Effectiveness of a Virtual Reality Walking Program for Spinal Cord Injury Neuropathic Pain Over the Medium to Long Term.

Description of the intervention Participants will use a Virtual Reality headset to complete a virtual walking experience. VRWalk app (Immersive Experience Labs, USA) is an immersive, embodied virtual walking experience. Participants will complete vitual walking using the VRwalk app for 20 minutes five times per week during the intervention periods. Participants will be assisted with the first session by the primary researcher (a qualified Physiotherapist) for familiarisation. The participant will be supported during the first week to gradually build up to the full 20-minute session length in the absence of any adverse effects. Procedures The study has an ABABC design, A refers to the non-intervention phases, B will be the intervention phases. C phase will be used as an assessment of feasibility. The first A phase will be a baseline phase of approximately two weeks. This will be followed by the first 4-week intervention phase. After this first intervention phase there will be a 3-4 week wash out phase (22-26 days), during which participants will no longer have access to the VRWalk intervention. After the wash out phase, participants will begin a second 4-week intervention phase, identical in structure and instructions to the first. This will be followed by a 2-week maintenance phase, during which participants will continue to have access to the device and app but will not be prompted or encouraged to use it. Usage during this phase is optional. Mode of delivery The intervention will be delivered through a virtual reality head mounted display. Using this device participants will access the VRWalk app and be prompted to walk and explore the virtual world. Location All intervention sessions will be conducted at the participants home. Personalisation/adaption While the intervention will not be personalised in a targetted way participants can explore the virtual world at their own pace throughout the intervention, therefore have control over their speed and exploration. Additionally, participants will be free to use the VR more than the amount previously mentioned so will be able to increase their dosage if they find it effective. Adhearence and fidelity Adherence data collected via the headset (frequency and duration of use). Participants will be contacted at least once per week to monitor progress, troubleshoot technical issues, and provide support.