RabbitRun: An Immersive Virtual Reality Game for Promoting Physical Activities Among People with Low Back Pain

Abstract

Low back pain (LBP) is one of the most common problems among adults. The usual physiotherapy treatment is to perform physical exercises. However, some LBP patients have false beliefs regarding their pain and they tend to avoid physical movements which might increase their pain and disability. Virtual reality (VR) has proven to be an effective intervention in improving motor functions and reducing pain perception. Existing VR interventions for LBP rehabilitation were based on a non-immersive VR, whereas to effectively reduce the pain intensity, we need an immersive VR. In this paper, we introduce the development and evaluation of a serious game called RabbitRun with an immersive experience to engage the patients in a virtual environment and distract them from the pain while performing LBP exercises. The initial usability evaluation results suggest that RabbitRun game is enjoyable and acceptable. The game is easy to play and learn and most of the participants are willing to play the game at home. This solution will enhance the rehabilitation outcome since the patients who are suffering from LBP can use the system at their home and train more for long period of time using a smartphone and low-cost virtual reality device, such as Google Cardboard.

Occupational Therapy's Role in Pain Management using Virtual Reality

“…Recent literature has also revealed VR's effectiveness in reducing pain by altering one's pain perception. According to Alazba, Al-Khalifa & AlSobayel (2018), pain can be effectively reduced with an immersive VR system that addresses the Fear Avoidance Model. The Fear Avoidance Model suggests that the development of pain in individuals differ based on their levels of pain-related fear of movement, also known as kinesiophobia (Alazba, Al-Khalifa & AlSobayel, 2018).…”

“…According to Alazba, Al-Khalifa & AlSobayel (2018), pain can be effectively reduced with an immersive VR system that addresses the Fear Avoidance Model. The Fear Avoidance Model suggests that the development of pain in individuals differ based on their levels of pain-related fear of movement, also known as kinesiophobia (Alazba, Al-Khalifa & AlSobayel, 2018). As such, those who are more prone to catastrophize pain are also more likely to exaggerate their pain or falsely perceive it as a sign of seriously harm or damage.…”

“…As such, those who are more prone to catastrophize pain are also more likely to exaggerate their pain or falsely perceive it as a sign of seriously harm or damage. Because of this, these individuals will tend to avoid movement and even physical activities altogether (Alazba, Al-Khalifa & AlSobayel, 2018). By addressing this fear of movement, VR has the OT's ROLE IN PAIN MANAGEMENT USING VIRTUAL REALITY ability to alter one's pain perception, thereby allowing them to not only move, but thrive in a less painful environment (Fowler, Ballistrea, Mazzone, Martin, Kaplan, Kip, Murphy, & Winkler, 2019).…”

“…Several other studies have also shown VR's ability to help individuals overcome their fear of movement due to pain, including those with impaired movements due to hemiplegia, hip pain, lower back pain, multiple sclerosis, and even Parkinson's disease (Walino-Paniagua et al, 2019;Alemanno et al, 2019;Alazba, Al-Khalifa & AlSobayel, 2018;Aran, Sahin, Torpil, Demirok & Kayihan, 2017;Bolte, Lussanet, & Lappe, 2015;Kim, Min, Kim & Lee, 2014).…”

“…By distracting pain and facilitating purposeful movement, VR can significantly reduce one's risk for greater functional disability, improve their ability to perform desired activities, and more importantly, improve their coping ability so that they can better manage their pain experience (Fowler et al, 2019;Alazba, Al-Khalifa & AlSobayel, 2018). However, like opioids, OT's ROLE IN PAIN MANAGEMENT USING VIRTUAL REALITY 8 the use of virtual reality alone cannot effectively improve an individual's pain management.…”