Effects of Virtual Walking Treatment on Spinal Cord Injury–Related Neuropathic Pain: Pilot Results and Trends Related to Location of Pain and at-level Neuronal Hypersensitivity
Abstract
Previous studies have shown that virtual walking to treat spinal cord injury-related neuropathic pain (SCI-NP) can be beneficial, although the type of SCI-NP that may benefit the most is unclear. This study's aims were to (1) determine the effect of location of SCI-NP on pain outcomes after virtual walking treatment and (2) examine the potential relationship between neuronal hyperexcitability, as measured by quantitative sensory testing, and pain reduction after virtual walking treatment. Participants were recruited from a larger ongoing trial examining the benefits of virtual walking in SCI-NP. Neuropathic pain was classified according to location of pain (at- or below-level). In addition, quantitative sensory testing was performed on a subset of individuals at a nonpainful area corresponding to the level of their injury before virtual walking treatment and was used to characterize treatment response. These pilot results suggest that when considered as a group, SCI-NP was responsive to treatment irrespective of the location of pain (F1, 44 = 4.82, P = 0.03), with a trend for the greatest reduction occurring in at-level SCI-NP (F1, 44 = 3.18, P = 0.08). These pilot results also potentially implicate cold, innocuous cool, and pressure hypersensitivity at the level of injury in attenuating the benefits of virtual walking to below-level pain, suggesting certain SCI-NP sensory profiles may be less responsive to virtual walking.
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In some studies, a mirror was used with a video projection of walking legs; in others, walking stimuli consisted of a video of an actor in first-person view walking along a path; and in another, participants viewed their virtual arms and legs in first person view in a virtual world through a head-mounted display.
“In some studies, a mirror was used with a video projection of walking legs [7, 15–17], in others the walking stimuli consisted of a video of an actor, in first-person view, walking along a path [18, 19] and in the last one participants viewed their virtual arms and legs in first person view in a virtual world through a head-mounted display [20].”
From Virtual walking therapy in neuropathic spinal cord injury pain: a feasibility study (2024) · cites this paper as [19]
Third-person perspective has already been described, while first-person perspective was also applied.
“Third-person perspective has already been described [7], [15–17], while first-person perspective was also applied [18–20].”
From Virtual walking therapy in neuropathic spinal cord injury pain: a feasibility study (2024) · cites this paper as [19]
The different studies regarding VW did not discuss therapy adherence.
“The different studies regarding VW did not discuss therapy adherence [7, 15–20].”
From Virtual walking therapy in neuropathic spinal cord injury pain: a feasibility study (2024) · cites this paper as [19]
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- Authors
- Jordan, M., & Richardson, E. J.
- Affiliations
- University of Alabama at Birmingham (US)
- Corresponding author
- Richardson, Elizabeth J.
- Venue
- American Journal of Physical Medicine & Rehabilitation
- Published
- 2016-05
- Volume
- 95
- Issue
- 5
- Pages
- 390-396
- ISSN
- 0894-9115 (ISSN-L)
- OpenAlex
- W2325606642
- Cited by
- 37
- References
- 23
- Citations by year
- 2026: 5 · 2025: 9 · 2024: 5 · 2023: 1 · 2022: 4 · 2021: 4 · 2020: 3 · 2019: 2 · 2018: 3 · 2017: 1
- FWCI
- 1.06
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Physical Medicine & Rehabilitation (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Spinal Cord Injury Research
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
- Keywords
- virtual walking, spinal cord injury, neuropathic pain, pain localization, neuronal hyperexcitability, quantitative sensory testing, cold hypersensitivity, treatment response
- MeSH terms
- Female, Humans, Hyperalgesia, Male, Middle Aged, Neuralgia, Pain Measurement, Pilot Projects, Spinal Cord Injuries, Walking, Virtual Reality Exposure Therapy
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