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Cardio-visual Stimulation in Augmented Reality for Pain Reduction

Not Applicable
Completed
Conditions
Regional Pain Syndrome
Chronic Pain Syndrome
Interventions
Device: HEART
Device: Placebo
Registration Number
NCT05085821
Lead Sponsor
Union de Gestion des Etablissements des Caisses d'Assurance Maladie - Nord Est
Brief Summary

The objective of this study is to evaluate the feasibility and efficacy of an Augmented Reality (AR) biofeedback intervention to alleviate pain symptoms in individuals suffering from chronic pain of the hand and/or the forearm.

Detailed Description

Chronic pain is a major public health problem with implications for high health care costs, lost productivity and an estimated financial burden of $500 billion. Individuals with chronic pain are also at an increased risk of developing an opioid use disorder.

Chronic pain has previously been associated with a distorted body representation, in particular of the affected body parts. Virtual Reality (VR) studies using embodiment-, respiration-, and heart-beat related feedback have demonstrated positive effects for induced pain in healthy participants (e.g., increased pain thresholds) and chronic pain in patient populations (e.g., decreased subjective pain, improved functionality, improved physiological markers of pain). Based on these studies, the AR intervention evaluated here aims to alleviate subjective pain symptoms and improve physiological pain markers in chronic pain patients using heartbeat-related feedback.

This within-subject study will compare subjective pain ratings before, during, and after an AR intervention that provides visual feedback of participants' on-going heartbeat in relation to their affected limb. Primary outcomes include subjective reports from participants (perceived efficacy, acceptability, and demand) and the intervention's clinical feasibility, including reports from therapists. Secondary outcomes include changes in heart rate and variability.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
32
Inclusion Criteria
  • Be over 18 years of age
  • Present permanent chronic pain (for more than 3 months), secondary to a peripheral pathology (traumatic, orthopedic or neurological), located in the hand or forearm.
Exclusion Criteria
  • Pregnant women
  • People in emergency situations
  • Persons unable to give informed consent
  • Persons who are mentally or linguistically unable to understand the research test instructions
  • Individuals who are not available to complete the entire study protocol
  • Cognitive impairments that prevent the use of the equipment
  • Psychiatric disorders
  • Patients with seizure disorders
  • Patients with central hemineglect
  • Pain secondary to central nervous system pathology
  • Patients with arrhythmia
  • Patients with head tremors or head shaking.

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
Experimental 1: HEART - Placebo - HEART - PlaceboHEARTThe patient receives visual feedback in an augmented reality environment in four session, over two weeks. Week 1: HEART, Placebo (after \>24hour washout) Week 2: HEART, Placebo (after \>24hour washout)
Experimental 2: HEART - Placebo - Placebo - HEARTHEARTThe patient receives visual feedback in an augmented reality environment in four session, over two weeks. Week 1: HEART, Placebo (after \>24hour washout) Week 2: Placebo, HEART (after \>24hour washout)
Experimental 3: Placebo - HEART - Placebo - HEARTHEARTThe patient receives visual feedback in an augmented reality environment in four session, over two weeks. Week 1: Placebo, HEART (after \>24hour washout) Week 2: Placebo, HEART (after \>24hour washout)
Experimental 4: Placebo - HEART - HEART - PlaceboHEARTThe patient receives visual feedback in an augmented reality environment in four session, over two weeks. Week 1: HEART, Placebo (after \>24hour washout) Week 2: Placebo, HEART (after \>24hour washout)
Experimental 2: HEART - Placebo - Placebo - HEARTPlaceboThe patient receives visual feedback in an augmented reality environment in four session, over two weeks. Week 1: HEART, Placebo (after \>24hour washout) Week 2: Placebo, HEART (after \>24hour washout)
Experimental 1: HEART - Placebo - HEART - PlaceboPlaceboThe patient receives visual feedback in an augmented reality environment in four session, over two weeks. Week 1: HEART, Placebo (after \>24hour washout) Week 2: HEART, Placebo (after \>24hour washout)
Experimental 3: Placebo - HEART - Placebo - HEARTPlaceboThe patient receives visual feedback in an augmented reality environment in four session, over two weeks. Week 1: Placebo, HEART (after \>24hour washout) Week 2: Placebo, HEART (after \>24hour washout)
Experimental 4: Placebo - HEART - HEART - PlaceboPlaceboThe patient receives visual feedback in an augmented reality environment in four session, over two weeks. Week 1: HEART, Placebo (after \>24hour washout) Week 2: Placebo, HEART (after \>24hour washout)
Primary Outcome Measures
NameTimeMethod
Change in perceived painchange in pain rating will be evaluated when participants first wear the Head-Mounted Display (baseline), after 3 minutes of video-passthrough (Pre), after 3 minutes of cardio-visual stimulation (post), after 3 minutes of video-passthrough (final)

The patient moves a cursor on a Visual Analog Scale to indicate their currently perceived level of pain. The gauge ranges from "no pain" (0) to "worst pain imaginable" (10).

Change in Heart-Rate Variability (frequency domain)a change in heart-rate variability will be evaluated between baseline (pre), intervention, and immediately following intervention (post)

frequency-domain metric of heart-rate variability (power)

Change in Heart-Rate Variability (time domain)a change in heart-rate variability will be evaluated between baseline (pre), intervention, and immediately following intervention (post)

time-domain metrics of heart-rate variability \[ms\]

Secondary Outcome Measures
NameTimeMethod
QuestionnaireThe fourth day of the study

Questionnaire on the sensations, usability, and satisfaction with the augmented reality stimulation using a Visual Analog Scale (0-10) where higher scores indicate agreement with the questionnaire item.

Trial Locations

Locations (1)

Institut Régional de Médecine Physique et de Réadaptation

🇫🇷

Nancy, France

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