This paper describes the research work being carried out by the Transforming Pain Research Group -the only group whose work is exclusively focused on the use of immersive VR for chronic pain management. Unlike VR research for acute or short-term pain, which relies on pain "distraction," this research posits a new paradigm for the use of VR. In addition to providing an overview of our work, the present paper also describes one of our current works in detail: the Virtual Meditative Walk.

In this paper, we address the issue of sound mapping in virtual environments (VEs). Currently, the use of sound in virtual environments is shifting towards adaptive or generative techniques in which sound no longer has a static quality but is dynamic via real-time controls that modify the tonal characteristics over time. We build upon the acoustic communication model posited by Barry Truax by examining two aspects: how sound mediates information and its importance to the listener through cognitive processing. Using this model and investigating the qualitative aspects of soundwalks, soundscape composition, and sound in virtual reality (VR), we present a hybrid model, which addresses the use of procedural sound design techniques to enhance the communicative and pragmatic role of sound in virtual environments. The end result produces a sonic environment that heightens the listeners' experience and cognitively engages them to sounds within a specific time and space. parameterization of sounds can improve the communicative quality of sound, and help the user engage more actively in the VE. The context and appropriate use of the sound influences the type of information that is received by the listener.The communication model in Figure 1., developed by Barry Truax illustrates the importance of sound and context. This model can be modified to include parameterization of sound, which can lead to a procedural communication model. We posit a procedural communication model (Fig. 3), one that emphasizes sound that dynamically changes, in order to improve the quality of information passed to the user in the virtual environment. COMMUNICATION MODELIn 1971, a team of researchers in the Communications department at Simon Fraser University organized the World Soundscape Project (WSP). Led by R. Murray Schafer, the objective of the project was to understand the acoustic environment and how human activity has affected the level of noise present in our surroundings. This work resulted in the publishing of two books, The New Soundscape and The Book of Noise. Furthermore, this body of knowledge helped introduce new Canadian noise bylaws. Through this longitudinal research project, these researchers established the field of Acoustic Ecology. Schafer's intention was to capture and record the idealized soundscape of the natural environment and preserve it from the negative aspects of modernization. Truax, on the other hand, set out to look at the communicative aspect of sound. Thus he developed the acoustic communication model, first published in the 2001 edition of his book, Acoustic Communication. In Truax's model, rather than focusing on the energy transfer of sound, he emphasized the importance of the greater exchange of information between the listener and the sounds of the environment. According to Truax, through cognitive processing we are able to examine the sonic information and to discern the level of importance we deem to be useful. The central tenet of this communication model then is the human act of listening. Unlike hearing...

This paper introduces a multidisciplinary and interactive approach to self-management of chronic pain using Virtual Reality (VR). This approach is meant to reduce the reliance on heavy use of medication and provide a non-pharmacological method for pain management. In addition, the paper discusses additional technologies that deal with issues surrounding immersion, presence, and interface design that directly impact the quality of treatment patients can obtain through VR therapy. A set of guidelines are also included that signify the importance of using biofeedback and interactive sound design to help improve rehabilitation and meditation practices for pain reduction.

Background Chronic pain is a highly prevalent and disabling condition which is often undertreated and poorly managed in the community. The emergence of COVID-19 has further complicated pain care, with an increased prevalence of chronic pain and mental health comorbidities, and burnout among physicians. While the pandemic has led to a dramatic increase in virtual health care visits, the uptake of a broader range of eHealth technologies remains unclear. The present study sought to better understand physicians’ current needs and barriers in providing effective pain care within the context of COVID-19, as well as gauge current use, interest, and ongoing barriers to eHealth implementation. Methods A total of 100 practicing physicians in British Columbia, Canada, completed a brief online survey. Results The sample was comprised of physicians practicing in rural and urban areas (rural = 48%, urban = 42%; both = 10%), with the majority (72%) working in family practice. The most prominent perceived barriers to providing chronic pain care were a lack of interdisciplinary treatment and allied health care for patients, challenges related to opioid prescribing and management, and a lack of time to manage the complexities of chronic pain. Moreover, despite expressing considerable interest in eHealth for chronic pain management (82%), low adoption rates were observed for several technologies. Specifically, only a small percentage of the sample reported using eHealth for the collection of intake data (21%), patient-reported outcomes (14%), and remote patient monitoring (26%). The most common perceived barriers to implementation were cost, complexity, and unfamiliarity with available options. Conclusions Findings provide insight into physicians’ ongoing needs and barriers in providing effective pain management during the COVID-19 pandemic. Despite the potential for eHealth technologies to help address barriers in pain care, and strong interest from physicians, enhanced useability, education and training, and funding are likely required to achieve successful implementation of a broader range of eHealth technologies in the future.

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