Cerda Ivo H, Therond Alexandra, Moreau Sacha, Studer Kachina, Donjow Aleksy R, Crowther Jason E, Mazzolenis Maria Emilia, Lang Min, Tolba Reda, Gilligan Christopher, Ashina Sait, Kaye Alan D, Yong R Jason, Schatman Michael E, Robinson Christopher L
Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA.
Department of Psychology, Université du Québec à Montréal, Montréal, QC, Canada.
Curr Pain Headache Rep. 2024 Mar;28(3):83-94. doi: 10.1007/s11916-023-01205-3. Epub 2024 Jan 4.
This review provides medical practitioners with an overview of the present and emergent roles of telehealth and associated virtual reality (VR) applications in chronic pain (CP) management, particularly in the post-COVID-19 healthcare landscape.
Accumulated evidence points to the efficacy of now well-established telehealth modalities, such as videoconferencing, short messaging service (SMS), and mobile health (mHealth) applications in complementing remote CP care. More recently, and although still in early phases of clinical implementation, a wide range of VR-based interventions have demonstrated potential for improving the asynchronous remote management of CP. Additionally, VR-associated technologies at the leading edge of science and engineering, such as VR-assisted biofeedback, haptic technology, high-definition three-dimensional (HD3D) conferencing, VR-enabled interactions in a Metaverse, and the use of wearable monitoring devices, herald a new era for remote, synchronous patient-physician interactions. These advancements hold the potential to facilitate remote physical examinations, personalized remote care, and innovative interventions such as ultra-realistic biofeedback. Despite the promise of VR-associated technologies, several limitations remain, including the paucity of robust long-term effectiveness data, heterogeneity of reported pain-related outcomes, challenges with scalability and insurance coverage, and demographic-specific barriers to patient acceptability. Future research efforts should be directed toward mitigating these limitations to facilitate the integration of telehealth-associated VR into the conventional management of CP. Despite ongoing barriers to widespread adoption, recent evidence suggests that VR-based interventions hold an increasing potential to complement and enhance the remote delivery of CP care.
本综述为医学从业者概述远程医疗及相关虚拟现实(VR)应用在慢性疼痛(CP)管理中的当前和新兴作用,特别是在新冠疫情后的医疗保健格局中。
越来越多的证据表明,诸如视频会议、短消息服务(SMS)和移动健康(mHealth)应用等现已成熟的远程医疗模式在补充远程CP护理方面具有疗效。最近,尽管仍处于临床实施的早期阶段,但一系列基于VR的干预措施已显示出改善CP异步远程管理的潜力。此外,处于科学和工程前沿的VR相关技术,如VR辅助生物反馈、触觉技术、高清三维(HD3D)会议、元宇宙中的VR交互以及可穿戴监测设备的使用,预示着远程、同步医患互动的新时代。这些进展有可能促进远程体格检查、个性化远程护理以及超逼真生物反馈等创新干预措施。尽管VR相关技术前景广阔,但仍存在一些局限性,包括缺乏有力的长期有效性数据、所报告的疼痛相关结果的异质性、可扩展性和保险覆盖方面的挑战以及特定人群在患者接受度方面的障碍。未来的研究应致力于减轻这些局限性,以促进远程医疗相关VR融入CP的常规管理。尽管广泛采用仍存在障碍,但最近的证据表明,基于VR的干预措施在补充和加强CP护理的远程提供方面具有越来越大的潜力。