Wednesday, April 24, 2019




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How Virtual Reality Therapy Can Treat Chronic Pain



“I didn’t think a human could experience that much pain,” Greenport, New York, resident Bob Jester says in a video from the website Immersive Health.

In August 2016, Jester fell from a rooftop and broke 19 bones, mainly in his back and legs. After multiple surgeries, he found himself with several rods and 16 bolts in his back and was facing excruciating pain that kept him awake at night. That’s when he started using virtual reality therapy as part of a chronic pain treatment program.

Each day, when he felt as though he needed to pop another pain pill, Jester would put on the virtual reality (VR) goggles and become immersed in a world that distracted him from his pain. It would take his attention away from the pain, he says, and soon he learned to train his brain to do that same thing for an hour or two after he used the technology. A year later, Jester has stopped using opioid pain medication and, although some doctors have told him that he will never walk again, he can now move his left leg.

Chronic pain affects 50 million people in the United States, according to the Centers for Disease Control. But virtual reality therapy is beginning to show results, reports a 2018 research review in the medical journal Current Pain and Headache Reports. The immersive experience distracts patients from pain enough to help them cope. For instance, a 2016 study published in PLOS One found that almost all of the 30 burn patients who used a five-minute VR application called “Cool!” reported a decrease in pain from the beginning of the session to the end. Ten said they felt no pain at all during the session. Findings like these are making virtual reality therapy a viable treatment for chronic pain.
Theory and Technology Merge

These medical approaches and other distraction-related VR therapies are based on the “gate control” theory of pain, which was first introduced in 1965, according to Pain-Health. The theory says that as pain messages travel through the nervous system, they encounter “gates” in the spinal cord. Some pain messages get through and reach the brain, while others do not. Distraction therapies give the brain a chance to send a signal down the spinal cord and close the pain gates before the signal arrives at the brain.

Several healthcare companies are merging medical theory and technology to develop chronic pain treatments that use VR. Los-Angeles-based AppliedVR is one of these providers. Since 2015, the company has developed solutions for more than 250 hospitals and 20,000 patients in eight countries globally. A variety of VR modules cover a different topic such as relaxation, breathing techniques, mindfulness meditation and positive thinking. Patients can not only learn to cope with chronic pain, anxiety or stress but also practice prepping for childbirth or an MRI scan.

The Silicon Valley-based firm CognifiSense wants to pair VR with psychological therapies to address so-called maladaptive neuroplastic changes in the brain. These are changes that occur in the brain when the nervous system responds to an injury by establishing new nerve connections or altering the strength of existing ones. Sometimes these changes drive chronic pain; in theory, retraining them could reduce that pain.

Virtual reality therapy is a relatively new kind of chronic pain treatment plan. But early results show that it may be effective. In a world where the overuse of opioid medications has led to addiction, overdose and death, finding new alternatives to dealing with pain is a priority. Relatively inexpensive and with no serious side effects, VR could offer an effective alternative.

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Virtual reality as a treatment for ADHD?


Researchers at UC Davis are investigating whether virtual reality can be used to help kids with ADHD cope in the non-virtual world. If effective, the treatment could point the way to an alternative to medication.

"Our long-term goal is to develop interventions that are widely accessible," said Julie Schweitzer, professor in the Department of Psychiatry and Behavioral Sciences and a MIND Institute researcher. "If a parent could download an app to purchase the treatment, families in many places around the world could access it."

The CDC reports an estimated 5-10 percent of American children are diagnosed with ADHD. Over 50 percent of those are being treated with medication. Due to the high rate of diagnosis here and in countries like Iceland, which has the highest per capita rate of Ritalin consumption, words like "epidemic" are frequently used.

The UC Davis MIND Institute is testing virtual reality exposure therapy as a non-pharmaceutical treatment for distractibility in general, one of the hallmarks of ADHD. The study will include 50 children ages 8-12 who are highly distractible and not taking medication for ADHD.

It's ironic that technology is being tested to remediate distraction, given that screens are one of the primary drivers of distraction in the world today. But virtual reality has the benefit of offering immersive environments, those in which distractions can be precisely controlled and amplified or decreased during exposure therapies.


The idea is similar to the exposure therapies often used to help people with anxiety. Habituating a sufferer to triggering stimuli helps diminish innate responses.

For the UC Davis study, participants will wear a VR headset for 25-minute sessions as they're tested during attention-demanding tasks in a virtual classroom environment. Virtual distractions, such as class chatter or teachers walking by, are introduced to habituate the participants.


"Distractions are a frequent problem today, whether they're text messages alerting us while we're driving, pop-up ads on our computers at work or e-mail alerts coming across our phone when we're sitting in meetings," Schweitzer said. "We're hoping our findings will help others learn how to ignore distractions when they interfere with our health, learning and productivity."

VR headsets are an intriguing diagnostic and teaching tool as they offer the ability to track user responses on a subconscious level through metrics like eye and head movement. The pilot has been awarded $1 million from the National Institutes of Health.


- ZDNET