Virtual Reality Analgesia With Interactive Eye Tracking During Brief Thermal Pain Stimuli: A Randomized Controlled Trial (Crossover Design)

In light of growing concerns about opioid analgesics, developing new non-pharmacologic pain control techniques has become a high priority. Adjunctive virtual reality can help reduce acute pain during painful medical procedures. However, for some especially painful medical procedures such as burn wou...

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Main Authors: Najood A. Al-Ghamdi, Walter J. Meyer, Barbara Atzori, Wadee Alhalabi, Clayton C. Seibel, David Ullman, Hunter G. Hoffman
Format: Article
Language:English
Published: Frontiers Media S.A. 2020-01-01
Series:Frontiers in Human Neuroscience
Subjects:
Online Access:https://www.frontiersin.org/article/10.3389/fnhum.2019.00467/full
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author Najood A. Al-Ghamdi
Walter J. Meyer
Walter J. Meyer
Barbara Atzori
Wadee Alhalabi
Wadee Alhalabi
Wadee Alhalabi
Clayton C. Seibel
David Ullman
Hunter G. Hoffman
Hunter G. Hoffman
author_facet Najood A. Al-Ghamdi
Walter J. Meyer
Walter J. Meyer
Barbara Atzori
Wadee Alhalabi
Wadee Alhalabi
Wadee Alhalabi
Clayton C. Seibel
David Ullman
Hunter G. Hoffman
Hunter G. Hoffman
author_sort Najood A. Al-Ghamdi
collection DOAJ
description In light of growing concerns about opioid analgesics, developing new non-pharmacologic pain control techniques has become a high priority. Adjunctive virtual reality can help reduce acute pain during painful medical procedures. However, for some especially painful medical procedures such as burn wound cleaning, clinical researchers recommend that more distracting versions of virtual reality are needed, to further amplify the potency of virtual reality analgesia. The current study with healthy volunteers explores for the first time whether interacting with virtual objects in Virtual Reality (VR) via “hands free” eye-tracking technology integrated into the VR helmet makes VR more effective/powerful than non-interactive/passive VR (no eye-tracking) for reducing pain during brief thermal pain stimuli.MethodForty eight healthy volunteers participated in the main study. Using a within-subject design, each participant received one brief thermal pain stimulus during interactive eye tracked virtual reality, and each participant received another thermal pain stimulus during non-interactive VR (treatment order randomized). After each pain stimulus, participants provided subjective 0–10 ratings of cognitive, sensory and affective components of pain, and rated the amount of fun they had during the pain stimulus.ResultsAs predicted, interactive eye tracking increased the analgesic effectiveness of immersive virtual reality. Compared to the passive non-interactive VR condition, during the interactive eye tracked VR condition, participants reported significant reductions in worst pain (p < 0.001) and pain unpleasantness (p < 0.001). Participants reported a significantly stronger illusion of presence (p < 0.001), and significantly more fun in VR (p < 0.001) during the interactive condition compared to during passive VR. In summary, as predicted by our primary hypothesis, in the current laboratory acute pain analog study with healthy volunteers, increasing the immersiveness of the VR system via interactive eye tracking significantly increased how effectively VR reduced worst pain during a brief thermal pain stimulus. Although attention was not directly measured, the pattern of pain ratings, presence ratings, and fun ratings are consistent with an attentional mechanism for how VR reduces pain. Whether the current results generalize to clinical patient populations is another important topic for future research. Additional research and development is recommended.
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spelling doaj.art-ccdf842013074230856bc7aa206f32e82022-12-22T01:37:54ZengFrontiers Media S.A.Frontiers in Human Neuroscience1662-51612020-01-011310.3389/fnhum.2019.00467467626Virtual Reality Analgesia With Interactive Eye Tracking During Brief Thermal Pain Stimuli: A Randomized Controlled Trial (Crossover Design)Najood A. Al-Ghamdi0Walter J. Meyer1Walter J. Meyer2Barbara Atzori3Wadee Alhalabi4Wadee Alhalabi5Wadee Alhalabi6Clayton C. Seibel7David Ullman8Hunter G. Hoffman9Hunter G. Hoffman10Department of Computer Science, Faculty of Computing and Information Technology, King Abdulaziz University, Jeddah, Saudi ArabiaShriners Hospitals for Children, Galveston, TX, United StatesDepartment of Psychiatry, The University of Texas Medical Branch at Galveston, Galveston, TX, United StatesDepartment of Health Sciences, School of Psychology, University of Florence, Florence, ItalyDepartment of Computer Science, College of Engineering, Effat University, Jeddah, Saudi ArabiaThe Virtual Reality Research Group, King Abdulaziz University, Jeddah, Saudi ArabiaDepartment of Computer Science, Dar Al-Hekma University, Jeddah, Saudi ArabiaVirtual Reality Research Center, Human Photonics Lab, University of Washington, Seattle, WA, United StatesVirtual Reality Research Center, Human Photonics Lab, University of Washington, Seattle, WA, United StatesVirtual Reality Research Center, Human Photonics Lab, University of Washington, Seattle, WA, United StatesDepartment of Mechanical Engineering, College of Engineering, University of Washington, Seattle, WA, United StatesIn light of growing concerns about opioid analgesics, developing new non-pharmacologic pain control techniques has become a high priority. Adjunctive virtual reality can help reduce acute pain during painful medical procedures. However, for some especially painful medical procedures such as burn wound cleaning, clinical researchers recommend that more distracting versions of virtual reality are needed, to further amplify the potency of virtual reality analgesia. The current study with healthy volunteers explores for the first time whether interacting with virtual objects in Virtual Reality (VR) via “hands free” eye-tracking technology integrated into the VR helmet makes VR more effective/powerful than non-interactive/passive VR (no eye-tracking) for reducing pain during brief thermal pain stimuli.MethodForty eight healthy volunteers participated in the main study. Using a within-subject design, each participant received one brief thermal pain stimulus during interactive eye tracked virtual reality, and each participant received another thermal pain stimulus during non-interactive VR (treatment order randomized). After each pain stimulus, participants provided subjective 0–10 ratings of cognitive, sensory and affective components of pain, and rated the amount of fun they had during the pain stimulus.ResultsAs predicted, interactive eye tracking increased the analgesic effectiveness of immersive virtual reality. Compared to the passive non-interactive VR condition, during the interactive eye tracked VR condition, participants reported significant reductions in worst pain (p < 0.001) and pain unpleasantness (p < 0.001). Participants reported a significantly stronger illusion of presence (p < 0.001), and significantly more fun in VR (p < 0.001) during the interactive condition compared to during passive VR. In summary, as predicted by our primary hypothesis, in the current laboratory acute pain analog study with healthy volunteers, increasing the immersiveness of the VR system via interactive eye tracking significantly increased how effectively VR reduced worst pain during a brief thermal pain stimulus. Although attention was not directly measured, the pattern of pain ratings, presence ratings, and fun ratings are consistent with an attentional mechanism for how VR reduces pain. Whether the current results generalize to clinical patient populations is another important topic for future research. Additional research and development is recommended.https://www.frontiersin.org/article/10.3389/fnhum.2019.00467/fullvirtual realityanalgesiapaindistractionnon-pharmacologic analgesic techniquesopioid analgesia
spellingShingle Najood A. Al-Ghamdi
Walter J. Meyer
Walter J. Meyer
Barbara Atzori
Wadee Alhalabi
Wadee Alhalabi
Wadee Alhalabi
Clayton C. Seibel
David Ullman
Hunter G. Hoffman
Hunter G. Hoffman
Virtual Reality Analgesia With Interactive Eye Tracking During Brief Thermal Pain Stimuli: A Randomized Controlled Trial (Crossover Design)
Frontiers in Human Neuroscience
virtual reality
analgesia
pain
distraction
non-pharmacologic analgesic techniques
opioid analgesia
title Virtual Reality Analgesia With Interactive Eye Tracking During Brief Thermal Pain Stimuli: A Randomized Controlled Trial (Crossover Design)
title_full Virtual Reality Analgesia With Interactive Eye Tracking During Brief Thermal Pain Stimuli: A Randomized Controlled Trial (Crossover Design)
title_fullStr Virtual Reality Analgesia With Interactive Eye Tracking During Brief Thermal Pain Stimuli: A Randomized Controlled Trial (Crossover Design)
title_full_unstemmed Virtual Reality Analgesia With Interactive Eye Tracking During Brief Thermal Pain Stimuli: A Randomized Controlled Trial (Crossover Design)
title_short Virtual Reality Analgesia With Interactive Eye Tracking During Brief Thermal Pain Stimuli: A Randomized Controlled Trial (Crossover Design)
title_sort virtual reality analgesia with interactive eye tracking during brief thermal pain stimuli a randomized controlled trial crossover design
topic virtual reality
analgesia
pain
distraction
non-pharmacologic analgesic techniques
opioid analgesia
url https://www.frontiersin.org/article/10.3389/fnhum.2019.00467/full
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