Virtual reality for spinal cord injury-associated neuropathic pain: Systematic review.

Document Type

Article

Abstract

BACKGROUND: Treatment of spinal cord injury (SCI)-associated neuropathic pain is challenging, with limited efficacy and no definitive options, and SCI patients often show resistance to pharmacologic treatment. Virtual reality (VR) therapy is a non-invasive, non-pharmacologic alternative with minimal adverse effects.

OBJECTIVE: To investigate the effect of VR therapy on SCI-associated neuropathic pain in a systematic review.

METHODS: Articles needed to 1) be written in English; 2) include adult subjects, with at least half the study population with a SCI diagnosis; 3) involve any form of VR therapy; and 4) assess neuropathic pain by quantitative outcome measures. Articles were searched in MEDLINE/PubMed, CINAHL

RESULTS: Among 333 studies identified, 9 included in this review (n=150 participants) evaluated 4 methods of VR therapy (virtual walking, VR-augmented training, virtual illusion, and VR hypnosis) for treating neuropathic pain in SCI patients. Each VR method reduced neuropathic pain: 4 studies supported virtual walking, and the other 3 VR methods were each supported by a different study. Combined treatment with virtual walking and transcranial direct current stimulation was the most effective. The quality of studies was a major limitation.

CONCLUSION: VR therapy could reduce SCI-associated neuropathic pain, although the clinical significance of this analgesic effect is unclear. Clinical trials evaluating VR therapy as standalone and/or adjunct therapy for neuropathic pain in SCI patients are warranted.

Medical Subject Headings

Adult; Combined Modality Therapy; Female; Humans; Male; Neuralgia; Spinal Cord Injuries; Transcranial Direct Current Stimulation; Treatment Outcome; Virtual Reality Exposure Therapy

Publication Date

1-1-2019

Publication Title

Ann Phys Rehabil Med

ISSN

1877-0665

Volume

62

Issue

1

First Page

49

Last Page

57

PubMed ID

30312665

Digital Object Identifier (DOI)

10.1016/j.rehab.2018.09.006

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