Application of Virtual Body Swapping to Patients with Complex Regional Pain Syndrome: A Pilot Study
Abstract
This study aimed to apply virtual body swapping through mental rehearsal for patients with complex regional pain syndrome (CRPS) and to investigate whether it is applicable to them. Ten patients who met the diagnostic criterion for CRPS type 1 were randomly assigned to either the treatment or control group. All participants were asked to watch the virtual body swapping training video clip with a head mounted display. The treatment group was additionally asked to assume a posture similar to the body on the screen and rehearse the movements mentally, as if the body presented on the screen was their body. No difference between the groups was found for pain intensity, however, the treatment group showed significantly more improvement in body perception disturbance (BPD) after the treatment than the control group. Even if the presented study is a preliminary one, the above results suggest that virtual body swapping through mental rehearsal is applicable for patients with CRPS and may be useful for improving BPD. The limitations of the study and the future investigations needed to provide clearer clinical suggestions are presented and discussed.
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In a recent study of CRPS type 1 patients, the treatment group that watched a video clip presenting virtual body swapping and mentally rehearsed movements showed improvement in body perception while the control group did not, despite no group difference in pain levels.
“The treatment group showed improvement in body perception while the control group did not, despite no group difference in pain levels.”
From Symptom reduction and improved function in chronic CRPS type 1 after 12-week integrated, interdisciplinary therapy (2019) · cites this paper as [35]
Cites
Frontiers in Human Neuroscience
Avenanti, A. (2013) · Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) · Cited by 1,572 · see citing works
That's my hand! Activity in premotor cortex reflects feeling of ownership of a limb
Ehrsson, H. H., Spence, C., & Passingham, R. E. (2004) · Science · doi:10.1126/science.1097011 · Cited by 1,348 · see citing works
The perception of phantom limbs. The D. O. Hebb lecture
Ramachandran, V. (1998) · Brain · doi:10.1093/brain/121.9.1603 · Cited by 1,065 · see citing works
If I were you: Perceptual illusion of body swapping
Petkova, V. I., & Ehrsson, H. H. (2008) · PLoS ONE · doi:10.1371/journal.pone.0003832 · Cited by 953 · see citing works
Proposed New Diagnostic Criteria for Complex Regional Pain Syndrome
Harden, R. N., Bruehl, S. P., Stanton-Hicks, M. D., & Wilson, P. R. (2007) · Pain Medicine · doi:10.1111/j.1526-4637.2006.00169.x · Cited by 947 · see citing works
Ehrsson, H. H., Holmes, N. P., & Passingham, R. E. (2005) · The Journal of Neuroscience · doi:10.1523/jneurosci.0800-05.2005 · Cited by 784 · see citing works
Moseley, L. G. (2004) · Pain · doi:10.1016/j.pain.2004.01.006 · Cited by 681 · see citing works
Mirror Therapy for Phantom Limb Pain
Chan, B. L., Witt, R. L., Charrow, A. P., Magee, A., Howard, R., Pasquina, P. F., Heilman, K. M., & Tsao, J. W. (2007) · New England Journal of Medicine · doi:10.1056/nejmc071927 · Cited by 615 · see citing works
Patterns of cortical reorganization in complex regional pain syndrome
Maihöfner, C., Handwerker, H. O., Neundörfer, B., & Birklein, F. (2003) · Neurology · doi:10.1212/01.wnl.0000098939.02752.8e · Cited by 605 · see citing works
Inducing illusory ownership of a virtual body
Slater, M. (2009) · Frontiers in Neuroscience · doi:10.3389/neuro.01.029.2009 · Cited by 605 · see citing works
McCabe, C. (2002) · British journal of rheumatology · doi:10.1093/rheumatology/keg041 · Cited by 505 · see citing works
Sensorimotor returning in complex regional pain syndrome parallels pain reduction
Pleger, B., Tegenthoff, M., Ragert, P., Förster, A., Dinse, H. R., Schwenkreis, P., Nicolas, V., & Maier, C. (2005) · Annals of Neurology · doi:10.1002/ana.20394 · Cited by 400 · see citing works
Complex regional pain syndrome
Birklein, F. (2005) · Journal of Neurology · doi:10.1007/s00415-005-0737-8 · Cited by 394 · see citing works
Pelvic Girdle Pain and Low Back Pain in Pregnancy: A Review
Vermani, E., Mittal, R., & Weeks, A. D. (2009) · Pain Practice · doi:10.1111/j.1533-2500.2009.00327.x · Cited by 386 · see citing works
Altered central sensorimotor processing in patients with complex regional pain syndrome
Juottonen, K., Gockel, M., Silén, T., Hurri, H., Hari, R., & Forss, N. (2002) · Pain · doi:10.1016/s0304-3959(02)00119-7 · Cited by 366 · see citing works
Body perception disturbance: A contribution to pain in complex regional pain syndrome (CRPS)
Lewis, J. S., Kersten, P., McCabe, C., McPherson, K. M., & Blake, D. R. (2007) · Pain · doi:10.1016/j.pain.2007.03.013 · Cited by 345 · see citing works
Cortical origin of pathological pain
Harris, A. J. (1999) · The Lancet · doi:10.1016/s0140-6736(99)05003-5 · Cited by 339 · see citing works
Pain and the body schema: Evidence for peripheral effects on mental representations of movement
Schwoebel, J. (2001) · Brain · doi:10.1093/brain/124.10.2098 · Cited by 323 · see citing works
An Updated Interdisciplinary Clinical Pathway for CRPS: Report of an Expert Panel
Stanton-Hicks, M., Burton, A. W., Bruehl, S., Carr, D., Harden, R., Hassenbusch, S., Lubenow, T., Oakley, J., Racz, G., Raj, P. P., et al. (2002) · Pain Practice · doi:10.1046/j.1533-2500.2002.02009.x · Cited by 289 · see citing works
Bilateral motor cortex disinhibition in complex regional pain syndrome (CRPS) type I of the hand
Schwenkreis, P., Janssen, F., Rommel, O., Pleger, B., Völker, B., Hosbach, I., Dertwinkel, R., Maier, C., & Tegenthoff, M. (2003) · Neurology · doi:10.1212/wnl.61.4.515 · Cited by 272 · see citing works
Mental Practice: A Review and Discussion Part I
Richardson, A. (1967) · Research Quarterly American Association for Health Physical Education and Recreation · doi:10.1080/10671188.1967.10614808 · Cited by 251 · see citing works
Moseley, G. L. (2005) · Pain · doi:10.1016/j.pain.2004.11.024 · Cited by 238 · see citing works
Movement and the Rubber Hand Illusion
Dummer, T., Picot-Annand, A., Neal, T., & Moore, C. L. (2009) · Perception · doi:10.1068/p5921 · Cited by 230 · see citing works
Impaired self-perception of the hand in complex regional pain syndrome (CRPS)
Förderreuther, S., Sailer, U., & Straube, A. M. (2004) · Pain · doi:10.1016/j.pain.2004.05.019 · Cited by 220 · see citing works
Mirror Therapy in Complex Regional Pain Syndrome Type 1 of the Upper Limb in Stroke Patients
Cacchio, A., Blasis, E. D., Blasis, V. D., Santilli, V., & Spacca, G. (2009) · Neurorehabilitation and neural repair · doi:10.1177/1545968309335977 · Cited by 192 · see citing works
Towards the integration of mental practice in rehabilitation programs. A critical review
Malouin, F., Jackson, P. L., & Richards, C. L. (2013) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2013.00576 · Cited by 188 · see citing works
Complex Regional Pain Syndrome
Rho, R. H., Brewer, R. P., Lamer, T. J., & Wilson, P. R. (2002) · Mayo Clinic Proceedings · doi:10.4065/77.2.174 · Cited by 184 · see citing works
Sato, K., Fukumori, S., Matsusaki, T., Maruo, T., Ishikawa, S., Nishie, H., Takata, K., Mizuhara, H., Mizobuchi, S., Nakatsuka, H., et al. (2010) · Pain Medicine · doi:10.1111/j.1526-4637.2010.00819.x · Cited by 184 · see citing works
Probing the neural basis of body ownership
Botvinick, M. (2004) · Science · doi:10.1126/science.1101836 · Cited by 181 · see citing works
How the brain represents the body: insights from neurophysiology and psychology.
Graziano, M. S. A., & Botvinick, M. M. (2002) · Common Mechanisms in Perception and Action · doi:10.1093/oso/9780198510697.003.0006 · Cited by 174 · see citing works
Mirror Visual Feedback Therapy. A Practical Approach
McCabe, C. (2010) · Journal of Hand Therapy · doi:10.1016/j.jht.2010.08.003 · Cited by 121 · see citing works
Cortical changes in complex regional pain syndrome (CRPS)
Swart, C. M. A. K., Stins, J. F., & Beek, P. J. (2008) · European Journal of Pain · doi:10.1016/j.ejpain.2008.11.010 · Cited by 103 · see citing works
Tichelaar, Y. I. G. V., Geertzen, J. H. B., Keizer, D., & van Wilgen, C. P. (2007) · International Journal of Rehabilitation Research · doi:10.1097/mrr.0b013e32813a2e4b · Cited by 81 · see citing works
Body Perception Disturbance (BPD) in CRPS
Lewis, J., & McCabe, C. (2010) · UWE Research Repository (UWE Bristol) · Cited by 64 · see citing works
Mirror box therapy for complex regional pain syndrome
Karmarkar, A. M., & Lieberman, I. H. (2006) · Anaesthesia · doi:10.1111/j.1365-2044.2006.04605.x · Cited by 56 · see citing works
The Effects of Mental Practice on Walking Balance in an Elderly Population
Linden, C. A., Uhley, J. E., Smith, D., & Bush, M. A. (1989) · The Occupational Therapy Journal of Research · doi:10.1177/153944928900900303 · Cited by 52 · see citing works
Burton, A. W., Bruehl, S. P., & Harden, R. N. (2005) · Expert Review of Neurotherapeutics · doi:10.1586/14737175.5.5.643 · Cited by 30 · see citing works
Recognition of Scrupulosity and Non-Religious OCD by Orthodox and Non-Orthodox Jews
Rosmarin, D. H., Pirutinsky, S., & Siev, J. (2010) · Journal of Social and Clinical Psychology · doi:10.1521/jscp.2010.29.8.930 · Cited by 21 · see citing works
Complex Regional Pain Syndrome (CRPS): Survey of Current Practices
Burton, A. W., Hassenbusch, S. J., Warneke, C. L., Racz, G. B., & Stanton-Hicks, M. D. (2004) · Pain Practice · doi:10.1111/j.1533-2500.2004.04202.x · Cited by 19 · see citing works
Flagged first, then by citations
1 of the 40 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Neuroscience of virtual reality: from virtual exposure to embodied medicine
Riva, G., Wiederhold, B. K., & Mantovani, F. (2019) · Cyberpsychology, Behavior, and Social Networking · doi:10.1089/cyber.2017.29099.gri · Cited by 608 · see citing works
“Some studies have suggested the possibility of using VR body swapping to improve body perception disturbance in patients with complex regional pain syndrome.(141,142) The second technique, reference frame shifting, structures the individual’s bodily self-consciousness through the focus and reorganization of its conten…”
BackgroundSmart, K. M., Wand, B. M., & O'Connell, N. E. (2016) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd010853.pub2 · Cited by 196 · see citing works
Virtual Reality Body Swapping: A Tool for Modifying the Allocentric Memory of the Body
Serino, S., Pedroli, E., Keizer, A., Triberti, S., Dakanalis, A., Pallavicini, F., Chirico, A., & Riva, G. (2015) · Cyberpsychology Behavior and Social Networking · doi:10.1089/cyber.2015.0229 · Cited by 192 · see citing works
“One of these techniques is the well-known body swapping illusion, which is a method to induce the illusory experience of owning a virtual body.(8,10,11) This illusion can be evoked by observing, from a first-person perspective, a virtual body being stroked synchronously and/or asynchronously with the participants’ rea…”
Virtual reality approaches to pain: toward a state of the science
Trost, Z., France, C. R., Anam, M., & Shum, C. (2020) · Pain · doi:10.1097/j.pain.0000000000002060 · Cited by 176 · see citing works
“In addition to phantom pain, VR has been applied to a growing number of chronic pain disorders including chronic low back pain,(2,22,28,77,78,97) neck pain,(50,84,85) fibromyalgia,(13,34,46,71) and complex regional pain syndrome.(53,86,92) Less well represented are applications to cancer pain,(9,11,38) sickle cell pai…”
BackgroundTreatment of complex regional pain syndrome: an updated systematic review and narrative synthesis
Duong, S., Bravo, D., Todd, K. J., Finlayson, R. J., & Tran, D. Q. H. (2018) · Canadian Journal of Anesthesia/Journal canadien d anesthésie · doi:10.1007/s12630-018-1091-5 · Cited by 87 · see citing works
“52 [33-120] months N Virtual body swapping video with the patient only watching the video vs reproducing and mentally rehearsing the posture 10/2 NA No intergroup differences in pain”
Smart, K. M., Ferraro, M. C., Wand, B. M., & O'Connell, N. E. (2022) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd010853.pub3 · Cited by 89 · see citing works
Spatially-defined motor deficits in people with unilateral complex regional pain syndrome
Reid, E., BRAITHWAITE, F., Wallwork, S. B., Harvie, D. S., Chalmers, J., Spence, C. J., Gallace, A., & Moseley, G. L. (2017) · Cortex · doi:10.1016/j.cortex.2017.06.024 · Cited by 53 · see citing works
Ferraro, M. C., Cashin, A. G., Wand, B. M., Smart, K. M., Berryman, C. F., Marston, L., Moseley, G. L., McAuley, J. H., & O'Connell, N. E. (2023) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd009416.pub3 · Cited by 48 · see citing works
Matthie, N., Giordano, N. A., Jenerette, C. M., Magwood, G., Leslie, S., Northey, E. E., Webster, C., & Sil, S. (2022) · Pain Management · doi:10.2217/pmt-2022-0030 · Cited by 43 · see citing works
Brady, N., McVeigh, J. G., McCreesh, K. M., Rio, E., Dekkers, T. A., & Lewis, J. S. (2021) · Physical Therapy Reviews · doi:10.1080/10833196.2021.1903209 · Cited by 44 · see citing works
“Virtual body swapping was effective for patients with CRPS, however, results improved when participants were actively completing a mental task [30].”
BackgroundThe State of Science in the Use of Virtual Reality in the Treatment of Acute and Chronic Pain
Baker, N. A., Polhemus, A. H., Ospina, E. H., Feller, H., Zenni, M., Deacon, M., DeGrado, G., Basnet, S., & Driscoll, M. (2022) · Clinical Journal of Pain · doi:10.1097/ajp.0000000000001029 · Cited by 40 · see citing works
The Effect of a Virtual-Reality Full-Body Illusion on Body Representation in Obesity
Scarpina, F., Serino, S., Keizer, A., Chirico, A., Scacchi, M., Castelnuovo, G., Mauro, A., & Riva, G. (2019) · Journal of Clinical Medicine · doi:10.3390/jcm8091330 · Cited by 42 · see citing works
“, body-ownership illusion) as a method for modulating body representations in both healthy such as [1–6] and clinical population (such as individuals suffering of eating disorders [7,8], Complex Regional Pain Syndrome [9] and Disturbed Body Integrity [10,11] has been repeatedly reported in recent literature.”
MethodShafiee, E., MacDermid, J. C., Packham, T., Walton, D. M., Grewal, R. S., & Farzad, M. (2023) · Clinical Journal of Pain · doi:10.1097/ajp.0000000000001089 · Cited by 37 · see citing works
Chau, B., Phelan, I., Ta, P. A., Chi, B., Loyola, K., Yeo, E., Dunn, J., Humbert, S. E., Hata, J., Haglund, R., et al. (2020) · PubMed Central · Cited by 29 · see citing works
Donegan, T., Ryan, B. E., Sanchez-Vives, M. V., & Świdrak, J. (2022) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2022.1024910 · Cited by 26 · see citing works
Feeling the burn: When it looks like it hurts, and belongs to me, it really does hurt more
Giummarra, M. J., Georgiou‐Karistianis, N., Verdejo‐García, A., & Gibson, S. J. (2015) · Consciousness and Cognition · doi:10.1016/j.concog.2015.07.010 · Cited by 25 · see citing works
Elomaa, M., Hotta, J., de C Williams, A. C., Forss, N., Äyräpää, A., Kalso, E., & Harno, H. (2019) · Scandinavian Journal of Pain · doi:10.1515/sjpain-2018-0098 · Cited by 24 · see citing works
“Another recent study applied virtual reality exercises for CRPS type 1 patients [35].”
BackgroundManaging limb pain using virtual reality: a systematic review of clinical and experimental studies
Wittkopf, P. G., Lloyd, D. M., & Johnson, M. I. (2018) · Disability and Rehabilitation · doi:10.1080/09638288.2018.1485183 · Cited by 21 · see citing works
“The frequency and duration of interventions used in clinical studies were between one 10-min session for phantom limb pain and complex regional pain syndrome [7,28,29], to two one-h sessions per week for eight weeks for phantom limb pain [16].”
BackgroundMethodVirtual reality in managing Complex Regional Pain Syndrome (CRPS): a scoping review
Arcos-Holzinger, M., Biebl, J. T., Storz, C., Gutmann, M., Azad, S. C., Holzapfel, B. M., & Kraft, E. (2023) · Frontiers in Neurology · doi:10.3389/fneur.2023.1069381 · Cited by 15 · see citing works
“(36) did not find any significant changes in pain”
BackgroundMethodRehabilitation Interventions for Complex Regional Pain Syndrome: An Overview of Systematic Reviews
Shafiee, E., MacDermid, J. C., Packham, T., Grewal, R. S., Farzad, M., Bobos, P., & Walton, D. M. (2023) · Clinical Journal of Pain · doi:10.1097/ajp.0000000000001133 · Cited by 12 · see citing works
Virtual Reality Interventions and Chronic Pain: Scoping Review
Ding, M. E., Traiba, H., & Perez, H. R. (2024) · Journal of Medical Internet Research · doi:10.2196/59922 · Cited by 12 · see citing works
Exergames für Patienten mit komplexem regionalem Schmerzsyndrom
Storz, C., Schulte-Göcking, H., Woiczinski, M., Azqueta‐Gavaldon, M., Azad, S. C., & Kraft, E. (2020) · Der Schmerz · doi:10.1007/s00482-019-00436-x · Cited by 5 · see citing works
Pausic, V., Jovanovic, G., Simić, S., & Knezevic, J. (2021) · Medicinski pregled · doi:10.2298/mpns2108257p · Cited by 2 · see citing works
Síndrome da dor complexa regional
Giostri, G. S., & Souza, C. D. A. (2024) · Revista Brasileira de Ortopedia · doi:10.1055/s-0044-1779331 · Cited by 2 · see citing works
Uses of Virtual Reality (VR) for Chronic Pain
Chi, B., Chau, B., & Ta, P. A. (2018) · Advances in psychology, mental health, and behavioral studies (APMHBS) book series · doi:10.4018/978-1-5225-7168-1.ch013 · Cited by 2 · see citing works
The role of embodiment in virtual Reality’s effects on hand osteoarthritis pain: a pilot study
Vo, D. H., Sawada, M., Edwards, R. R., & Baker, N. A. (2026) · Frontiers in Virtual Reality · doi:10.3389/frvir.2026.1735996 · Cited by 1 · see citing works
Uses of Virtual Reality (VR) for Chronic Pain
Chi, B., Chau, B., & Ta, P. A. (2019) · IGI Global eBooks · doi:10.4018/978-1-7998-1680-5.ch013 · Cited by 1 · see citing works
Withdrawn: 3D Virtual Reality Motionless Imagery Exercise through Avatar in Older PeoplePreprint
Lee, M. C., Chang Hoon, P. A. R. K., & Han, K. H. (2024) · Preprints.org · doi:10.20944/preprints202403.1114.v1
Virtual reality: A shift of theoretical focus in the study of language processing
Repetto, C., & Scerrati, E. (2026) · The Psychology of learning and motivation/The psychology of learning and motivation · doi:10.1016/bs.plm.2026.02.003
Weiss, C. B., Lewis, G. N., Shaikh, N., & Bean, D. J. (2026) · Health and Technology · doi:10.1007/s12553-026-01078-7
“Fully immersive virtual reality (VR) systems were prevalent, with multiple studies using commercially available head mounted displays (HMDs) [ 30, 31, 33, 34, 39, 43].”
InfluentialSebastien, J., Zhu, J., Chirico, A., Mancuso, V., MARKS, A., Soffer, G., & Won, A. S. (2026) · Augmented Humans International Conference (AHs) · doi:10.1145/3795011.3795032
“For decades, virtual reality (VR) has been used to help people transcend physical pain [23, 37, 38, 40, 91, 95]; from burn-related acute pain [36, 37] to chronic pain conditions such as Complex Regional Pain Syndrome [42, 52, 70] or phantom limb pain [7, 35, 74, 83].”
Lee, M. C., Park, C.-H., & Han, K. H. (2026) · Digital Health · doi:10.1177/20552076261461053
- Authors
- Jeon, B., Cho, S., & Lee, J.-H.
- Affiliations
- Chung-Ang University (KR)
- Chungnam National University (KR)
- Corresponding author
- Cho, Sungkun
- Lee, Jang-Han
- Venue
- Cyberpsychology, Behavior, and Social Networking
- Publisher
- SAGE Publications
- Published
- 2014-06
- Volume
- 17
- Issue
- 6
- Pages
- 366-370
- ISSN
- 2152-2715 (ISSN-L)
- 2152-2723
- OpenAlex
- W2100062056
- Cited by
- 32
- References
- 40
- Citations by year
- 2026: 5 · 2024: 3 · 2023: 4 · 2022: 4 · 2021: 2 · 2020: 3 · 2019: 3 · 2018: 4 · 2017: 1 · 2016: 1 · 2015: 2
- FWCI
- 1.82
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Cyberpsychology Behavior and Social Networking (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Physical Sciences › Computer Science › Human-Computer Interaction › Virtual Reality Applications and Impacts
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Keywords
- complex regional pain syndrome, mental imagery, virtual reality, pain intensity
- MeSH terms
- Adult, Analysis of Variance, Female, Humans, Male, Pain Measurement, Pilot Projects, Complex Regional Pain Syndromes, Republic of Korea, Virtual Reality Exposure Therapy
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