Maddox Todd, Oldstone Liesl, Linde-Zwirble Walter, Bonakdar Robert, Maddox Roselani, Sackman Josh, Adair Takisha, Ffrench Kelsey, Sparks Charisse, Darnall Beth D
AppliedVR, Inc, 16760 Stagg Street, Suite 216, Van Nuys, CA, 91406-1642, USA.
Mainstay Medical, 2159 India Street, Suite 200, San Diego, CA, 92101, USA.
Sci Rep. 2025 Apr 25;15(1):14430. doi: 10.1038/s41598-025-98716-3.
High-impact chronic pain (HICP) affects 8.5% of the population and is associated with higher healthcare utilization and costs. Sparse data exist on pain treatment response differences between HICP vs. lower-impact chronic pain (LICP). We conducted a secondary analysis of a randomized controlled trial in a diverse community sample (N = 1067) with chronic low back pain who were demographically diverse (female: 77%; non-Caucasian: 32%; high school or less education: 19%; mean age: 50.8) and clinically severe (baseline pain intensity = 6.6, baseline pain interference = 6.2, and 42% severe/completely disabled). We compared HICP vs. LICP treatment responses for an 8-week Skills-Based Virtual Reality program at end-of-treatment and at 12-months for pain intensity and pain interference (multi-primary outcomes). MMRM analysis (multiplicity corrected) revealed significantly larger reductions (and clinically meaningful reductions) for HICP than LICP for both primary outcomes at both post-treatment time points. End-of-treatment reduction in pain interference among HICP reclassified 70% of them as LICP, and this improvement held at 12-months (67%). Significantly larger reductions were found for HICP vs LICP for the secondary outcomes Sleep Disturbance and the Oswestry Disability Index, but not for Depression. No differences were found for HICP vs. LICP for device engagement or usability scores.Trial registration: ClinicalTrials.govNCT05263037 .
高影响性慢性疼痛（HICP）影响8.5%的人口，并与更高的医疗利用率和成本相关。关于HICP与低影响性慢性疼痛（LICP）之间疼痛治疗反应差异的数据稀少。我们对一项随机对照试验进行了二次分析，该试验的样本来自一个多样化的社区（N = 1067），参与者患有慢性腰痛，人口统计学特征多样（女性：77%；非白种人：32%；高中及以下学历：19%；平均年龄：50.8岁），且临床症状严重（基线疼痛强度 = 6.6，基线疼痛干扰 = 6.2，42%为重度/完全残疾）。我们比较了HICP和LICP在接受为期8周的基于技能的虚拟现实项目治疗结束时以及治疗后12个月时的疼痛强度和疼痛干扰（多主要结局）的治疗反应。混合效应模型重复测量分析（多重性校正）显示，在两个治疗后时间点，HICP在两个主要结局上的降低幅度均显著大于LICP（且具有临床意义的降低）。HICP组在治疗结束时疼痛干扰的降低将其中70%重新分类为LICP，且这种改善在12个月时仍保持（67%）。在次要结局睡眠障碍和奥斯维斯特里残疾指数方面，HICP的降低幅度显著大于LICP，但在抑郁方面没有差异。在设备参与度或可用性评分方面，HICP与LICP没有差异。试验注册：ClinicalTrials.govNCT05263037 。
