Journal of Traditional Medical Complementary Therapies

.: REVIEW
Sanal Gerçeklik Teknolojileri ve Kronik Ağrı
Virtual Reality Technologies and Chronic Pain
Özgül ÖZTÜRKa, Özlem FEYZİOĞLUa
aAcıbadem Mehmet Ali Aydınlar Üniversitesi Sağlık Bilimleri Fakültesi, Fizyoterapi ve Rehabilitasyon ABD, İstanbul, TÜRKİYE
J Tradit Complem Med. 2020;3(2):211-6
doi: 10.5336/jtracom.2019-72224
Article Language: TR
Full Text
ÖZET
 Ağrı, akut veya kronik karakterde seyreden ve tüm dünyada sağlık sistemlerine ekonomik ve sosyal yük getiren bir sağlık problemidir. Özellikle farklı etiyolojiler sonucunda gelişen kronik ağrı, bireylerin yaşam kalitesini azaltmakta ve psikolojik sorunlara yol açmaktadır. Günümüzde, ağrı ile baş etmede kullanılan medikal tedavilere ek olarak uygulanabilecek konservatif tedavi yöntemleri ile ilgili çalışmalar önem kazanmaktadır. Bu çalışmada, kronik ağrı tedavisinde sanal gerçeklik teknolojilerinin yerinin incelenmesi amaçlanmıştır. Aynı zamanda, sanal gerçeklik sistemlerinin ağrı kontrolündeki mekanizması da araştırılmıştır. Sanal gerçekliğin, özellikle akut ağrı kontrolünde giderek artan bir yeri olduğu gösterilmiştir. Bununla birlikte bu yöntemin kronik ağrılı bireyler üzerinde etkilerinin araştırıldığı çalışmalar, literatürde yer alsa da sayısı ve niteliği oldukça sınırlıdır. Sanal gerçeklik yöntemlerinin ağrı kontrolündeki mekanizması, dikkatin dağıtılması ve geri bildirim sağlanması olarak gösterilmiştir. Fizyoterapi ve rehabilitasyon alanında farklı patolojiler de araştırılmış, ağrıyı azaltmada, fiziksel aktivitelere katılımda ve motivasyonu artırmada etkin olduğu gösterilmiştir. Sanal gerçeklik yöntemlerinin, ağrının yanı sıra hastanın hareket korkusu ve fonksiyonellik düzeyi üzerine olumlu etkilerinin olduğu da rapor edilmiştir. Bununla birlikte, optimal tedavi protokollerinin geliştirilmesi amacıyla uzun dönem kontrollü ve farklı patolojilerin incelendiği araştırmalara ihtiyaç duyulmaktadır.

Anahtar Kelimeler: Sanal gerçeklik; kronik ağrı
ABSTRACT
 Acute or chronic pain is a health problem that brings economic and social burden to health systems around the world. In particular, chronic pain resulting from different etiologies decreases the quality of life of individuals and causes psychological problems. Recently, studies on conservative treatment methods that can be applied in addition to medical treatments used to cope with pain gain importance. The aim of this study was to investigate the role of virtual reality technologies in the treatment of chronic pain. Also, the mechanism of virtual reality methods in pain control is investigated. Virtual reality has been shown to play an increasingly important role in acute pain control. However, although the studies investigating the effects of this method on chronic pain subjects are reported in the literature, the number and quality of these studies are very limited. The mechanism of virtual reality methods in pain control has been shown as distraction and feedback. It has been investigated in different pathologies in the field of physiotherapy and rehabilitation and has been shown to be effective in reducing pain and increasing participation and motivation in physical activities. Virtual reality methods have been reported to have positive effects on the patient's fear of movement and functionality as well as pain. However, long-term controlled investigations of different pathologies are needed to develop optimal treatment protocols.

Keywords: Virtual reality; chronic pain
REFERENCES:
  1. IASP Terminology. https://www.iasp-pain.org/Education/Content.aspx?ItemNumber=1698 (Erişim tarihi: 1Temmuz 2019)
  2. Davis KD, Flor h, Greely hT, Iannetti GD, Mackey S, Ploner M, et al. Brain imaging tests for chronic pain: medical, legal and ethical issues and recommendations. Nat Rev Neurol. 2017;13(10):624-38. [Crossref]  [PubMed] 
  3. Breivik h, Eisenberg E, O'Brien T. The individual and societal burden of chronic pain in Europe: the case for strategic prioritisation and action to improve knowledge and availability of appropriate care. BMC Public health. 2013;13:1229. [Crossref]  [PubMed]  [PMC] 
  4. Bushnell MC, Ceko M, Low LA. Cognitive and emotional control of pain and its disruption in chronic pain. Nat Rev Neurosci. 2013;14(7):502-11. [Crossref]  [PubMed]  [PMC] 
  5. De Felice M, Ossipov MH. Cortical and subcortical modulation of pain. Pain Manag. 2016;6(2):111-20. [Crossref]  [PubMed] 
  6. Tracey I, Mantyh PW. The cerebral signature for pain perception and its modulation. Neuron. 2007;55(3):377-91. [Crossref]  [PubMed] 
  7. Luque-Suarez A, Martinez-Calderon , Falla D. Role of kinesiophobia on pain, disability and quality of life in people suffering from chronic musculoskeletal pain: a systematic review. Br J Sports Med. 2019;53(9):554-9. [Crossref]  [PubMed] 
  8. Turk DC, Wilson hD. Fear of pain as a prognostic factor in chronic pain: conceptual models, assessment, and treatment implications. Curr Pain headache Rep. 2010;14(2):88-95. [Crossref]  [PubMed]  [PMC] 
  9. Lundberg M, Larsson M, Ostlund h, Styf J. Kinesiophobia among patients with musculoskeletal pain in primary healthcare. J Rehabil Med. 2006;38(1):37-43. [Crossref]  [PubMed] 
  10. Li L, Yu F, Shi D, Shi J, Tian Z, Yang J, et al. Application of virtual reality technology in clinical medicine. Am J Transl Res. 2017;9(9):3867-80.[PubMed] 
  11. Trost Z, Zielke M, Guck A, Nowlin L, Zakhidov D, France CR, et al. The promise and challenge of virtual gaming technologies for chronic pain: the case of graded exposure for low back pain. Pain Manag. 2015;5(3):197-206. [Crossref]  [PubMed] 
  12. Won AS, Bailey J, Bailenson J, Tataru C, Yoon IA, Golianu B. Immersive virtual reality for pediatric pain. Children (Basel). 2017;4(7):52. [Crossref]  [PubMed]  [PMC] 
  13. Baus O, Bouchard S. Moving from virtual reality exposure-based therapy to augmented reality exposure-based therapy: a review. Front hum Neurosci. 2014;8:112. [Crossref]  [PubMed]  [PMC] 
  14. Pourmand A, Davis S, Marchak A, Whiteside T, Sikka N. Virtual reality as a clinical tool for pain management. Curr Pain headache Rep. 2018;22(8):53. [Crossref]  [PubMed] 
  15. Ravi DK, Kumar N, Singhi P. Effectiveness of virtual reality rehabilitation for children and adolescents with cerebral palsy: an updated evidence-based systematic review. Physiotherapy. 2017;103(3):245-58. [Crossref]  [PubMed] 
  16. Schultheis MT, Rizzo A. The application of virtual reality technology in rehabilitation. Rehabilitation Psychology. 2001;46(3):296-311. [Crossref] 
  17. Gumaa M, Youssef AR. Is virtual reality effective in orthopedic rehabilitation? A systematic review and meta-analysis. Phys Ther. 2019;99(10)1304-25. [Crossref]  [PubMed] 
  18. Collado‐Mateo D, Merellano‐Navarro E, Olivares PR, García-Rubio J, Gusi N. Effect of exergames on musculoskeletal pain: a systematic review and meta‐analysis. Scand J Med Sci Sports. 2018;28(3):760-71. [Crossref]  [PubMed] 
  19. Lin hT, Li YI, hu WP, huang CC, Du YC. A scoping review of the efficacy of virtual reality and exergaming on patients of musculoskeletal system disorder. J Clin Med. 2019;8(6):791. [Crossref]  [PubMed]  [PMC] 
  20. Gupta A, Scott K, Dukewich M. Innovative technology using virtual reality in the treatment of pain: does it reduce pain via distraction, or is there more to it? Pain Med. 2018;19(1):151-9. [Crossref]  [PubMed] 
  21. hoffman hG, Prothero J, Wells MJ, et al. Virtual chess: Meaning enhances users' sense of presence in virtual environments. International Journal of human-Computer Interaction. 1998;10:251-63. [Crossref] 
  22. Luo h, Cao C, Zhong J, Chen J, Cen Y. Adjunctive virtual reality for procedural pain management of burn patients during dressing change or physical therapy: a systematic review and meta‐analysis of randomized controlled trials. Wound Repair Regen. 2019;27(1)90-101. [Crossref]  [PubMed] 
  23. Pancekauskaitė G, Jankauskaitė L. Paediatric pain medicine: pain differences, recognition and coping acute procedural pain in paediatric emergency room. Medicina (Kaunas). 2018;54(6):94. [Crossref]  [PubMed]  [PMC] 
  24. Shahrbanian S, Simmonds MJ, Effects of dif- ferent virtual reality environments on experi- mental pain rating in post-stroke individuals with and without pain in comparison to pain free healthy individuals. Wiederhold BK, Gamberini L, Bouchard S, Riva G. Annual Review of CyberTherapy and Telemedicine. 2008.
  25. Triberti S, Repetto C, Riva G. Psychological factors influencing the effectiveness of virtual reality-based analgesia: a systematic review. Cyberpsychol Behav Soc Netw. 2014;17(6):335-45. [Crossref]  [PubMed] 
  26. Trost Z, Parsons TD. Beyond distraction: virtual reality graded exposure therapy as treatment for pain‐related fear and disability in chronic pain. J Appl Biobehav Res. 2014;19(2):106-26. [Crossref] 
  27. Malloy KM, Milling LS. The effectiveness of virtual reality distraction for pain reduction: a systematic review. Clin Psychol Rev. 2010;30(8):1011-8. [Crossref]  [PubMed] 
  28. Osumi M, Ichinose A, Sumitani M, Wake N, Sano Y, Yozu A, et al. Restoring movement representation and alleviating phantom limb pain through short‐term neurorehabilitation with a virtual reality system. Eur J Pain. 2017;21(1):140-7. [Crossref]  [PubMed] 
  29. Wittkopf PG, Lloyd DM, Johnson MI. Managing limb pain using virtual reality: a systematic review of clinical and experimental studies. Disabil Rehabil. 2019;41(26):3103-17. [Crossref]  [PubMed] 
  30. Ozunlu Pekyavas N, Ergun N. Comparison of virtual reality exergaming and home exercise programs in patients with subacromial impingement syndrome and scapular dyskinesis: short term effect. Acta Orthop Traumatol Turc. 2017;51(3):238-42. [Crossref]  [PubMed]  [PMC] 
  31. Botella C, Garcia-Palacios A, Vizcaíno Y, herrero R, Ba-os RM, Belmonte MA. Virtual reality in the treatment of fibromyalgia: a pilot study. Cyberpsychol Beh Soc Netw. 2013;16(3): 215-23. [Crossref]  [PubMed] 
  32. Shiri S, Feintuch U, Weiss N, Pustilnik A, Geffen T, Kay B, et al. A virtual reality system combined with biofeedback for treating pediatric chronic headache--a pilot study. Pain Med. 2013;14(5):621-7. [Crossref]  [PubMed] 
  33. Ortiz-Catalan M, Guðmundsdóttir RA, Kristoffersen MB, Zepeda-Echavarria A, Caine-Winterberger K, Kulbacka-Ortiz K, et al. Phantom motor execution facilitated by machine learning and augmented reality as treatment for phantom limb pain: a single group, clinical trial in patients with chronic intractable phantom limb pain. Lancet. 2016;388(10062):2885-94. [Crossref]  [PubMed] 
  34. Yilmaz Yelvar GD, Çırak Y, Dalkılınç M, Parlak Demir Y, Guner Z, Boydak A. Is physiotherapy integrated virtual walking effective on pain, function, and kinesiophobia in patients with non-specific low-back pain? Randomised controlled trial. Eur Spine J. 2017;26(2):538-45. [Crossref]  [PubMed] 
  35. Wittkopf PG, Lloyd DM, Coe O, Yacoobali S, Billington J. The effect of interactive virtual reality on pain perception: a systematic review of clinical studies. Disabil Rehabil. 2019:1-12. [Crossref]  [PubMed] 
  36. Bahat hS, Takasaki h, Chen X, Bet-Or Y, Treleaven J. Cervical kinematic training with and without interactive VR trainingfor chronic neck pain - a randomized clinical trial. Man Ther. 2015;20(1):68-78. [Crossref]  [PubMed] 
  37. Bahat hS, Croft K, Carter C, hoddinott A, Sprecher E, Treleaven J. Remote kinematic training for patients with chronic neck pain: a randomised controlled trial. Eur Spine J. 2018;27(6):1309-23. [Crossref]  [PubMed] 
  38. Garcia-Palacios A, herrero R, Vizcaíno Y, Belmonte MA, Castilla D, Molinari G, et al. Integrating virtual reality with activity management for the treatment of fibromyalgia: acceptability and preliminary efficacy. Clin J Pain. 2015;31(6):564-72. [Crossref]  [PubMed] 

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