Effects of virtual reality-based neck-specific sensorimotor training in patients with chronic neck pain: A randomized controlled pilot trial

Abstract

Objective To evaluate the effects of neck-specific sensorimotor training using a virtual reality device compared with 2 standard rehabilitation programmes: with, and without general sensorimotor training, in patients with non-traumatic chronic neck pain. Design Pilot randomized control study. Patients and methods A total of 51 participants were randomly assigned to 1 of 3 groups: 1: control group; 2: sensorimotor group; 3: virtual reality group. All 3 groups received the clinic’s standard rehabilitation programme. Group 2 also received “general sensorimotor training” in the form of group therapy, for a total of 120 min. Group 3 received additional virtual reality-based “neck-specific sensorimotor training” for a total of 120 min. Participants’ neck pain, headaches, active cervical range of motion, and Neck Disability Index were determined before and after 3 weeks of intervention. Results Compared with the control group, the virtual reality group showed significant ( p < 0.05) advantages in relief of headaches, and active cervical range of motion in flexion and extension. Compared with the sensorimotor group, the virtual reality group showed significant improvements in cervical extension. Conclusion Virtual reality-based sensorimotor training may increase the effects of a standard rehabilitation programme for patients with non-traumatic chronic neck pain, especially active cervical range of motion in extension. LAY ABSTRACT The aim of this study was to evaluate the effectiveness of neck-specific coordination training using a virtual reality device, in comparison with general coordination training and a standard exercise programme as part of inpatient rehabilitation for patients with chronic neck pain. Pain, disability and mobility of the neck were determined before and after 3 weeks of training intervention in 51 patients. The virtual reality training group exhibited greater effects in relief of headaches, and bending the neck forwards and backwards compared with the standard exercise group, and an increased ability to bend the neck backwards compared with the coordination training group. The results suggest that neck-specific coordination training using a virtual reality device increases the benefits of standard inpatient rehabilitation in patients with chronic neck pain, particularly in bending the neck backwards.

Provider experiences of virtual reality in clinical treatment

“…The majority of providers surveyed believe that VR helps their clients/patients progress in treatment compared to similar therapy without VR. These subjective findings corroborate previous studies that have shown the effectiveness of VR in treatment of phobias [4,11,12,[26][27][28], anxiety [5,6,10,13,20,29], PTSD [2,7,14], addictions [8,30,31], and pain management [2,3,15,16,18,32].…”

“…Virtual reality (VR) is an innovative technology that allows the user to vividly experience scenarios via immersive, multi-sensory information, typically delivered via headset including visual and auditory cues. Clinical applications of this technology include the treatment of specific phobias, trauma, eating disorders, and also management of acute and of chronic pain [1,2]. Recent years have seen VR applications developed and integrated into many realms of psychiatry and behavioral medicine, particularly for the treatment of anxiety disorders [3][4][5][6], post-traumatic stress disorder (PTSD) [7], and pain management [8,9].…”

Virtual reality exercises in an interdisciplinary rehabilitation programme for persons with chronic neck pain: A feasibility study

“…The participants reported that the VR intervention motivated them to exercise in many ways; it provided feedback, the levels encouraged them to reach a higher level, and it was important to perform the exercises correctly. The only negative effect noted was that the device was experienced as heavy, which was also observed in the study by Nusser et al ( 35 ).…”

“…The results showed increased function regarding mobility and speed in neck movements, and improved balance and increased patient satisfaction compared with kinematic training without VR ( 19 ). In a recently published pilot-study patients with non-traumatic chronic neck pain practiced sensorimotor training with a VR device in combination with a standard rehabilitation programme ( 35 ). The results were compared with those for patients who did not receive training with a VR device.…”

Neck Pain: Do We Know Enough About the Sensorimotor Control System?

“…Coordination exercises, aiming to restore the active neck movements and retrain the fine movement control of the cervical spine, are reported to reduce pain and alter motor control strategy between deep and superficial cervical muscles (Rudolfsson et al, 2014). With the development of virtual reality (VR) techniques, the VR-based kinematic training on patients with neck pain shows improvements in range of motion, accuracy, velocity, smoothness, fine motor control and coordination of the cervical spine (Nusser et al, 2021). It is believed that the VR-based kinematic training could motivate the visual systems, vestibular systems and sensorimotor control system simultaneously in patients with neck pain (Sarig Bahat et al, 2015).…”