Virtual reality-based software for the treatment of fibromyalgia: a case study

Abstract

The aim of this study was to explore the efficacy and acceptance of virtual reality-based software for pain reduction (VirtualPain) in a 53-year-old female with fibromyalgia (FM), a chronic pain syndrome. Treatment consisted of four 60-minute sessions. Each session involved 40 minutes of cognitive behavioral therapy (CBT) and 20 minutes of exposure to VirtualPain software. VirtualPain consists of a recreation of the human body in which the pain or lack of pain experienced by the participant in each body part (e.g., hand or knee) is represented by color, movement and sound. During exposure, the patient modified these characteristics to increase her sensation of control over the pain. In our study, the software was displayed on a stereoscopic laptop with a 17' screen. Pain intensity was assessed on a visual analog scale (VAS, from 0 to 10). Before and after the treatment, the patient completed the Pain Anxiety Symptoms Scale Short Form (PASS-20), the Pain Catastrophizing Scale (PCS) and the Pain Self-Efficacy Scale (CPSS). During each session, the patient reported the amount of extra medication for pain consumed during the week. Follow-up was conducted at 6 and 12 months. The patient showed a substantial reduction in anxiety, catastrophic thoughts and pain perception, and improved selfefficacy after treatment. Most importantly, at 6-month follow-up (after six months without treatment) results were maintained, but at 12-month follow-up (after the patient had been allowed to use VirtualPain at home for 6 months) the clinical improvements increased. The addition of VirtualPain to a CBT intervention reduced pain intensity and psychological symptoms (anxiety, catastrophism and low selfefficacy) in a patient with FM. Controlled studies with large samples are now needed to assess the specific additional contribution of VirtualPain to CBT in the treatment of fibromyalgia.