Application of Virtual Body Swapping to Patients with Complex Regional Pain Syndrome: A Pilot Study

Abstract

This study aimed to apply virtual body swapping through mental rehearsal for patients with complex regional pain syndrome (CRPS) and to investigate whether it is applicable to them. Ten patients who met the diagnostic criterion for CRPS type 1 were randomly assigned to either the treatment or control group. All participants were asked to watch the virtual body swapping training video clip with a head mounted display. The treatment group was additionally asked to assume a posture similar to the body on the screen and rehearse the movements mentally, as if the body presented on the screen was their body. No difference between the groups was found for pain intensity, however, the treatment group showed significantly more improvement in body perception disturbance (BPD) after the treatment than the control group. Even if the presented study is a preliminary one, the above results suggest that virtual body swapping through mental rehearsal is applicable for patients with CRPS and may be useful for improving BPD. The limitations of the study and the future investigations needed to provide clearer clinical suggestions are presented and discussed.

Physiotherapy for pain and disability in adults with complex regional pain syndrome (CRPS) types I and II

“…We extracted relevant data from eight included trials (Askin 2014;Aydemir 2006;Cacchio 2009a;Dimitrijevic 2014;Duman 2009;Durmus 2004;Hazneci 2005;Li 2012). We contacted or attempted to contact the corresponding authors of 10 trials on three occasions in order to obtain missing outcomes data (Cacchio 2009b;Jeon 2014;Moseley 2004;Moseley 2005;Moseley 2009;Mucha 1992;Schreuders 2014;Uher 2000). One trial author responded and supplied data for an outcome measure of 'impairment' but we were unable to extract outcome data linked to 'pain intensity' from the supplied data ; one trial author responded stating that they were unable to supply the relevant data (Schreuders 2014); and there was no response from the other trial authors we had contacted.…”

“…There were no trials that included participants with CRPS II. Fourteen trials included participants with CRPS I of the upper limb (Askin 2014;Aydemir 2006;Cacchio 2009a;Cacchio 2009b;Duman 2009;Durmus 2004;Hazneci 2005;Li 2012;Moseley 2004;Moseley 2005;Moseley 2009;Mucha 1992;Schreuders 2014), two with either upper or lower limb CRPS I (Dimitrijevic 2014;, one with CRPS I of the lower limb (Uher 2000) and one trial included participants with either upper, lower, multi-limb or whole body CRPS I (Jeon 2014). Participants developed CRPS I linked to a range of aetiologies including onset post fracture, soft-tissue injuries, stroke, surgery, carpal tunnel syndrome as well as of idiopathic onset.…”

“…Participants developed CRPS I linked to a range of aetiologies including onset post fracture, soft-tissue injuries, stroke, surgery, carpal tunnel syndrome as well as of idiopathic onset. Participants had acute symptoms (less than or equal to three months) of CRPS I in six trials (Cacchio 2009a;Dimitrijevic 2014;Durmus 2004;Hazneci 2005;Li 2012;Mucha 1992), chronic symptoms (greater than three months) in seven trials (Duman 2009;Jeon 2014;Moseley 2004;Moseley 2005;Moseley 2009;Schreuders 2014), a mix of acute and chronic symptoms in two trials (Askin 2014;, and three trials did not report the duration of symptoms (Aydemir 2006;Cacchio 2009b;Uher 2000). Trials were undertaken across a range of geographical locations including: Turkey (N = 5); Australia (N = 4); Italy, Germany, the Netherlands (N = 2 each); China, Serbia, and South Korea (N = 1 each).…”

“…Five trials directly compared an active and placebo intervention (Askin 2014;Aydemir 2006;Cacchio 2009a;Cacchio 2009b;Durmus 2004). Six trials evaluated electrotherapy modalities (Askin 2014;Aydemir 2006;Dimitrijevic 2014;Durmus 2004;Hazneci 2005;Mucha 1992), eight trials evaluated cortically-directed sensory-motor rehabilitation strategies (Cacchio 2009a;Cacchio 2009b;Jeon 2014;Moseley 2004;Moseley 2005;Moseley 2009;Schreuders 2014), two trials evaluated MLD (Duman 2009;Uher 2000) and two trials evaluated general rehabilitation therapies (Li 2012;.…”

“…We judged the overall risk of bias as being 'high' for 15 trials (Askin 2014;Cacchio 2009a;Cacchio 2009b;Dimitrijevic 2014;Duman 2009;Jeon 2014;Li 2012;Moseley 2004;Moseley 2005;Moseley 2009;Mucha 1992;Schreuders 2014;Uher 2000) and 'unclear' for three trials (Aydemir 2006;Durmus 2004;Hazneci 2005). We did not judge any of the included trials as having an overall 'low' risk of bias.…”