Brazilian Journal of Pain
https://brjp.org.br/article/doi/10.5935/2595-0118.20200187
Brazilian Journal of Pain
Original Article

Comparison of the effect of two virtual reality stimuli on pressure pain sensitivity and autonomic response

Comparação do efeito de dois estímulos de realidade virtual na sensibilidade de dor a pressão e na resposta autonômica

Thayná Caetano Alves Silva; Pamela Martin Bandeira; Amanda Dutra da Silva Ranzatto; Ney Armando Meziat-Filho; Leandro Alberto Calazans Nogueira; Orlando Fernandes Júnior; Felipe José Jandre dos Reis

http://dx.doi.org/10.5935/2595-0118.20200187 BrJP, vol.3, n4, p.328-332, 2020
PDF English
PDF Português
SciELO
Downloads: 0
Views: 556

Abstract

BACKGROUND AND OBJECTIVES: Virtual reality can have a modulatory action on pain and the autonomic nervous system. This study sought to verify the effect of two different VR stimuli on the pressure pain threshold and heart rate variability.

METHODS: Healthy volunteers were randomized into two groups of virtual reality, nature and control. The pressure pain threshold was measured pre and post stimulus and heart rate variability measurements were collected pre, during and after virtual reality stimuli. The exploratory data analysis was performed. The t test was used to compare pressure pain threshold. For the differences in heart rate variability measurements, the linear mixed model was used. The level of significance adopted was 95%.

RESULTS: The virtual reality nature group was composed of 19 participants with mean age of 22.7±4.72 years and the control virtual reality group was composed of 22 participants with mean age of 21.13±2.42 years. The virtual reality nature group showed an increase in the pressure pain threshold after virtual reality and the mean difference was -0.41 [CI (95%)= -0.74 to -0.07; p=0.01]. There was no difference in heart rate variability parameters measured during and after virtual reality stimulation.

CONCLUSION: The group that was exposed to a virtual reality stimulus with scenes from nature showed an increase in the pressure pain threshold. There was no difference in heart rate variability between groups.

Keywords

Autonomic nervous system, Expression emotion, Heart rate, Virtual reality

Resumo

JUSTIFICATIVA E OBJETIVOS: A realidade virtual pode ter ação modulatória sobre a dor e o sistema nervoso autônomo. O objetivo deste estudo foi verificar o efeito de dois estímulos diferentes de realidade virtual sobre o limiar de dor a pressão e a variabilidade da frequência cardíaca.

MÉTODOS: Os voluntários sadios foram randomizados para dois grupos de realidade virtual, natureza e controle. Foram coletadas as medidas do limiar de dor a pressão pré e pós-estímulo e as medidas da variabilidade da frequência cardíaca pré, durante e após o estímulo de realidade virtual. Foi realizada a análise exploratória dos dados. O teste t foi utilizado para comparar o limiar de dor a pressão. Para as diferenças nas medidas da variabilidade da frequência cardíaca utilizou-se o modelo linear misto. O nível de significância adotado foi de 95%.

RESULTADOS: O grupo realidade virtual natureza foi composto por 19 participantes com média de idade de 22,7±4,72 anos e o grupo realidade virtual controle foi composto por 22 participantes com média de idade de 21,13±2,42 anos. O grupo realidade virtual natureza apresentou um aumento do limiar de dor a pressão após realidade virtual e a diferença entre as médias foi de -0,41 [IC (95%)=-0,74 a -0,07; p=0,01]. Não houve diferença para os parâmetros da variabilidade da frequência cardíaca mensurados durante e após o estímulo de realidade virtual.

CONCLUSÃO: O grupo que foi exposto a um estímulo de realidade virtual com cenas da natureza apresentou um aumento do limiar de dor. Não foram observadas diferenças na variabilidade da frequência cardíaca entre os grupos.

Palavras-chave

Emoções manifestas, Frequência cardíaca, Realidade virtual, Sistema nervoso autônomo

References

Keefe F, Nowlin L, France CR, Zakhidov D, Trost Z, Zielke M. The promise and challenge of virtual gaming technologies for chronic pain: the case of graded exposure for low back pain. Pain Manag. 2015;5(3):197-206.

Marques FLSN, Costa RMEM, Machado LS, Moraes RM. Realidade virtual para saúde no brasil: conceitos, desafios e oportunidades. Rev Bras Eng Biomed. 2011;27(4):243-58.

Malinska M, Zuzewicz K, Bugajska J, Grabowski A. Heart rate variability (HRV) during virtual reality immersion. Int J Occup Saf Ergon. 2015;21(1):47-54.

Pourmand A, Davis S, Marchak A, Whiteside T, Sikka N. Virtual reality as a clinical tool for pain management. Curr Pain Headache Rep. 2018;22(8):53.

Massetti T, da Silva TD, Crocetta TB, Guarnieri R, de Freitas BL, Bianchi Lopes P. The clinical utility of virtual reality in neurorehabilitation: a systematic review. J Cent Nerv Syst Dis. 2018;10:1179573518813541.

Oing T, Prescott J. Implementations of virtual reality for anxiety-related disorders: systematic review. JMIR Serious Games. 2018;6(4).

Blum J, Rockstroh C, Göritz AS. Heart rate variability biofeedback based on slow-paced breathing with immersive virtual reality nature scenery. Front Psychol. 2019;10:2172.

Tsai CF, Yeh SC, Huang Y, Wu Z, Cui J, Zheng L. The effect of augmented reality and virtual reality on inducing anxiety for exposure therapy: a comparison using heart rate variability. J Healthc Eng. 2018;25:6357351.

Van Den Houte M, Van Oudenhove L, Bogaerts K, Van Diest I, Van Den Bergh O. Endogenous pain modulation: association with resting heart rate variability and negative affectivity. Pain Med. 2018;19(8):1587-96.

Keefe FJ, Lumley M, Anderson T, Lynch TR, Studts JL, Carson KL. Erratum. Pain and emotion: new research directions. 2001;57(4):587-607.

Rhudy JL, Meagher MW. The role of emotion in pain modulation. Curr Opin Psychiatry. 2001;14(3):241-5.

Kenntner-Mabiala R, Pauli P. Affective modulation of brain potentials to painful and nonpainful stimuli. Psychophysiology. 2005;42(5):559-67.

Rhudy JL, Williams AE, McCabe KM, Russell JL, Maynard LJ. Emotional control of nociceptive reactions (ECON): do affective valence and arousal play a role?. Pain. 2008;136(3):250-61.

Tracy LM, Ioannou L, Baker KS, Gibson SJ, Georgiou-Karistianis N, Giummarra MJ. Meta-analytic evidence for decreased heart rate variability in chronic pain implicating parasympathetic nervous system dysregulation. Pain. 2016;157(1):7-29.

Williams DW, Cash C, Rankin C, Bernardi A, Koenig J, Thayer JF. Resting heart rate variability predicts self-reported difficulties in emotion regulation: a focus on different facets of emotion regulation. Front Psychol. 2015;6:261.

Ravinder J, Crawford M. How does the body affect the mind? Role of cardiorespiratory coherence in the spectrum of emotions. Adv Mind Body Med. 2015;29(4):4-16.

Thayer JF, Brosschot JF. Psychosomatics and psychopathology: Looking up and down from the brain. Psychoneuroendocrinology. 2005;30(10):1050-8.

Thayer JF, Lane RD. A model of neurovisceral integration in emotion regulation and dysregulation. J Affect Disord. 2000;61(3):201-16.

Guidelines Heart rate variability. Eur Heart J. 1996:354-81.

Catai AM, Pastre CM, Godoy MF, Silva ED, Takahashi ACM, Vanderlei LCM. Heart rate variability: are you using it properly? Standardisation checklist of procedures. Braz J Phys Ther. 2020;24(2):91-102.

Thayer JF, Åhs F, Fredrikson M, Sollers 3rd JJ, Wager TD. A meta-analysis of heart rate variability and neuroimaging studies: implications for heart rate variability as a marker of stress and health. Neurosci Biobehav Rev. 2012;36(2):747-56.

Tsai CF, Yeh SC, Huang Y, Wu Z, Cui J, Zheng L. The effect of augmented reality and virtual reality on inducing anxiety for exposure therapy: a comparison using heart rate variability. J Healthc Eng. 2018;2018:6357351.

Rus-Calafell M, Garety P, Sason E, Craig TJK, Valmaggia LR. Virtual reality in the assessment and treatment of psychosis: A systematic review of its utility, acceptability and effectiveness. Psychol Med. 2018;48(3):362-91.

Scapin S, Echevarría-Guanilo ME, Boeira Fuculo Junior PR, Gonçalves N, Rocha PK, Coimbra R. Virtual reality in the treatment of burn patients: a systematic review. Burns. 2018;44(6):1403-16.

Bluett B, Bayram E, Litvan I. The virtual reality of Parkinson's disease freezing of gait: a systematic review. Parkinsonism Relat Disord. 2019;61:26-33.

Massetti T, da Silva TD, Crocetta TB, Guarnieri R, de Freitas BL, Bianchi Lopes P. The clinical utility of virtual reality in neurorehabilitation: a systematic review. J Cent Nerv Syst Dis. 2018;10:117957351881354.

Botella C, Fernández-Álvarez J, Guillén V, García-Palacios A, Baños R. Recent progress in virtual reality exposure therapy for fobias: a systematic review. Curr Psychiatry Rep. 2017;19(7):42.

Mallari B, Spaeth EK, Goh H, Boyd BS. Virtual reality as an analgesic for acute and chronic pain in adults: a systematic review and meta-analysis. J Pain Res. 2019;12:2053-85.

Eijlers R, Utens EMWJ, Staals LM, de Nijs PFA, Berghmans JM, Wijnen RMH. Systematic review and meta-analysis of virtual reality in pediatrics: effects on pain and anxiety. Anesth Analg. 2019;129(5):1344-53.

Maani C V, Hoffman HG, Morrow M, Maiers A, Gaylord K, McGhee LL. Virtual reality pain control during burn wound debridement of combat-related burn injuries using robot-like arm mounted VR goggles. J Trauma. 2011;71(^sSuppl 1):S125-30.

Chan E, Foster S, Sambell R, Leong P. Clinical efficacy of virtual reality for acute procedural pain management: a systematic review and meta-analysis. PLoS One. 2018;13(7).

Hoffman HG, Richards TL, Van Oostrom T, Coda BA, Jensen MP, Blough DK. The analgesic effects of opioids and immersive virtual reality distraction: evidence from subjective and functional brain imaging assessments. Anesth Analg. 2007;105(6):1776-83.

Biaggio AMB, Natalício L, Spielberger CD. Desenvolvimento da forma experimental em português do Inventário de Ansiedade Traço-Estado (IDATE), de Spielberger. Arq Bras Psicol. 1977;29(3):31-44.

Fioravanti ACM, Santos LF, Maissonette S, Cruz APM, Landeira-Fernandez J. Avaliação da estrutura fatorial da Escala de Ansiedade-Traço do IDATE. Aval Psicol. 2006;5(2):217-24.

Giles D, Draper N, Neil W. Validity of the Polar V800 heart rate monitor to measure RR intervals at rest. Eur J Appl Physiol. 2016;116(3):563-71.

Dobbs WC, Fedewa MV, MacDonald HV, Holmes CJ, Cicone ZS, Plews DJ. The accuracy of acquiring heart rate variability from portable devices: a systematic review and meta-analysis. Sports Med. 2019;49(3):417-35.

Georgiou K, Larentzakis AV, Khamis NN, Alsuhaibani GI, Alaska YA, Giallafos EJ. Can wearable devices accurately measure heart rate variability? A systematic review. Folia Med. 2018;60(1):7-20.

Peltola MA. Role of editing of R-R intervals in the analysis of heart rate variability. Front Physiol. 2012;3:148.

Twisk JW. Longitudinal data analysis A comparison between generalized estimating equations and random coefficient analysis. Eur J Epidemiol. 2004;19(8):769-76.

Laura Frank PM VB. The repeatability of pressure algometry in asymptomatic individuals over consecutive days. Int J Osteopath Med. 2013;16(3):143-52.

Waller R, Straker L, O'Sullivan P, Sterling M, Smith A. Reliability of pressure pain threshold testing in healthy pain free young adults. Scand J Pain. 2015;9(1):38-41.

Gutiérrez-Maldonado J, Gutiérrez-Martínez O, Loreto-Quijada D, Nieto-Luna R. The use of virtual reality for coping with pain with healthy participants TT - El uso de la realidad virtual para el afrontamiento del dolor con participantes sanos. Psicothema. 2012;24(4):516-22.

Arendt-Nielsen L, Skou ST, Nielsen TA, Petersen KK. Altered central sensitization and pain modulation in the CNS in chronic joint pain. Curr Osteoporos Rep. 2015;13(4):225-34.

Pessoa L, Padmala S, Kenzer A, Bauer A. Interactions between cognition and emotion during response inhibition. Emotion. 2012;12(1):192-7.

Strauss GP, Ossenfort KL, Whearty KM. Reappraisal and distraction emotion regulation strategies are associated with distinct patterns of visual attention and differing levels of cognitive demand. PLoS One. 2016;11(11).

Morawetz C, Bode S, Baudewig J, Kirilina E, Heekeren HR. Changes in effective connectivity between dorsal and ventral prefrontal regions moderate emotion regulation. Cereb Cortex. 2016;26(5):1923-37.

Anderson AP, Mayer MD, Fellows AM, Cowan DR, Hegel MT, Buckey JC. Relaxation with immersive natural scenes presented using virtual reality. Aerosp Med Hum Perform. 2017;88(6):520-6.

Valtchanov D, Barton KR, Ellard C. Restorative effects of virtual nature settings. Cyberpsychol Behav Soc Netw. 2010;13(5):503-12.

Submitted date:
04/06/2020

Accepted date:
05/10/2020

60872e40a95395598a3c5ef4 brjp Articles
2595-3192 (Electronic) 2595-0118 (Printed)
BrJP ©2024 All rights reserved.

BrJP

Share this page
Page Sections