Virtual Reality Facilitated Exercise Increases Sympathetic Activity and Reduces Pain Perception: A Randomized Crossover Study.
Samuel T Rodriguez, Nathan Makarewicz, Ellen Y Wang, Michelle Zuniga-Hernandez, Janet Titzler, Christian Jackson, Man Yee Suen, Oswaldo Rosales, Thomas J Caruso
Author Information
Samuel T Rodriguez: From the Stanford Chariot Program, Lucile Packard Children's Hospital Stanford, Palo Alto, California (STR, NM, EYW, MZ-H, JT, MYS, TJC); Division of Pediatric Anesthesiology, Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford School of Medicine, Stanford, California (STR, EYW, CJ, TJC), Stanford University School of Medicine, Stanford, California (NM), and Stanford University Graduate School of Education, Stanford, California (OR, TJC).
OBJECTIVE: Both virtual reality and exercise reduce pain while avoiding the risks of traditional pharmacotherapy. The aim of this study was to assess how virtual reality-facilitated exercise modulates sympathetic activity and pain perception. DESIGN: Healthy adult volunteers were randomized by hand dominance and then subjected to a standardized cold pressor test while experiencing a virtual reality application. After a 5-min washout, participants were crossed-over and repeated the test on their other hand while undergoing a virtual reality-facilitated exercise application. Sympathetic activation, pain sensation, and pain tolerance data were collected identically during both conditions. RESULTS: One hundred ten participants were analyzed. Sympathetic activity increased in both conditions but was higher in the virtual reality-facilitated exercise condition ( P < 0.0001). Pain sensation scores were initially higher with virtual reality-facilitated exercise but dropped below the virtual reality-only condition by the end of the intervention ( P = 0.0175). There were no differences in pain tolerance between conditions ( P = 0.18). CONCLUSIONS: The decrease in pain perception with virtual reality-facilitated exercise condition compared to virtual reality alone indicates virtual reality-facilitated exercise can be a useful tool for managing pain. Though this effect did not translate into higher pain tolerance, virtual reality-facilitated exercise may be a useful intervention in the setting of physical therapy or for patients with chronic pain.
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