University of Twente Student Theses
Effectiveness of Virtual reality for chronic pain in patients with inflammatory arthritis: A preliminary mixed-methods study within a randomized controlled pragmatic clinical trial
Riet, D.S. den (2025) Effectiveness of Virtual reality for chronic pain in patients with inflammatory arthritis: A preliminary mixed-methods study within a randomized controlled pragmatic clinical trial.
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| Full Text Status: | Access to this publication is restricted |
| Embargo date: | 7 March 2027 |
| Abstract: | Introduction: Patients with inflammatory arthritis, such as rheumatoid arthritis (RA), psoriatic arthritis (PsA), and spondyloarthritis (SpA) often experience pain during active disease, which is usually effectively treated with medication. However, some patients still report pain despite inactive disease and the absence of damage, likely due to central sensitization (CS). Therefore, alternative treatments other than painkillers may be more effective for this type of chronic pain. Virtual reality (VR) has shown promising effects in relieving pain across various pain conditions. Objective: This study aims to explore the preliminary effects of VR on patient-reported outcomes, with pain scores as primary outcome. In addition, early experiences with VR of the first included patients will be identified. Method: This exploratory sub-study, within an open-label randomized controlled trial (RCT), involves the VR program Reducept. Eighteen patients were randomized to control or VR. The intervention group used VR at home for 8 weeks, where the Experiencing sampling method (ESM) was applied with daily pain and fatigue assessments (0-10 NRS). Weekly questionnaires measuring pain and fatigue were administered to both groups. The baseline and final visit of the trial included measures of pain catastrophizing, pain hypersensitivity, health-related quality of life, physical functioning, and self-efficacy. Semi-structured interviews were conducted to evaluate VR experiences, perceived effects, the ideal-based VR treatment, and preferences for the implementation of VR. Results: The use of VR was associated with a slight, but non-significant decrease in both weekly and daily pain scores in the intervention group. Fatigue and pain were strongly correlated, with individual daily fatigue scores in the VR group showing similar trajectories to the daily pain scores. Most patients in the VR group scored lower on pain catastrophic thinking after the trial, possibly pointing to a better coping with pain. No cybersickness was reported due to VR use. Additionally, no effect was seen in other patient-reported outcomes including pain hypersensitivity, health-related quality of life, physical functioning, and self-efficacy concerning pain management. During the interviews, a majority of patients reported relieved pain, relaxation, and distraction during VR use. They also highlighted an increase in pain awareness and a better understanding of pain. Interviews highlighted a preference for 2-3 weekly sessions of 15-30 minutes at home, with recommendations for a more diverse and challenging program including clear instructions and an improved workflow for optimal implementation. Conclusion: The preliminary results and findings from this mixed-method study suggest several potential benefits of VR as a self-administered tool for managing chronic pain management inflammatory arthritis. The results of this fully powered RCT are needed to firmly confirm its effectiveness and its impact on patient-reported outcomes. |
| Item Type: | Essay (Master) |
| Faculty: | TNW: Science and Technology |
| Subject: | 44 medicine, 77 psychology |
| Programme: | Health Sciences MSc (66851) |
| Link to this item: | https://purl.utwente.nl/essays/105357 |
| Export this item as: | BibTeX EndNote HTML Citation Reference Manager |
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