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The use of virtual reality in patients with rheumatoid arthritis suffering from chronic pain
Greef, F. de (2023) The use of virtual reality in patients with rheumatoid arthritis suffering from chronic pain.
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| Abstract: | Background. Patients with rheumatoid arthritis (RA) are often suffering from pain. Most of the time treatment with disease-modifying anti-rheumatic drugs (DMARDs) is effective in reducing nociceptive pain, however, some patients experience nociplastic pain and are still suffering from chronic pain. Since this treatment is ineffective in reducing this chronic pain, another treatment is necessary. Therefore, virtual reality (VR) can be a solution, since VR focuses on distraction, education and visualisation of how pain works, which can help patients manage their pain. Several studies showed that VR treatment has promising effects on reducing chronic pain. However, its efficacy for RA patients is still unclear. Objective. The primary aim of this pilot study is to investigate the feasibility and applicability of using virtual reality at home in patients with RA suffering from chronic pain. The secondary aim was to get indications of VR treatment’s possible efficacy in reducing pain intensity, which can be used for the upcoming randomized controlled trial (RCT). This RCT will further examine the effects of VR on chronic pain. Methods. A longitudinal pilot study was conducted involving the Reducept intervention at the rheumatology department of Medisch Spectrum Twente (MST). For this study, a mixed-methods approach is used. Seven patients with RA suffering from chronic pain participated in this study. Pico VR goggles with the Reducept application were used. Reducept is a digital training program designed for people suffering from chronic pain. Participants used the VR goggles for 8 weeks at home. The primary outcome variables were technical difficulties, satisfaction and cybersickness. These variables are necessary to determine the feasibility. The secondary outcome variables were the type of pain, pain intensity, quality of life and self-efficacy. These variables are necessary to determine the applicability. These variables were measured using the virtual reality sickness questionnaire (VRSQ), generalized pain questionnaire (GPQ), numerical pain rating scale (NRS), arthritis self-efficacy scale (ASES) and 36-item short-from health survey (SF-36) respectively. The VRSQ results are displayed in a heatmap, to see the differences before and after VR use. The GPQ results were summed up to check if the score is higher than ten. The NRS results were presented in a graph, to show the progress in 8 weeks. The SF-36 and ASES results were divided into different categories, to determine each independent score. Results. Seven patients participated in the study, with three of them having been part of an earlier cross-sectional pilot study. One patient dropped out due to cybersickness, while another completed the study without using the VR goggles. The remaining five participants completed the study as intended. Most participants did not experience deterioration of virtual reality sickness symptoms, except for one participant whose symptoms worsened. Fatigue was the most reported symptom, but its severity remained the same or even improved after VR use. Overall, VR did not worsen the participants’ symptoms. Besides, the VR goggles were fun and easy to use. With regard to the exercises, it can be made more challenging. There were no unsolvable problems that occurred by using VR at home. Three of the five participants are experiencing less pain after using VR, however, the pain scores fluctuate a lot. The scores for quality of life and self-efficacy are some points higher after the VR treatment. Conclusion. This study demonstrated good feasibility of the VR treatment at home. To keep users engaged, challenging and diverse exercises are recommended. The applicability of the treatment remains limited, only small improvements are measured. However, these results give promising indications for further research, including a longer study period and investigation of different VR applications. |
| Item Type: | Essay (Master) |
| Faculty: | TNW: Science and Technology |
| Programme: | Health Sciences MSc (66851) |
| Link to this item: | https://purl.utwente.nl/essays/95293 |
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