Herrero, R., García-Palacios, A., Castilla, D., Molinari, G., & Botella, C. (2014). Virtual reality for the induction of positive emotions in the treatment of fibromyalgia: a pilot study over acceptability, satisfaction, and the effect of virtual reality on mood. Cyberpsychology, Behavior and Social Networking, 17(6), 379–84. doi:10.1089/cyber.2014.0052
Results showed significant increases in general mood state, positive emotions, motivation, and self-efficacy. These preliminary findings show the potential of VR as an adjunct to the psychological treatment of such an important health problem as chronic pain.
Hoffman, H. G., Meyer, W. J., Ramirez, M., Roberts, L., Seibel, E. J., Atzori, B.,  & Patterson, D. R. (2014). Feasibility of articulated arm mounted Oculus Rift Virtual Reality goggles for adjunctive pain control during occupational therapy in pediatric burn patients. Cyberpsychology, Behavior and Social Networking, 17(6), 397–401. doi:10.1089/cyber.2014.0058
Significant reductions in pain measures including: worst pain, time thinking about pain, level of pain unpleasantness.
Loreto-Quijada, D., Gutiérrez-Maldonado, J., Nieto, R., Gutiérrez-Martínez, O., Ferrer-García, M., Saldaña, C., & Liutsko, L. (2014). Differential effects of two virtual reality interventions: distraction versus pain control. Cyberpsychology, Behavior and Social Networking, 17(6), 353–8. doi:10.1089/cyber.2014.0057
Pain control was more effective than mere distraction
Tanja-Dijkstra, K., Pahl, S., White, M. P., Andrade, J., Qian, C., Bruce, M., Moles, D. R. (2014). Improving dental experiences by using virtual reality distraction: a simulation study. PloS One, 9(3), e91276. doi:10.1371/journal.pone.0091276
The VR distraction had effects not only on concurrent experiences, such as perceived control, but longitudinally upon the vividness of memories after the dental experience had ended. Participants with higher dental anxiety (for whom the dental procedures were presumably more aversive) showed a greater reduction in memory vividness than lower dental-anxiety participants.
“This study thus suggests that VR distractions can be considered as a relevant intervention for cycles of care in which people’s previous experiences affect their behaviour for future events.”
Pickrell, J. E., Hollander, A., Mancl, L., Rose, H., Drangsholt, M. T., Gromala, D.,& Coldwell, S. E. (2014). VRmanuscript_042514. Pending Review.
VR significantly better than control, HMD vs. non-HMD not significantly different
Czub, M., & Piskorz, J. (2014). How Body Movement Influences Virtual Reality Analgesia? 2014 International Conference on Interactive Technologies and Games, 13–19. doi:10.1109/iTAG.2014.8
Found that using a Kinect for large motor movement in VR reduced pain better than small motor movement with a mouse.
Wiederhold, B. K., Gao, K., Sulea, C., & Wiederhold, M. D. (2014). Virtual reality as a distraction technique in chronic pain patients. Cyberpsychology, Behavior and Social Networking, 17(6), 346–52. doi:10.1089/cyber.2014.0207
Chronic pain patients demonstrated significant relief in subjective ratings of pain that corresponded to objective measurements in peripheral, noninvasive physiological measures.
Furman, E., Jasinevicius, T. R., Nabil, F., Victoroff, K. Z., Skillicorn, R., & Buchner, M. (2013). Virtual Reality Distraction for Pain Control During Periodontal Scaling and Root Planing Procedures. Journal of the American Dental Association, (JADA 2009;140(12):1508-1516
Paired t tests revealed that VAS scores were sig- nificantly lower during VR compared with the movie (P < .001) and control (P < .001) conditions. Similarly, BP and PR were lowest during VR, followed by the movie and control conditions. Patients reported that they preferred the VR condition.
Ramachandran V.S.,& Seckel E.L. (2013). Using mirror visual feedback and virtual reality to treat fibromyalgia. Medical Hypotheses 2013; 75:495–496.
Reductions in pain and associated anxiety.
Gordon, N. S., Merchant, J., Zanbaka, C., Hodges, L. F., & Goolkasian, P. (2011). Interactive gaming reduces experimental pain with or without a head mounted display. Computers in Human Behavior, 27(6), 2123–2128. doi:10.1016/j.chb.2011.06.006
VR superior to Emotion Induction Task and no difference between tracked HMD and Projector at same (low) FOV
Maani, C. V, Hoffman, H. G., Morrow, M., Maiers, A., Gaylord, K., McGhee, L. L., & DeSocio, P. a. (2011). Virtual reality pain control during burn wound debridement of combat-related burn injuries using robot-like arm mounted VR goggles. The Journal of Trauma, 71(1 Suppl), S125–30. doi:10.1097/TA.0b013e31822192e2
VR + medication was significantly better than control. Pain reduction was greatest with the patients in the worst pain.
Schmitt Y.S., Hoffman H.G., & Blough D.K., et al. (2011). A randomized, controlled trial of immersive virtual reality analgesia, during physical therapy for pediatric burns. Burns: Journal of the International Society for Burn Injuries. 2011;37(1):61–68.”
“Subjects reported significant decreases (27–44%) in pain ratings during virtual reality. They also reported improved affect (‘‘fun’’) during virtual reality. The analgesia and affect improvements were maintained with repeated virtual reality use over multiple therapy sessions….”These results suggest that immersive virtual reality is an effective nonpharmacologic, adjunctive pain reduction technique in the pediatric burn population undergoing painful rehabilitation therapy. The magnitude of the analgesic effect is clinically meaningful and is maintained with repeated use.”
Dahlquist, L. M., Weiss, K. E., Clendaniel, L. D., Law, E. F., Ackerman, C. S., & McKenna, K. D. (2009). Effects of videogame distraction using a virtual reality type head-mounted display helmet on cold pressor pain in children. Journal of Pediatric Psychology, 34(5), 574–84. doi:10.1093/jpepsy/jsn023
There was a significant increase in pain tolerance and pain threshold in both passive and interactive distraction. Distraction helmet showed more effect.
Carrougher G.J., Hoffman H.G., Nakamura D., et al. (2009). The effect of virtual reality on pain and range of motion in adults with burn injuries. Journal of Burn Care & Research, 30(5):785–791.
“VR reduced all Graphic Rating Scale pain scores (worst pain, time spent thinking about the pain, and pain unpleasantness by 27, 37, and 31% respectively), relative to the no VR condition.
– Ninety-seven percent of patients reported zero to mild nausea after the VR session. “
Wender, R., Hoffman, H. G., Hunner, H. H., Seibel, E. J., Patterson, D. R., & Sharar, S. R.(2009). Interactivity influences the magnitude of virtual reality analgesia. Journal of Cyber Therapy Rehabilitation, 2, 27–33.”
Results showed more pain reduction during interactive VR than during non-interactive VR. Compared to the non-interactive group, the interactive VR group reported 32% more reduction in time spent thinking about pain, 75% more reduction in pain unpleasantness, 74% more reduction in worst pain, and 47% more increase in fun during VR
Cole J., Crowle S., Austwick G., Henderson B., Slater D. (2009). Exploratory findings with virtual reality for phantom limb pain; from stump motion to agency and analgesia. Disabil Rehabil 31(10):846–854
Found that when movements of the virtual limb correspond to capture motion data measured on the patient’s stump instead of the opposite remaining limb, it allows the patients to gain agency for the movement they see, and feel embodied within the limb
Shahrbanian, S., & Simmonds, M. J. (2008). Effects of different virtual reality environments on experimental pain rating in post-stroke individuals with and without pain in comparison to pain free healthy individuals. Annual Review of CyberTherapy and Telemedicine, 53.
All VR conditions decreased pain ratings compared to the control condition. VR appeared to differentially influence pain rating to both hot and cold stimuli.
Hoffman, H. G., Patterson, D. R., Seibel, E., Soltani, M., Jewett-Leahy, L., & Sharar, S. R. (2008). Virtual reality pain control during burn wound debridement in the hydrotank. The Clinical Journal of Pain, 24(4), 299–304. doi:10.1097/AJP.0b013e318164d2cc
VR distraction showed significant reduction in pain for patients experiencing severe to excruciating pain during wound care.
Simmonds, M.J., & Shahrbanian, S. (2008). Effects of different virtual reality environments on pain threshold in individuals with pain following stroke. Proceeding of ICDVRAT,2008, ISBN: 0704915006.
All VR conditions increased pain threshold, and were more engaging than control condition.
Muhlberger, A., Wieser, M., & Wiederhold, B. (2007). Cyberpsychology & Behavior, 10 (4), 516- 522.
” Both VR environments reduced pain for heat and cold pain stimuli when compared to the control
(-) No significant changes in measures of Cyber sickness were detected.”
Dahlquist, L. M., McKenna, K. D., Jones, K. K., Dillinger, L., Weiss, K. E., & Ackerman, C. S. (2007). Active and passive distraction using a head-mounted display helmet: Effects on cold pressor pain in children. Health Psychololgy. 26(6), 794-801.
” either passive or interactive distraction caused improvements in both pain tolerance and threshold
Interactive distraction was more effective than the passive.”
Mosso, J.L., Rizzo S., Wiederhold B., Lara V., Flores J., Espiritusanto E., Minor A., Santander A., Avila O., Balice O.,  & Benavides B. (2007). Cybertherapy—new applications for discomfort reductions. Surgical care unit of heart, neonatology care unit, transplant kidney care unit, delivery room-cesarean surgery and ambulatory surgery, 27 case reports. Studies in Health Technology and Informatics, 125:334-6.
Pain reduced. Patients reported higher wellbeing. There was the reduction of medication dosage that predicts the usefulness of VR.
Sharar, S. R., Carrougher, G. J., Nakamura, D., Hoffman, H. G., Blough, D. K., & Patterson, D. R. (2007). Arch Phys Med Rehabil, 88 (12 Suppl 2), S43-49
All pain ratings were significantly lower during the VR distraction than during non-VR.
Hoffman, H. G., Richards, T. L., Van Oostrom, T., Coda, B. a, Jensen, M. P., Blough, D. K., & Sharar, S. R. (2007). The analgesic effects of opioids and immersive virtual reality distraction: evidence from subjective and functional brain imaging assessments. Anesthesia and Analgesia, 105(6), 1776–83, table of contents. doi:10.1213/01.ane.0000270205.45146.db
Combined opioid + VR reduced pain reports more effectively than opioid alone or VR distraction alone, on all subjective pain measures.
Gold, J. I., Kim, S. H., Kant, A. J., Joseph, M. H., & Rizzo, A. S. (2006). Effectiveness of virtual reality for pediatric pain distraction during IV placement. CyberPsychology & Behavior, 9(2), 207-212.
All outcome scores were reduced for children in the VR group. No simulator sickness.
Magora, F., Cohen, S., Shochina, M., & Dayan, E. (2006). Virtual reality immersion method of distraction to control experimental ischemic pain. Israel Medical Association Journal, 8, 261–265.”
Pain components were significantly lower in VR. Tolerance time in VR was significantly longer than No VR.
Patterson, D. R, Wiechman, S. A., Jensen, M., & Sharar, S. R. (2006). Hypnosis delivered through immersive virtual reality for burn pain: A clinical case series. International Journal of Clinical and Experimental Hypnosis, 54(2), 130-142.
VR group showed significant reduction in pain intensity regardless whether it combined with hypnosis or not. Combination of PHS with VR reduced worst pain and unpleasantness more.
Patterson, D. R., Hoffman, H. G., Palacios, A. G., & Jensen, M. J. (2006). Analgesic effects of posthypnotic suggestions and virtual reality distraction on thermal pain. Journal of abnormal psychology, 115(4), 834.
Results showed that combination of VR and hypnosis more effectively decreased all GRS pain scores than hypnosis alone.
Hoffman, H. G., Seibel, E. J., Richards, T. L., Furness, T. a, Patterson, D. R., & Sharar, S. R. (2006). Virtual reality helmet display quality influences the magnitude of virtual reality analgesia. The Journal of Pain : Official Journal of the American Pain Society, 7(11), 843–50. doi:10.1016/j.jpain.2006.04.006
High-Tech-VR helmet group, showed a clinically significant effects on all pain related outcomes during virtual reality.
Gold J.I., Reger G., & Rizzo A.A., et al. (2005). Virtual reality in outpatient phlebotomy: evaluating pediatric pain distraction during blood draw. Presented at the 10th Annual Poster Session of the Saban Research Institute. Los Angeles: Children’s Hospital Los Angeles; The Journal of Pain 6(3), Supplement , Page S57, March 2005
Lower frequency of moderate to severe pain intensity in VR via HMD
Wolitzky K., Fivush R., Zimand E., Hodges L., & Rothbaum B.O.(2005).  Effectiveness of virtual reality distraction during a painful medical procedure in pediatric oncology patients. Psychology & Health, 20(6):817–824.
Areas covered include stroke rehabilitation (upper and lower extremity training, spatial and perceptual-motor training), acquired brain injury, Parkinson’s disease, orthopedic rehabilitation, balance training, wheelchair mobility and functional activities of daily living training, and the newly developing field of telerehabilitation. Four major findings emerge from these studies:
(1) people with disabilities appear capable of motor learning within virtual environments;
(2) movements learned by people with disabilities in VR transfer to real world equivalent motor tasks in most cases, and in some cases even generalize to other untrained tasks;
(3) in the few studies (n = 5) that have compared motor learning in real versus virtual environments, some advantage for VR training has been found in all cases; and
(4) no occurrences of cybersickness in impaired populations have been reported to date in experiments where VR has been used to train motor abilities.
Hoffman, H. G., Richards, T. L., Coda, B., Bills, A. R., Blough, D., Richards, A. L., & Sharar, S. R. (2004). Modulation of thermal pain-related brain activity with virtual reality: evidence from fMRI. NeuroReport, 15(8), 1245–1248. doi:10.1097/01.wnr.0000127826.73576.91
virtual reality signigcantly reduced pain-related brain activity in all 5 regions of interest; the anterior cingulate cortex, primary and secondary somatosensory cortex, insula, and thalamus
Lee, D. W. H., Chan, A. C. W., Wong, S. K. H., Fung, T. M. K., Li, A. C. N., Chan, S. K. C., Chung, S. C. S. (2004). Can visual distraction decrease the dose of patient-controlled sedation required during colonoscopy? A prospective randomized controlled trial. Endoscopy, 36(03), 197-201.
The mean pain score and the dose of sedative medication required in group 2 was significantly lower compare to group 1 and 3
Hoffman, H. G., Sharar, S. R., Coda, B., Everett, J. J., Ciol, M., Richards, T., & Patterson, D. R. (2004). Manipulating presence influences the magnitude of virtual reality analgesia. Pain, 111(1), 162-168.
High-Tech-VR helmet group, showed a clinically significant reduction in pain intensity and a stronger presence during VR
Frere, C. L., Crout, R., Yorty, J., & McNeil, D. W. (2001). Effects of audiovisual distraction during dental prophylaxis. Journal of the American Dental Association, 132(7), 1031-1040.
The results showed that using A/V eyeglasses decreased anxiety and pain discomfort more than using no eyeglasses.
Hoffman, H. G., Patterson, D. R., Carrougher, G. J., & Sharar, S. R. (2001). Effectiveness of virtual reality-based pain control with multiple treatments. The Clinical Journal of Pain, 17(3), 229–35. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/11587113
There was a significant reduction in all pain ratings while patients immersed in VR during PT.
Magnitude of pain reduction did not diminish with repeated use of VR.
Hoffman, H. G., Patterson, D. R., & Carrougher, G. J. (2000). Use of virtual reality for adjunctive treatment of adult burn pain during physical therapy: a controlled study. The Clinical Journal of Pain, 16(3), 244-250.
All pain ratings for all pain measures were significantly lower during VR than in the control condition.
Ramachandran, V. S., & Rogers-Ramachandran, D. (1996). Synaesthesia in phantom limbs induced with mirrors. Proceedings. Biological Sciences / The Royal Society, 263(1369), 377–386. doi:10.1098/rspb.1996.0058
Phantom limb pain reduced using a “virtual reality box”.