Rodriguez Samuel T, Makarewicz Nathan, Wang Ellen Y, Zuniga-Hernandez Michelle, Titzler Janet, Jackson Christian, Suen Man Yee, Rosales Oswaldo, Caruso Thomas J
Stanford Chariot Program, Lucile Packard Children's Hospital Stanford, Palo Alto, CA, USA; Department of Anesthesiology, Perioperative, and Pain Medicine, Division of Pediatric Anesthesiology, Stanford School of Medicine, Stanford, CA, USA.
Department of Anesthesiology, Perioperative, and Pain Medicine, Division of Pediatric Anesthesiology, Stanford School of Medicine, Stanford, CA, USA; Stanford University School of Medicine, Stanford, CA, USA.
J Clin Anesth. 2023 Dec;91:111257. doi: 10.1016/j.jclinane.2023.111257. Epub 2023 Sep 13.
Both virtual reality (VR) and exercise are recognized for their analgesic and anxiolytic properties. The purpose of this study is to evaluate the ability of VR-facilitated exercise to modulate pain.
Within-subject cross-over clinical trial.
The Stanford Chariot Program conducted this study at Lucile Packard Children's Hospital Stanford (LCPHS).
Healthy participants meeting inclusion criteria were recruited by volunteer solicitation from LCPHS.
Participants were randomized by hand dominance and subjected to a standardized cold pressor test with no VR or exercise. After a 5-min wash-out period, participants repeated the test on their other hand while experiencing a VR-facilitated exercise condition. Pain sensitivity, pain tolerance, and sympathetic activation data were collected during both conditions.
Pain sensitivity was scored 0-10 and collected every 30 s. Pain tolerance was recorded as the duration a participant could endure the painful stimuli. Sympathetic activation was measured by skin conductance response density (SCRD) and recorded in 30 s epochs by a biosensor. In all analyses, data were nested by participant.
Forty-one participants completed both interventions. Pain sensitivity was reduced in the VR-facilitated exercise condition (p < 0.0001). There was no difference in pain tolerance between conditions. While both conditions resulted in an increase in sympathetic activity, SCRD was higher at all time points in the VR-facilitated exercise condition.
The reduction in pain sensitivity indicates VR-facilitated exercise results in improved pain perception. VR-facilitated exercise may be especially useful for patients with chronic pain or other conditions requiring physical therapy, where pain may be exacerbated by exercise.
虚拟现实(VR)和运动都因其镇痛和抗焦虑特性而得到认可。本研究的目的是评估VR辅助运动调节疼痛的能力。
受试者自身交叉临床试验。
斯坦福大学儿童健康中心(LCPHS)的斯坦福战车项目开展了这项研究。
通过在LCPHS招募志愿者,纳入符合纳入标准的健康参与者。
参与者按利手随机分组,在无VR或运动的情况下接受标准化冷加压试验。经过5分钟的洗脱期后,参与者用另一只手重复测试,同时体验VR辅助运动状态。在两种状态下均收集疼痛敏感性、疼痛耐受性和交感神经激活数据。
疼痛敏感性评分为0至10分,每30秒收集一次。疼痛耐受性记录为参与者能够忍受疼痛刺激的持续时间。交感神经激活通过皮肤电导反应密度(SCRD)测量,并由生物传感器以30秒的时间段记录。在所有分析中,数据按参与者进行嵌套。
41名参与者完成了两种干预。在VR辅助运动状态下,疼痛敏感性降低(p < 0.0001)。两种状态下的疼痛耐受性没有差异。虽然两种状态都导致交感神经活动增加,但在VR辅助运动状态下,所有时间点的SCRD都更高。
疼痛敏感性降低表明VR辅助运动可改善疼痛感知。VR辅助运动对于慢性疼痛患者或其他需要物理治疗的疾病患者可能特别有用,因为运动可能会加剧这些患者的疼痛。