Remote kinematic training for patients with chronic neck pain: a randomised controlled trial

Bahat, Hilla; Croft, Kate; Carter, Courtney; Hoddinott, A.; Sprecher, Elliot; Treleaven, Julia

doi:10.1007/s00586-017-5323-0

Cited by 96 publications

(171 citation statements)

References 56 publications

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“…Therefore, VR treatment offers increased feedback, turning the technique into a powerful pain-distracting mechanism. It has been used in burn patients, central sensitization, chronic pain and neurological disorders [22,23]. Interaction and immersion in VR systems determine the different types of VR (immersive, semi-investment projection, semi-investment second person, non-immersive or video games).…”

Section: Introductionmentioning

confidence: 99%

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Effects of Virtual Reality versus Exercise on Pain, Functional, Somatosensory and Psychosocial Outcomes in Patients with Non-specific Chronic Neck Pain: A Randomized Clinical Trial

Tejera

Beltrán-Alacreu

Cano‐de‐la‐Cuerda

et al. 2020

IJERPH

112

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Background: Virtual reality (VR) applied to patients with neck pain is a promising intervention to produce positive effects when used alone or combined with exercise. Therefore, the objective of this manuscript is to compare the effects of VR versus exercise treatment on pain intensity, conditioned pain modulation (CPM), temporal summation (TS) and functional and somatosensory outcomes in patients with non-specific chronic neck pain (NS-CNP). Methods: A single-blinded, randomized clinical trial was carried out. A total sample of 44 patients with NS-CNP was randomized into a VR treatment group or neck exercises group. The intervention consisted of two treatment sessions per week, for four weeks and eight sessions. Four measurement moments (at baseline, immediately, 1 month, and 3 months after intervention) were considered. Pain intensity, CPM, TS, functional and somatosensory outcomes were measured. Results: Statistically significant differences were revealed for time factor (F = 16.40, p < 0.01, ηp2 = 0.28) and group*time interaction for kinesiophobia (F = 3.89, p = 0.01, ηp2 = 0.08) showing post-hoc differences in favor of the VR group at 3 months (p < 0.05, d = 0.65). Significant effects were shown for time factor (p < 0.05) but not for the group*time interaction (p > 0.05) for pain intensity, rotation range of motion (ROM), Neck Disability Index, pain catastrophizing, fear-avoidance beliefs, left side pressure pain threshold (PPT) and anxiety. Statistically significant differences were not found for time factor (p > 0.05) and neither in group*time interaction (p > 0.05) for CPM, TS, right side PPT, flexo-extension and lateral-flexion ROM. Conclusions: Kinesiophobia was the only outcome that showed differences between VR and exercise at 3 months. Nevertheless, pain intensity, CPM, TS, ROM, neck disability, pain catastrophizing, fear-avoidance beliefs, PPT and anxiety did not show differences between both interventions.

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Section: Introductionmentioning

confidence: 99%

“…The hypoalgesic effects of distraction by VR have been mainly investigated during experimentally induced pain in healthy subjects or during acute procedural pain. In rehabilitation sciences, some clinical trials have previously evaluated the effectiveness of VR on individuals with neck pain [22,23].…”

Section: Introductionmentioning

confidence: 99%

Effects of Virtual Reality versus Exercise on Pain, Functional, Somatosensory and Psychosocial Outcomes in Patients with Non-specific Chronic Neck Pain: A Randomized Clinical Trial

Tejera

Beltrán-Alacreu

Cano‐de‐la‐Cuerda

et al. 2020

IJERPH

112

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“…Five were randomized controlled trials, one was a non-randomized controlled trial, six were single group pre-test post-test without a control group comparison and one was a within-subject repeated measures design study. The randomized controlled trial conducted by Sarig Bahat et al [16] was divided into two phases and the two phases are reported separately. Three studies evaluated participants with neck pain [5,16,17], three studies evaluated participants with phantom limb pain [18,19,20], and two studies evaluated participants with chronic back pain.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…The randomized controlled trial conducted by Sarig Bahat et al [16] was divided into two phases and the two phases are reported separately. Three studies evaluated participants with neck pain [5,16,17], three studies evaluated participants with phantom limb pain [18,19,20], and two studies evaluated participants with chronic back pain. [10,21] Two studies evaluated participants with neuropathic pain [22,23], one study evaluated participants with ankylosing spondylitis [9], one study evaluated participants post-mastectomy and one study evaluated participants with subacromial impingement syndrome and scapular dyskinesis.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…[10,21,23] In the three studies investigating participants with neck pain, movements of the head were tracked by accelerometers attached to the head-mounted display. [16,17] Movements of virtual limbs were controlled by movements of the nonaffected limb in three studies investigating phantom limb pain [19,20,22] and by the affected limb in one study. [18] Treatment frequency and duration of interventions varied between studies from one 10-minute session for phantom limb pain [19], to five 30-minute sessions per week for eight weeks for ankylosing spondylitis.…”

Section: Treatment Characteristicsmentioning

confidence: 99%

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The effect of interactive virtual reality on pain perception: a systematic review of clinical studies

Wittkopf

Lloyd

Coe

et al. 2019

Disability and Rehabilitation

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The aim of this systematic review was to evaluate the effect of immersive and non-immersive interactive virtual reality on pain perception in patients with a clinical pain condition. Methods: The following databases were searched from inception: Medline (Ovid), PsychInfo, CINAHL, Cochrane library and Web of Science. Two reviewers screened reports and extracted the data. A third reviewer acted as an arbiter. Studies were eligible if they were randomized controlled trials, quasi-randomized trials, and uncontrolled trials. Crossover and parallel-group designs were included. Risk of bias was assessed for all included studies. Results: Thirteen clinical studies were included. The majority of studies investigated a sample of participants with chronic pain. Six were controlled trials and seven uncontrolled studies. Controlled research showed that interactive virtual reality reduces pain associated with ankylosing spondylitis and post-mastectomy, but results are inconsistent for patients with neck pain. Findings from uncontrolled studies showed that interactive virtual reality reduced neuropathic limb pain, and phantom limb pain, but had no effect on non-specific chronic back pain. Conclusions: There is not enough evidence upon which to judge the effectiveness of the use of virtual reality for the management of pain.

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Exercise‐induced changes in central sensitization outcomes in individuals with chronic musculoskeletal pain: A systematic review with meta‐analysis

Chen,

Rolan,

Hutchinson

et al. 2024

European Journal of Pain

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Background and ObjectiveTemporal summation of pain (TSP) and conditioned pain modulation (CPM) are the two most commonly used clinical measures of central sensitization (CS). However, the effectiveness of exercise on TSP and CPM has yet to be evaluated. This review aims to investigate the effect of exercise alone on CS outcomes in individuals with chronic musculoskeletal pain.Databases and Data TreatmentThis is a systematic review and meta‐analysis. MEDLINE, EMBASE, CINAHL, PEDro and Cochrane databases were searched. Data were extracted based on the exercise modality and grouped into aerobic, resistance, isometric, or motor control modalities. Risk of bias was assessed using RoB2, RoB2 for crossover trials and ROBINS‐I tools. Quality of evidence was assessed using GRADE. Random‐effects meta‐analyses were conducted, with subgroup analysis conducted for each exercise modality.ResultsThe meta‐analyses included thirteen studies, consisting of eight non‐randomized studies, three randomized controlled trials and three randomized crossover trials. Data were categorized into four subgroups for analyses based on exercise modality. No statistically significant effect existed for both TSP and conditioned pain modulation. However, motor control exercise was found to have a significant enhancing effect on conditioned pain modulation. No significant differences were found between the exercise subgroup for both TSP and conditioned pain modulation.ConclusionsWe did not find an overall effect of physical exercise on TSP and CPM. However, subgroup analysis shows favourable effects of motor control exercise in individuals with chronic neck pain. Future research should focus on exercise modality and dosage and their role in the mechanism involved in TSP and CPM in predefined populations.Significance StatementResults from this study found that motor control exercise has a significant enhancing effect on conditioned pain modulation, with subgroup analysis showing favourable effects of motor control exercise in individuals with chronic neck pain. This indicates that physical exercise may have a positive effect on central sensitisation in individual with chronic neck pain. However, differential effects may exist between different types of exercise. These findings will inform understanding of neurobiological effects underlying chronic neck pain and may guide the development of more effective, personalised treatments.

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Remote kinematic training for patients with chronic neck pain: a randomised controlled trial

Abstract: ACTRN12615000231549.

Cited by 96 publications

References 56 publications

Effects of Virtual Reality versus Exercise on Pain, Functional, Somatosensory and Psychosocial Outcomes in Patients with Non-specific Chronic Neck Pain: A Randomized Clinical Trial

Effects of Virtual Reality versus Exercise on Pain, Functional, Somatosensory and Psychosocial Outcomes in Patients with Non-specific Chronic Neck Pain: A Randomized Clinical Trial

The effect of interactive virtual reality on pain perception: a systematic review of clinical studies

Exercise‐induced changes in central sensitization outcomes in individuals with chronic musculoskeletal pain: A systematic review with meta‐analysis

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