None listed
Conditions
Brief summary
A randomised controlled proof of concept and feasibility study will investigate whether virtually embodying hyper-muscular and hyper-capable avatars in virtual reality (VR) can augment body image as it relates to the perception of bodily integrity and vulnerability, and whether these changes relate to short-term improvements in clinical outcomes. Thirty adults with chronic low back pain will be recruited from the Metro South Health Persistent Pain Management Service and randomised to receive a single session VR intervention targeting body image ‘Body Image-VR’ (n=20), or single session of general virtual reality ‘General-VR’ (n=10). Primary outcome measures of body image, pain, and strength, will be assessed: (1) Immediately pre- and post-intervention, and (2) At one week follow-up to assess carry-over effects. A qualitative interview will be conducted with Intervention participants to investigate VR experience, acceptability, feasibility, and tolerability. We hypothesise that embodying hyper-capable avatars in VR will improve body image, pain and strength. We expect outcomes to inform future research and clinical implementation.
Interventions
Intervention: Body Image-VR
The VR experience will involve three enhanced embodiment experiences: 1. A muscular boxer, 2. A super hero, 3. A rock climber.
Notably, all phases can be performed sitting and/or standing to suit the tolerance of the individual. All components of the intervention will be conducted and/or supervised by a qualified clinician (physiotherapist and/or clinical exercise physiologist).
Three bodily experiences will be completed in a single session with a 5-minute interval
Intervention: Body Image-VR The VR experience will involve three enhanced embodiment experiences: 1. A muscular boxer, 2. A super hero, 3. A rock climber. Notably, all phases can be performed sitting and/or standing to suit the tolerance of the individual. All components of the intervention will be conducted and/or supervised by a qualified clinician (physiotherapist and/or clinical exercise physiologist). Three bodily experiences will be completed in a single session with a 5-minute interval between each. At the beginning of each experience the experimenter will assist the user to operate the hand controls and facilitate avatar embodiment by encouraging the user to move and observe their virtual body before talking the participant through the activity. Before, after, and during each experience, participants will rate their perceived strength, vulnerability, agility & confidence (Pain-related Body Image Scale) and pain intensity using 0-10 numerical rating scales. Between each activity participants will exit VR for instruction on the next activity. Boxing Avatar (6-minutes) Prior to entering VR, the experimenter will demonstrate a series of ‘muscle poses’ and 'boxing actions' that they will be encouraged to do once in VR to embody the avatar and it's characteristics. When in VR, participants will observe their body, make muscle poses, and interact with a virtual boxing bag. Rock Climbing Avatar (6-minutes) Prior to entering VR the experimenter will demonstrate the controls needed to climb. Participants will then scale a virtual cliff by reaching, grasping, and pulling on hand-holds in the cliff face. Immediately prior, during, and immediately following, participants will rate the body image and pain scales. Super Hero: The Incredible Hulk Avatar (6-minutes) Prior to entering VR, the experimenter will demonstrate the activity and how to use the controls in order to use the avatars 'special strength powers' that they will perform when in VR. When in VR, participants will do activities such as lift and throw 'heavy' virtual objects and create earth quakes using their 'strength'. To ensure fidelity to the intervention protocol, a senior researcher from the research team will observe the first three participants from each group.
Sponsors
Griffith University
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Subject, Investigator)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Adults (>18 years of age) who have been referred to the Metro South Health Persistent Pain Management Service (Bourke Street Centre) for the management of chronic low back pain (duration at least 6 months), who have scores of at least “moderate” on questions 7 (“How much bodily pain have you had during the past 4 weeks?”), and question 8 (“During the past 4 weeks, how much did pain interfere with your normal work (including both work outside the home and housework)?”) of the SF-36 (Ware & Sherbourne 1992), are able to read and understand English language, can operate a computer, and are able to provide informed consent, will be eligible for inclusion in the study.
Exclusion criteria
Exclusion criteria will comprise a diagnosis of, or the presence of red flags indicating, serious spinal pathology (i.e. infection, tumour, recent fracture, significant structural deformity such as unstable/unstabilised spondylolisthesis or progressive scoliosis, inflammatory disorder, and neuropathic radicular syndrome or cauda equina syndrome with clear neurological impairment). Inability to tolerate visual stimulation (i.e. susceptibility to migraines aggravated by light) or inability to tolerate the head mounted display (i.e. sensitivity to touch around the face and head) will also result in exclusion.
Outcome results
None listed