In the Virtual Hospital: Shared Virtual Spaces for Patients with Chronic Pain

Background & Aims

Chronic low back pain (cLBP) remains a societal challenge due to its high disease burden and years lived with disability. There is strong evidence that a multidisciplinary approach may benefit patients who suffer from cLBP compared to unimodal interventions, but coordinating multidisciplinary meetings can be difficult and presential meetings are often inconvenient for patients, who may have trouble attending due to problems with mobility and geographical isolation. As an alternative, this study aimed to explore the potential feasibility of conducting meetings in shared virtual reality (VR) spaces.

Methods

Patients with cLBP, along with clinicians, researchers, and VR developers, participated in a series of virtual focus groups. The purpose of these groups was ostensibly to attain feedback on a prototype of a therapeutic VR application for low back pain. In a private non-commercial shared virtual space, participants were represented by a look-alike virtual avatar generated from a single front-facing photograph. The sessions involved interactive dialogue guided by researchers, where patients provided feedback on their experience using the virtual rehabilitation program. A face-to-face meeting with participants was held several days later to discuss the experience of the virtual meeting focusing on its acceptability, feasibility and tolerability.

Results

The virtual focus group experience was positively received by patients, researchers, and clinicians. Participants had a strong sense of embodiment over their virtual avatar, and presence in the virtual meeting room, felt that others were really there with them, valued the convenience of attending the meeting from home, and found the interaction between participants to be comfortable and natural. At the face-to-face meeting performed three days after the virtual meeting, patients recognized each other and had the feeling that they had already met. The immersive VR environment provided heightened levels of engagement and focus and potential distraction from pain, highlighting its potential feasibility over the conventional non-immersive virtual meetings. Some technical glitches and discomfort with VR headsets were reported with prolonged use but did not significantly impact the overall experience.

Conclusions

Shared virtual spaces such as the metaverse show promise for conducting patient focus groups, in particular in chronic pain. Virtual meetings have the potential to reduce costs and clinical resources and improve accessibility for patients with reduced mobility. The strong sense of embodiment and presence potentially makes them superior to videoconferencing technologies, with the immersive VR environment enhancing engagement and participation. Future expansion of the metaverse can include various types of patient support and information groups, leading to improved healthcare delivery, patient satisfaction, and treatment outcomes.

References

Casey MB, Smart KM, Segurado R, Doody C. Multidisciplinary-based Rehabilitation (MBR) Compared With Active Physical Interventions for Pain and Disability in Adults With Chronic Pain: A Systematic Review and Meta-analysis. Clin J Pain. 2020 Nov;36(11):874-886.

Birckhead, B., Khalil, C., Liu, X., Conovitz, S., Rizzo, A., Danovitch, I., et al. (2019). Recommendations for methodology of virtual reality clinical trials in health care by an international working group: Iterative study. JMIR Mental Health 6. doi: 10.2196/11973

Mummah, S. A., Robinson, T. N., King, A. C., Gardner, C. D., and Sutton, S. (2016). IDEAS (Integrate, Design, Assess, and Share): A Framework and Toolkit of Strategies for the Development of More Effective Digital Interventions to Change Health Behavior. J Med Internet Res 18, e317. doi: 10.2196/jmir.5927

Garmer, K., Ylvén, J., and Karlsson, I.M. (2004). User participation in requirements elicitation comparing focus group interviews and usability tests for eliciting usability requirements for medical equipment: a case study. International Journal of Industrial Ergonomics 33(2), 85-98.

Leung, F.-H., and Savithiri, R. (2009). Spotlight on focus groups. Canadian Family Physician 55(2), 218-219.

Sanchez-Vives, M.V., Spanlang, B., Frisoli, A., Bergamasco, M., and Slater, M. (2010). Virtual hand illusion induced by visuomotor correlations. PloS one 5(4), e10381.