title: Nonimmersive virtual reality mirror visual feedback therapy and its application for the treatment of complex regional pain syndrome: an open-label pilot study.
abstract: OBJECTIVE
  Chronic pain conditions such as phantom limb pain and complex regional pain syndrome are difficult to treat, and traditional pharmacological treatment and invasive neural block are not always effective. Plasticity in the central nervous system occurs in these conditions and may be associated with pain. Mirror visual feedback therapy aims to restore normal cortical organization and is applied in the treatment of chronic pain conditions. However, not all patients benefit from this treatment. Virtual reality technology is increasingly attracting attention for medical application, including as an analgesic modality. An advanced mirror visual feedback system with virtual reality technology may have increased analgesic efficacy and benefit a wider patient population. In this preliminary work, we developed a virtual reality mirror visual feedback system and applied it to the treatment of complex regional pain syndrome.
  
  
  METHODS
  A small open-label case series. Five patients with complex regional pain syndrome received virtual reality mirror visual feedback therapy once a week for five to eight sessions on an outpatient basis. Patients were monitored for continued medication use and pain intensity.
  
  
  RESULTS
  Four of the five patients showed >50% reduction in pain intensity. Two of these patients ended their visits to our pain clinic after five sessions.
  
  
  CONCLUSIONS
  Our results indicate that virtual reality mirror visual feedback therapy is a promising alternative treatment for complex regional pain syndrome. Further studies are necessary before concluding that analgesia provided from virtual reality mirror visual feedback therapy is the result of reversing maladaptive changes in pain perception.
authors.affiliation: Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine and Dentistry, Okayama City, Okayama Prefecture, 700-8551, Japan. tento@cc.okayama-u.ac.jp
authors.forename: Kenji
authors.initials: K
authors.lastname: Sato
authors.forename: Satoshi
authors.initials: S
authors.lastname: Fukumori
authors.forename: Takashi
authors.initials: T
authors.lastname: Matsusaki
authors.forename: Tomoko
authors.initials: T
authors.lastname: Maruo
authors.forename: Shinichi
authors.initials: S
authors.lastname: Ishikawa
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nishie
authors.forename: Ken
authors.initials: K
authors.lastname: Takata
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Mizuhara
authors.forename: Satoshi
authors.initials: S
authors.lastname: Mizobuchi
authors.forename: Hideki
authors.initials: H
authors.lastname: Nakatsuka
authors.forename: Masaki
authors.initials: M
authors.lastname: Matsumi
authors.forename: Akio
authors.initials: A
authors.lastname: Gofuku
authors.forename: Masataka
authors.initials: M
authors.lastname: Yokoyama
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Morita
mesh_terms: D020918:Complex Regional Pain Syndromes / Q000503:physiopathology / Q000628:therapy*; D003198:Computer Simulation; D056228:Feedback, Sensory / Q000502:physiology*; D006801:Humans; D009068:Movement / Q000502:physiology; D026741:Physical Therapy Modalities / Q000295:instrumentation; D010865:Pilot Projects; D013813:Therapy, Computer-Assisted / Q000295:instrumentation / Q000379:methods; D014584:User-Computer Interface