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Virtual Reality and Meditation for Fibromyalgia

Not Applicable
Completed
Conditions
Fibromyalgia
Interventions
Device: Virtual Reality Meditation
Device: Non-VR Meditation
Registration Number
NCT05512650
Lead Sponsor
Tufts University
Brief Summary

Fibromyalgia (FM) is a particularly debilitating rheumatological syndrome which affects millions of adults in the United States. The condition presents with widespread chronic muscular pain and reduced pain thresholds, fatigue, insomnia, and negative affect. Chronic pain that is caused by FM can have significant effects on physical function, psychological parameters, and overall quality of life. Currently, there is a need for safe and effective non-pharmacologic pain-management strategies for FM, and research has shown that virtual reality (VR) may be a useful tool for some of these clients. The literature has suggested improvements in pain scores on a visual analog scale (VAS) for adults with a variety of rheumatological issues, including FM. Additional research has demonstrated that affect was improved for clients with FM who participated in a 10-minute VR mindfulness session. Such findings highlight the potential benefits of VR and mindfulness meditation for clients with FM. However, there is a great deal that remains unknown about the effectiveness of these pain management techniques. Therefore, this pilot study will examine and compare the effectiveness of combining VR and meditation for improving symptoms of FM in adults. We hypothesize that a VR meditation session will facilitate greater improvements in pain, affect, and physiological vital stats as compared to a non-immersive meditation intervention.

Detailed Description

Current treatments for fibromyalgia (FM) include pharmaceutical pain medications (ranging from over the counter to prescription opioids) as well as psychological programs with components of relaxation, cognitive therapy, and activity management. However, pain medications are not fully effective, can be addictive, and can cause hyperalgesia, and there is little research on psychological interventions for FM.

One treatment that has demonstrated some efficacy for reducing chronic pain is meditation. Various studies have demonstrated that there are generally reductions in affective pain for those who practice meditation. Another promising treatment option for FM is virtual reality (VR). VR is an immersive 3D experience during which the participant wears a headset or helmet which simulates the sensation of being elsewhere. There is evidence which shows that VR can be an effective treatment for pain reduction. However, most studies which utilize VR as a method of pain reduction focus on acute pain and studies looking at VR for chronic pain are scarce.

One preliminary study examined the utility of VR in treating FM. Results from this study showed that positive affect increased after participants engaged in a 10-minute meditation and mindfulness VR session. Further, they found a slight reduction in the negative impact of FM on overall life and wellbeing, as measured by the FM Impact Questionnaire (FIQ). However, small sample sizes and the addition of other adjunctive therapies limit the significance of these study results. Additional research on VR and meditation for the treatment of FM and other rheumatological conditions also demonstrated reductions in pain scores, offering promising data on meditation and VR being used in combination.

Given the promising literature on VR and meditation, this study will aim to further the field of knowledge surrounding use of VR meditation for reducing pain and increasing affect for adults with FM. Despite the encouraging data on using these interventions for FM, it is unknown whether the immersive aspect of the VR is helping to improve results. This pilot study will aim to address this question by comparing an immersive VR meditation session with a non-immersive, typical meditation for FM patients.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
9
Inclusion Criteria
  1. Adults ages 18 and older (no upper limit)
  2. Diagnosis of fibromyalgia with a minimum average pain level of 3 over the last week
  3. English-speaking
  4. Willing and able to visit the Brigham and Women's Pain Management Center site on two separate occasions to participate in the study
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Exclusion Criteria
  1. Unwilling to put on VR headset
  2. Experience a seizure in the last 5 years
  3. Cognitive impairment
  4. Hearing/visual deficit
  5. Active, contagious skin infection
  6. Eye infections
  7. Has a pacemaker or defibrillator
  8. Has a hearing aid
  9. History of myocardial infarction or other serious cardiovascular condition
  10. Current peripheral neuropathy
Read More

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
VR firstVirtual Reality MeditationAt their first visit, subjects will engage in a virtual reality meditation while wearing the VR headset. At their second visit, they will engage in a non-immersive meditation without the 3D VR aspect.
VR firstNon-VR MeditationAt their first visit, subjects will engage in a virtual reality meditation while wearing the VR headset. At their second visit, they will engage in a non-immersive meditation without the 3D VR aspect.
VR secondVirtual Reality MeditationAt their first visit, subjects will engage in a non-immersive meditation without the 3D VR aspect. At their second visit, they will engage in a virtual reality meditation while wearing the VR headset.
VR secondNon-VR MeditationAt their first visit, subjects will engage in a non-immersive meditation without the 3D VR aspect. At their second visit, they will engage in a virtual reality meditation while wearing the VR headset.
Primary Outcome Measures
NameTimeMethod
Pain Numerical Rating Scale [NRS] (change from pre-intervention to post-intervention)Pre-intervention and within 20 minutes after intervention at both visits.

Measures the intensity of pain on an 11-point scale, ranging from 0-10. 0 is "no pain", and 10 is "pain as bad as you can imagine".

Secondary Outcome Measures
NameTimeMethod
Pain Catastrophizing Scale [PCS]Pre-intervention at visit 1.

Thirteen-item self-report questionnaire that collects data on the types of thoughts and feelings the participants have when in pain. The participants will be asked to rank the degree to which they have certain thoughts and feelings when they are in pain using a 5-point Likert scale, from 0 (not at all) to 4 (all the time).

Quantitative Sensory Testing (QST)Pre-intervention and within 10 minutes after intervention at both visits.

Measurements of pain thresholds for bilateral trapezius muscles using a pressure algometer and measurement of temporal summation using a Neuropen on the non-dominant middle finger.

Blood PressurePre-intervention and immediately after intervention at both visits.

Systolic and Diastolic blood pressure will be obtained using an automated BP cuff.

Brief Pain Inventory-Short FormPre-intervention at both visits.

Fifteen-item self-report questionnaire that measures participant's various levels of pain severity in the past 24 hours, and perception of the degree to which pain prevents participation in important daily activities (e.g. work, socialization) and enjoyment of life. Eight pain severity items are rated on a 11-point scale of 0 (no pain) to 10 (pain as bad as you can imagine). Seven pain interference items are rated on a 11-point scale of 0 (does not interfere) to 10 (completely interferes).

PROMIS Emotional Distress - Short FormPre-intervention at both visits

24-item self report questionnaire that measures how often participant experiences feelings related to depression, anxiety and anger in the past seven days. These questionnaires have been modified to ask about the past 24 hours. The questionnaire uses a 5-point Likert scale, from 1 (never) to 5 (always). This questionnaire will assess the participant's psychological state.

Baseline SurveyPre-intervention at visit 1

Obtains demographics, medical history, perceptions/attitudes of pain, and experiences with VR.

User Engagement Scale (UES)Within 20 minutes after intervention at both visits.

Twelve-item self-report questionnaire that measures the participant's perception of how engaged they were with the experience using a 5-point Likert scale from 1 (strongly disagree) to 5 (strongly agree). This questionnaire will determine immersion into the meditation.

Heart RatePre-intervention and immediately after intervention at both visits.

Heart rate will be obtained using an automated BP cuff.

Fibromyalgia Impact Questionnaire (FIQ)Pre-intervention at visit 1.

10-item self-report questionnaire that measures the functional impacts FM had on the participants' life over the last 7 days. Items relate to physical functioning and physical symptoms, as well as psychological impact of FM, and occupational interference.

Simulator Sickness Questionnaire [SSQ]Within 20 minutes after intervention at both visits.

List of sixteen symptoms which are commonly experienced by users of virtual reality systems. Participants rate the severity of these symptoms while using the VR system using a 4-point Likert scale from 1 (none) to 4 (severe). This questionnaire will monitor the extent of motion sickness in our participants.

Meditation Experience Questionnaire (MEQ)Within 20 minutes after intervention at both visits.

Thirteen-item self-report questionnaire that asks subjects to rate the frequency of occurrence of various experiences, such as fatigue, pleasant/unpleasant thoughts, and thoughts about planning or memories, during meditation intervention to evaluate quality of meditation immersion. Uses 5-point Likert scale from 1 (never) to 5 (almost constantly).

Positive and Negative Affect Scale [PANAS]Pre-intervention and within 20 minutes after intervention at both visits.

This ten-item self-report questionnaire measures the extent to which the participant felt various emotions right now. This questionnaire uses a 5-point Likert scale, from 1 (very slightly or not at all) to 5 (extremely). This questionnaire will assess the participant's psychological state.

Trial Locations

Locations (1)

Brigham and Women's Pain Management Center

🇺🇸

Chestnut Hill, Massachusetts, United States

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