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research article

Heartbeat-enhanced immersive virtual reality to treat complex regional pain syndrome

Solcà, Marco  
•
Ronchi, Roberta
•
Bello-Ruiz, Javier
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2018
Neurology

OBJECTIVES: To develop and test a new immersive digital technology for complex regional pain syndrome (CRPS) that combines principles from mirror therapy and immersive virtual reality and the latest research from multisensory body processing. METHODS: In this crossover double-blind study, 24 patients with CRPS and 24 age- and sex-matched healthy controls were immersed in a virtual environment and shown a virtual depiction of their affected limb that was flashing in synchrony (or in asynchrony in the control condition) with their own online detected heartbeat (heartbeat-enhanced virtual reality [HEVR]). The primary outcome measures for pain reduction were subjective pain ratings, force strength, and heart rate variability (HRV). RESULTS: HEVR reduced pain ratings, improved motor limb function, and modulated a physiologic pain marker (HRV). These significant improvements were reliable and highly selective, absent in control HEVR conditions, not observed in healthy controls, and obtained without the application of tactile stimulation (or movement) of the painful limb, using a readily available biological signal (the heartbeat) that is most often not consciously perceived (thus preventing placebo effects). CONCLUSIONS: Next to these specific and well-controlled analgesic effects, immersive HEVR allows the application of prolonged and repeated doses of digital therapy, enables the automatized integration with existing pain treatments, and avoids application of painful bodily cues while minimizing the active involvement of the patient and therapist. CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that HEVR reduces pain and increases force strength in patients with CRPS.

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Type
research article
DOI
10.1212/WNL.0000000000005905
Web of Science ID

WOS:000440911900010

Author(s)
Solcà, Marco  
Ronchi, Roberta
Bello-Ruiz, Javier
Schmidlin, Thomas
Herbelin, Bruno
Luthi, François
Konzelmann, Michel
Beaulieu, Jean-Yves
Delaquaize, François
Schnider, Armin
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Date Issued

2018

Published in
Neurology
Volume

91

Issue

5

Start page

e479

End page

e489

Editorial or Peer reviewed

REVIEWED

Written at

EPFL

EPFL units
LNCO  
CNP  
Available on Infoscience
December 17, 2018
Use this identifier to reference this record
https://infoscience.epfl.ch/handle/20.500.14299/152995
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