Maddox Todd, Oldstone Liesl, Sackman Josh, Maddox Roselani, Adair Takisha, Ffrench Kelsey, Sparks Charisse, Darnall Beth D
AppliedVR, Inc., Van Nuys, CA, USA.
Inspire Medical Systems, Inc, Golden Valley, MN, USA.
Pain Rep. 2024 Sep 4;9(5):e1182. doi: 10.1097/PR9.0000000000001182. eCollection 2024 Oct.
Low-risk, accessible, and long-term effective nonpharmacologic behavioral interventions for chronic low back pain (cLBP) are needed. Pain education and cognitive behavioral therapy (CBT) are recommended first-line treatments, but access is poor, treatment effectiveness is variable, and long-term effectiveness is inconsistent. In-home virtual reality (VR)-delivered therapies might address these shortcomings because therapeutic content can be delivered in a consistent and quality-controlled manner.
To determine whether a 56-session, self-administered in-home, Skills-Based VR program for cLBP (RelieVRx) yields long-term reductions in pain intensity and pain interference 12 months posttreatment in a large demographically diverse and clinically severe real-world sample.
Participants were 1,093 demographically diverse individuals with self-reported nonmalignant cLBP >3 months duration and average pain intensity and interference scores >4/10. Participants were randomized to Skills-Based VR or active Sham, and data were collected from January 31, 2022 to October 31, 2023. Pretreatment to 12-month posttreatment analyses were conducted.
From baseline to 12 months posttreatment, Skills-Based VR reductions for average pain intensity (1.7 ± 2.1) and pain interference (1.9 ± 2.3) were robust and significantly greater than those found for Sham. More than half of Skills-Based VR participants reported at least a 2-point reduction in pain intensity, pain interference, or both at 12 months posttreatment.
A standardized, in-home Skills-Based VR therapy is effective for reducing pain intensity and pain interference, and these effects are maintained to 12 months posttreatment.
对于慢性下腰痛（cLBP），需要低风险、易获得且长期有效的非药物行为干预措施。疼痛教育和认知行为疗法（CBT）被推荐为一线治疗方法，但可及性差，治疗效果不一，长期疗效也不稳定。家庭虚拟现实（VR）疗法可能会解决这些缺点，因为治疗内容可以以一致且质量可控的方式提供。
在一个人口统计学特征多样且临床症状严重的大型现实世界样本中，确定一个为期56节、可自行在家进行的基于技能的cLBP虚拟现实项目（RelieVRx）在治疗后12个月是否能长期降低疼痛强度和疼痛干扰。
参与者为1093名人口统计学特征多样的个体，他们自我报告患有非恶性cLBP，病程超过3个月，平均疼痛强度和干扰得分>4/10。参与者被随机分为基于技能的VR组或主动假治疗组，并于2022年1月31日至2023年10月31日收集数据。进行了治疗前到治疗后12个月的分析。
从基线到治疗后12个月，基于技能的VR组在平均疼痛强度（1.7±2.1）和疼痛干扰（1.9±2.3）方面的降低幅度很大，且显著大于假治疗组。超过一半的基于技能的VR组参与者在治疗后12个月报告疼痛强度、疼痛干扰或两者至少降低了2分。
标准化的家庭基于技能的VR疗法可有效降低疼痛强度和疼痛干扰，且这些效果在治疗后12个月仍能维持。
