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Cited by 75Stroke Rehabilitation and RecoveryCancer survivorship and careVirtual Reality Applications and Impacts

A feasibility study to determine the benefits of upper extremity virtual rehabilitation therapy for coping with chronic pain post-cancer surgery

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House, Gregory, Burdea, Grigore, Grampurohit, Namrata, Polistico, Kevin, Roll, Doru, Damiani, Frank, Hundal, Jasdeep, Demesmin, Didier·2016·British Journal of Pain
DOI 10.1177/2049463716664370PMC PMC5102098
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Abstract

Background: Persistent pain in shoulder and arm following post-surgical breast cancer treatment can lead to cognitive and physical deficits. Depression is also common in breast cancer survivors. Virtual reality therapy with integrative cognitive and physical rehabilitation has not been clinically trialed for this population. The novel BrightArm Duo technology improved cognition and upper extremity (UE) function for other diagnoses and has great potential to benefit individuals coping with post-surgical breast cancer pain. Objectives: The aim of this study was to explore the feasibility of BrightArm Duo therapy for coping with post-surgical chronic pain and associated disability in breast cancer survivors with depression. Methods: BrightArm Duo is a robotic rehabilitation table modulating gravity loading on supported forearms. It tracks arm position and grasping strength while patients play three-dimensional (3D) custom integrative rehabilitation games. Community-dwelling women (N = 6) with post-surgical breast cancer pain in the upper arm trained on the system twice a week for 8 weeks. Training difficulty increased progressively in game complexity, table tilt and session length (20–50 minutes). Standardized assessments were performed before and after therapy for pain, cognition, emotion, UE function and activities of daily living. Results: Subjects averaged upwards of 1300 arm repetitions and 850 hand grasps per session. Pain intensity showed a 20% downward trend (p = 0.1) that was corroborated by therapist observations and participant feedback. A total of 10 out of 11 cognitive metrics improved post-training (p = 0.01) with a significant 8.3-point reduction in depression severity (p = 0.04). A total of 17 of 18 range of motion metrics increased (p < 0.01), with five affected-side shoulder improvements above the Minimal Clinically Important Difference (8°). In all, 13 out of 15 strength and function metrics improved (p = 0.02) with lateral deltoid strength increasing 7.4 N on the affected side (p = 0.05). Conclusion: This pilot study demonstrated feasibility of using the BrightArm Duo Rehabilitation System to treat cancer survivors coping with upper body chronic pain. Outcomes indicate improvement in cognition, shoulder range, strength, function and depression.

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  • GET, exercises with a behavioural approach, CBT, Coping Strategies, Psychological Flexibility, and V.R. had positive effects on pain reduction compared to usual care, while Web-BCPA, EFT, matching therapy to psychological features, and physical cognitive-mindfulness did not affect reducing pain intensity.

    “GET, exercises with a behavioural approach, CBT, Coping Strategies, Psychological Flexibility, and V.R. had positive effects on pain reduction compared to usual care (Table 2) [18, 26, 27, 29, 30, 33]. Web-BCPA, EFT, matching therapy to psychological features, and physical cognitive-mindfulness did not affect reducing pain intensity.”

    From A Scoping Review of the Evidence regarding Assessment and Management of Psychological Features of Shoulder Pain. (2021) · cites this paper as [30]

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  1. [9]9. Just J, Mücke M, Bleckwenn M. Dependence on prescription opioids. Dtsch Ärztebl Int 2016; 113(13): 213–220. [DOI] [PMC free article] [PubMed] [Google Scholar]
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Authors
House, G., Burdea, G., Grampurohit, N., Polistico, K., Roll, D., Damiani, F., Hundal, J., & Demesmin, D.
Affiliations
  • Bright Cloud International (United States) (US)
  • Roosevelt Care Center, Edison, NJ, USA
  • Hundal Neuropsychology Group LLC, Watchung, NJ, USA
  • Somerset Medical Center (US)
Corresponding author
House, Gregory
ORCID
Venue
British Journal of Pain
Publisher
SAGE Publications
Published
2016-09-16
Volume
10
Issue
4
Pages
186-197
ISSN
  • 2049-4637 (ISSN-L)
  • 2049-4645
DOI
10.1177/2049463716664370
PMC
PMC5102098
OpenAlex
W2514036397
Cited by
75
References
43
Citations by year
2026: 3 · 2025: 10 · 2024: 14 · 2023: 5 · 2022: 17 · 2021: 7 · 2020: 10 · 2019: 5 · 2018: 2 · 2017: 2
FWCI
3.21
Type
journal article
Language
en
Open access
Licence
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations
  • British Journal of Pain (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Rutgers University Community Repository (Rutgers University) (submittedVersion)
Funders
National Institute on Drug Abuse (R43DA032224)
Topics
  • Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
  • Physical Sciences › Computer Science › Human-Computer Interaction › Virtual Reality Applications and Impacts
Keywords
virtual reality rehabilitation, upper limb rehabilitation, chronic pain, breast cancer survivors, depression, cognitive function, shoulder range of motion, arm muscle strength, rehabilitation robotics, feasibility, rehabilitation games

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