November 4, 2019
Of the therapeutic applications for VR, chronic pain is the hardest condition to deal with (the effect only lasts as long as the patient wears the headset), and anxiety treatment offers best results thanks to the distraction effect. According to Diane Jooris, CEO and co-founder of Belgian start-up OnComfort which offers variety of VR tools for the healthcare sector, no universal therapeutic tool is possible because no two medical conditions are the same. For instance, simplistic 3D images are required for dementia sufferers whose fading memory struggles anyway with the complexity of the real world, while advanced and engaging virtual worlds must be created to distract cancer patients from the painful procedures they have to endure. VR for young children is a whole different story where a fairy-tale, cartoon-like approach is vital.
Various experiments and pilots taking place around the world validate Jooris’ conclusions. Medical VR is believed to be at its strongest when faced with procedural pain and phobias but not as efficient in alleviating long-term physical pain. The pleasant distraction it renders is enjoyed by children subjected to painful medical procedures, patients whose severe injuries require urgent medical intervention, cancer-sufferers undergoing chemotherapy. However, its effect on chronic pain is still unclear, as scientists believe more experiments are to be conducted before categorical conclusions are reached.
Packard’s Children’s hospital in the USA is among the first in the world to deploy VR therapy to fight the anxiety and pain in its young patients. Parents’ testimonies published on the hospital’s website tell about screams of terror turning into exclamations of amazement once little patient is immersed into the wondrous world of VR. Virtual miracles work on adults too. Would you wear a VR headset while having your wisdom tooth extracted? A study led by the University of Plymouth in the UK revealed an interesting fact – a virtual walk through the streets of a real-life town had a soothing effect on dental patients, while a stroll through a virtual settlement did nothing to ease the pain and tension caused by the routine intervention. This has led scientists to conclude that the mere distracting effect of VR is not sufficient, and immersive reality needs to feel familiar in order to provide comfort.
Specialists believe that VR will open the door to remote rehabilitation and patients recovering in the comfort of their home.
Simon Sherrington, MD
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VR has been praised for having a positive effect on phobias
R has been praised for having a positive effect on phobias too. In July 2018, a report published by the NHS revealed how VR headset could help people overcome their fear of heights (acrophobia). The disruptive technology was used to “lift” patients to various virtual heights – from skyscrapers’ rooftops to mountaintops. During VR session people were advised by professional psychologist on how to deal with heights in a more positive manner. 51 participants with proven acrophobia were subjected to the innovative treatment. Results revealed that after four weeks of VR therapy their levels of fear were reduced. The same amount of time showed no change in patients who were treated in a more conservative way excluding VR.
According to the NHS report: “No adverse effects of the intervention were reported on VR patients”. However, the study failed to answer whether the improvement in patients will have a long-lasting effect or what will happen once participants in the VR experiment decide to put their fears to test in a real-life environment. It is also unclear if a sample of 100 people could be considered representative as acrophobia is a common mental health issue which, according to various reports, affects one in five adults. And VR’s therapeutic effects are yet to be assessed against those of cognitive behavioural therapy. Researchers at the University of Oxford, University of Barcelona and Virtual Bodyworks in Barcelona, Spain who conducted the survey conclude: “Psychological therapy delivered automatically by a [virtual reality] coach can produce large clinical benefits. Evidence-based [virtual reality] treatments have the potential to greatly increase treatment provision for mental health disorders.”
Meanwhile, the NHS itself is testing a VR therapy on another group of mental health patients – dementia sufferers. The ongoing experiment due to be completed in the coming months is based on showing participants VR images from their youth such as seaside resorts, street celebrations to stimulate memory and improve bonding with family and caregivers. The trial aims to find if the technology has broader scale future.
Deploying medical VR on a broader scale is something that the UAE’s Ministry of Health and Prevention plans to do. In the summer of 2018, it announced its intentions to use VR for physiotherapy for stroke sufferers, patients with balance disorder and children with development disorders. Specialists believe that VR will open the door to remote rehabilitation and patients recovering in the comfort of their home. But until similar initiatives get underway, VR’s impact on chronic pain will be regarded as uncharted territory as there are relatively few research projects.
One of the few studies that has been published (in December 2016 by Ted Jones, Todd Moore and James Choo) focuses on the impact of a brief virtual reality session on the experience of chronic pain. The authors suggest that that
“VR is more effective for chronic pain disorders that more intimately involve the central nervous system such as complex regional pain syndrome (chronic pain condition that may result in extreme sensitivity and pain to the hands and elbows or knees and legs, in particular, without an obvious cause that would explain the degree of pain) or fibromyalgia (long-term condition that causes pain all over the body) while being less effective for more mechanically-based pain disorders such as low back pain or arthritic conditions.”
The study also points out that future researches on the subject must find out how age and gender affect the way chronic pain patients respond to VR treatment. Another more recent study was conducted by the University of Seville, University of Malaga, Pablo de Olavide University and University of Osuna, Spain, on over 400 patients with multiple sclerosis. It showed that VR treatment impact on gait impairment and chronic pain was positive but no different to that of conventional treatment.
Experiments, research and pilots will continue to define VR’s most promising healthcare applications. At present hospitals, surgeries and dental practices appear to be best equipped to accommodate the disruptive technology. VR also shows potential in paediatrics and psychotherapy practices, especially when it comes to dealing with phobias and mental impairments. These are the likeliest places where its future commercial deployment is expected to commence. However, VR headsets are already available to end-users in the market. Many believe that in the near future, once their efficiency is finally defined, they could become a “must have” item for people experiencing health problems, just as they are to gamers now.
This is the second of 3 articles on VR in Healthcare. The previous article is In Pain? Don a VR Headset. The final article will examine Regulatory Issues.
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