Two virtual reality pilot studies for the treatment of pediatric CRPS

Abstract

Dear Editor, The following letter describes two pilot studies testing the feasibility of immersive virtual reality therapy on pediatric patients with unilateral lower limb complex regional pain syndrome (CRPS). In these studies, patients completed target-hitting tasks in virtual reality using novel avatar bodies. Patients completed all sessions without adverse effects and both patients and parents were enthusiastic about the treatment. We discuss how function was tracked within and across sessions, and next steps. Because virtual reality (VR) replaces sensory information from the physical world, users may partially replace their sense of presence in the physical world, or in their physical body. This quality of presence was first used to treat pain using distraction and has also been used to produce relaxation or increased engagement (e.g., in physical therapy). A second quality that may be utilized in pain treatment is flexibility: the ability to change the relationship between a participant's appearance and/or actions in the physical world, and the appearance and actions that this participant perceives virtually . Leveraging the flexibility of virtual reality allows the creation of avatars whose movements differ from that of the participants' own, allowing more radical interventions than mirroring the unaffected limb. Following Lanier's concept of homuncular flexibility , researchers have demonstrated that users can learn to identify with avatars that have very different bodies and learn to control these avatars very rapidly . We propose that using such novel bodies may also be therapeutic for pain.