D, 360-degree VR device with a large choice of applications matching their interests. The preferred frequency and duration of VR use was 2-3 sessions a day for 10-15 min each. Adjusting the VR use to individuals' needs and contexts was reported to be key for successful implementation, with attention paid to improving the awareness of VR as a non-pharmacological means of promoting postsurgical recovery among patients and healthcare professionals.
RESUMEN
OBJECTIVES: Low back pain is the leading cause of years lived with disability with a large impact on quality of life and resistance to a broad array of current treatments. This study aimed to investigate the effect of a novel self-administered behavioral therapy-based virtual reality (VR) application on the quality of life of patients with nonspecific chronic low back pain (CLBP). METHODS: A pilot randomized controlled trial was conducted in adults with nonspecific CLBP with moderate to severe pain, waiting for treatment in a teaching hospital-based pain clinic. The intervention group used a self-administered behavioral therapy-based VR application for at least 10 minutes daily for 4 weeks. The control group received standard care. The primary outcome was quality of life at 4 weeks measured by the short form-12 physical and mental scores. Secondary outcomes were daily worst and least pain, pain coping strategies, activities of daily living, positive health, anxiety, and depression. Discontinuation of therapy and adverse events were analyzed as well. RESULTS: Forty-one patients were included. One patient withdrew due to personal reasons. No significant treatment effect was found for the short form-12 physical score (mean difference: 2.6 points; 95% CI: -5.60 to 0.48) and mental score (-1.75; -6.04 to 2.53) at 4 weeks. There was a significant treatment effect for daily "worst pain score" ( F [1, 91.425] = 33.3, P < 0.001) and "least pain score" ( F [1, 30.069] = 11.5, P = 0.002). Three patients reported mild and temporary dizziness. DISCUSSION: Four weeks of self-administered VR for CLBP does not improve quality of life, however, it may positively affect daily pain experience.
