Following SCI, a significant portion of rehabilitation focuses on improving motor function. However, pain also affects the majority of individuals with SCI and can have a tremendous impact on motor recovery and on the quality of life. Virtual reality (VR) interventions have long been known to affect acute pain via distraction mechanisms, but there is growing evidence that these tools can also be used to address more complicated and chronic manifestations of pain. Over the last decade, VR rehabilitation approaches have been increasingly employed both to improve motor functions and reduce pain among individuals with SCI and other related conditions; such VR interventions may represent an opportunity to address several consequences of a SCI in a more integrated manner.
In this symposium, we will explore various approaches that have been recently developed and assessed in individuals with SCI to improve motor function, decrease pain, or both. Catherine Mercier (Laval University) will discuss basic science findings supporting the need to address pain and motor recovery in an integrated manner, and will present results of a study using a VR-based complex gait training to improve locomotion and decrease pain after SCI. Dolors Soler (Institute Guttman) will focus on the development and application of VR combined with non-invasive brain stimulation techniques targeting lower and upper limbs in patients with SCI, as well as on clinical factors which predict clinical responses in this type of treatment. Dr. Zina Trost (University of Alabama at Birmingham) will present recent findings from an ongoing international research program that draws on the utility of visual illusory feedback therapies to develop an immersive virtual walking intervention for individuals with complete paraplegia and SCI-related neuropathic pain, with concurrent examination of underlying brain mechanisms of action. She will also present novel efforts to utilize virtual embodiment to address loss of sensory function among individuals with incomplete SCI. Finally, Michael Villiger (Davos Hospital) will present an innovative VR training performed at home (i.e. unsupervised) with individuals with an incomplete SCI and stroke, in which virtual representations of the legs and feet are controlled via movement sensors. Furthermore, he will present a new system targeting interactive cardiovascular training.
The symposium will include the presentation of several videos to give a concrete idea of how these approaches are implemented. It will take advantage of the fact that several of the speakers have developed conceptually related VR interventions using different approaches to exchange on our current knowledge about the optimal parameters for the implementation of VR interventions. For example, how important is the level of interactivity? What is the optimal duration and frequency of VR sessions? Should VR be combined with other types of therapy, and if yes, how? What patients are likely to benefit from VR? How should we deal with potential adverse effects, for example, pain provocation?
The symposium will conclude with a 15 minutes roundtable with a question and answer session.
The authors have no conflict of interest to declare.