Adapting Virtual Reality Technology for the Treatment of Phantom Limb Pain

采用虚拟现实技术治疗幻肢痛

• 批准号: 8920264
• 负责人: THOMAS RUTLEDGE
• 金额: --
• 依托单位: VA SAN DIEGO HEALTHCARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-10-01 至 2018-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8920264
• 关键词: Acute Pain; Address; Adherence; Adverse effects; Aftercare; Amputation; Amputees; Appointment; Area; Behavior Therapy; Behavioral; Caring; Chronic; Chronic Disease; Client satisfaction; Clinic Visits; Clinical Trials; Cognitive Therapy; Conflict (Psychology); Data; Development; Devices; Diabetes Mellitus; Dimensions; Distress; Ecological momentary assessment; Effectiveness; Elements; Environment; Equipment; Esthesia; Evaluation; Event; Exercise; Exercise Therapy; Frequencies; Functional Magnetic Resonance Imaging; Funding; Gold; Health Services Accessibility; Healthcare; Home environment; Illusions; Image; Intervention; Life; Limb structure; Lower Extremity; Military Personnel; Modality; Modeling; Moods; Nature; Neurobiology; Pain; Pain Research; Pain intensity; Pain management; Participant; Patient Self-Report; Patients; Pattern; Persons; Phantom Limb; Phantom Limb Pain; Phase; Population; Primary Health Care; Protocols documentation; Psychotherapy; Quality of life; Questionnaires; Randomized; Relaxation Therapy; Reporting; Research; Research Personnel; Resistance; Severities; Specialist; Staging; Strategic Planning; System; Technology; Testing; Time; Training; Translating; Treatment Efficacy; Upper Extremity; Veterans; alternative treatment; base; care systems; chronic pain; comparative effectiveness; comparative efficacy; design; disability; effective therapy; effectiveness trial; experience; functional status; health care delivery; improved; individualized medicine; infancy; limb amputation; medical specialties; new technology; novel; outreach; psychological distress; public health relevance; satisfaction; standard care; treatment duration; trial comparing; usability; user-friendly; virtual reality

 DESCRIPTION (provided by applicant): The VA recognizes pain as the "5th vital sign" in healthcare delivery, encouraging advancements in the assessment and management of pain in Veterans. Due to both ongoing military conflicts and common chronic diseases such as diabetes, a growing number of Veterans are living with amputations. Among this group, many report a phenomenon called phantom limb pain, a form of pain experienced in the amputated limb of the Veteran that is often chronic, debilitating, and resistant to standard biomedical pain therapies. Developing effective alternative treatments for phantom limb pain can potentially improve the quality of life and functional status of these Veterans. In a previous VA-funded clinical trial, this team of investigators completed the first comparativeness effectiveness study for phantom limb pain that evaluated mirror therapy, a behavioral treatment with promise for the treatment of phantom limb pain. In the current proposal, we aim to advance mirror therapy to the next stage of development by developing an immersive virtual reality treatment that incorporates the effective components of standard mirror therapy while also addressing the known weaknesses of mirror therapy. For example, in standard mirror therapy, only patients with unilateral amputations can perform the exercises and the person needs to carry the mirror in order to perform the therapy. Using a virtual reality platform, we can circumvent these limitations by immersing Veterans in a highly portable simulated environment in which they can perform mirror therapy exercises irrespective of amputation pattern. We will also address important questions about the relative benefits of virtual reality treatments for pain in this study. At present, it is unknown if it is te nonspecific elements of virtual reality that produce pain reduction benefits or if it is more speciic features of the virtual reality environment. We will evaluate these questions using a protocol in which patients are randomized to either the virtual reality equipment over one month treatment periods or to a matched standard behavioral mirror therapy treatment. The objective of this two year study is to develop an develop a portable and user friendly virtual reality treatment platform for treating phantom limb pain and evaluating its feasibility among a group of Veterans.

 描述（由申请人提供）： VA认为疼痛是医疗保健提供的“第五生命体征”，鼓励了退伍军人疼痛评估和管理方面的进步。由于持续的军事冲突和常见的慢性疾病（例如糖尿病），越来越多的退伍军人生活在截肢上。在该组中，许多人报告了一种称为幻影肢体疼痛的现象，这是一种经常长期慢性，衰弱和对标准生物医学疼痛疗法具有抗药性的截肢肢体所经历的疼痛形式。为幻影肢体疼痛开发有效的替代治疗方法可能会改善这些退伍军人的生活质量和功能状况。在先前由VA资助的临床试验中，该研究人员完成了第一个评估镜像治疗的幻影症疼痛的比较有效性研究，该研究是一种行为治疗，这是一种有望治疗幻影肢体疼痛的人。在当前的提案中，我们旨在通过开发沉浸式虚拟现实疗法来将镜像疗法推向下一阶段，该疗法结合了标准镜像疗法的有效组成部分，同时还解决了镜像疗法的已知弱点。例如，在标准镜像疗法中，只有单侧截肢的患者才能进行练习，并且该人需要携带镜子才能进行治疗。使用虚拟现实平台，我们可以通过将退伍军人浸入高度便携式的模拟环境中来规避这些限制，在这种环境中，他们可以进行镜像疗法练习，而与截肢模式无关。在本研究中，我们还将解决有关虚拟现实治疗对疼痛的相对好处的重要问题。目前，尚不清楚虚拟现实的非特异性要素会产生减轻疼痛的益处，或者是虚拟现实环境的更具体的特征。我们将使用一条方案评估这些问题，在该方案中，患者在一个月的治疗期内将患者随机分配到虚拟现实设备或匹配的标准行为镜治疗治疗。这项两年研究的目的是开发一个便携式和用户友好的虚拟现实处理平台 用于治疗幻影肢体疼痛并评估其在一组退伍军人中的可行性。