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CyberTherapy & Rehabilitation, Issue 3 (1), Spring 2010

CyberTherapy & Rehabilitation, Issue 3 (1), Spring 2010

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Published by Giuseppe Riva
CyberTherapy & Rehabilitation Magazine (C&R), the official voice of the International Association of CyberPsychology, Training & Rehabilitation (iACToR - http://www.imi-europe.eu/ - http://iactor.ning.com/). iACToR is an international association that has been created with the goal of disseminating knowledge about exciting new findings being made to transform healthcare through the addition of cutting edge technologies.
This publication will serve as a catalyst whereby society may rapidly benefit from the remarkable technological revolution that is occurring, with the ultimate aim of improving the quality of today's healthcare, helping to quickly disseminate research results, and ultimately elevating the level of care available for each citizen.
CyberTherapy & Rehabilitation Magazine (C&R), the official voice of the International Association of CyberPsychology, Training & Rehabilitation (iACToR - http://www.imi-europe.eu/ - http://iactor.ning.com/). iACToR is an international association that has been created with the goal of disseminating knowledge about exciting new findings being made to transform healthcare through the addition of cutting edge technologies.
This publication will serve as a catalyst whereby society may rapidly benefit from the remarkable technological revolution that is occurring, with the ultimate aim of improving the quality of today's healthcare, helping to quickly disseminate research results, and ultimately elevating the level of care available for each citizen.

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Published by: Giuseppe Riva on Oct 15, 2010
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11/07/2012

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Issue 1 / 2010
ManagementBattlefield Pain
 
and much more...
The Official Voice of iACToR
ISSN 2031 - 278
FEATURES:
VR and Interactive Simulationfor Pain Distraction: An Overview
p 12
Tools of Distraction:Video Games vs. Handhelds
p 17
Portable VR Systems to ReducePreoperative Anxiety
p 21
COVER STORY:PRODUCTCOMPARISON:
Pain Management Systems
p 21
COUNTRY FOCUS:
China
p 46
 
1
President’s Note
Professor Dr. Brenda K. Wiederhold
Dear Reader,As I write this, I have a headache. I am in good com-pany–45 million other Americans will suffer fromchronic headaches this year.Wouldn’t you be outraged if you knew that one in fivepeople worldwide suffered from a chronic disease thatwas largely ignored and under-treated? Yet, that is of-ten the case with chronic pain, for a variety of reasons:
Pain is subjective.
My pain and your pain are very dif-ferent. How can we describe it? Only recently have webeen encouraged to use a common vocabulary, suchas stabbing, burning, or throbbing, to communicate ourpain to our doctors, along with the familiar 0-to-10 scale.
Secondary pain takes a back seat to a primary diagno- sis.
If a doctor discovers I have cancer, they will con-centrate on treatments that will result in complete re-mission. Pain caused by the tumor or the treatmentis recognized, but in the doctor’s mind, and maybe inmy mind too, alleviating the pain is less importantthan fighting the cancer.
“It’s all in your head.” 
Certainly, pain has a psycholog-ical component. If I am depressed, I am more likely tohave chronic pain. If I allow my negative emotions totake over, my suffering may increase. Nevertheless, thisis no reason to ignore my pain, rather, my underlyingpsychological condition needs to be addressed, too.
If I am a member of a minority group, I may not have equal access to treatment.
If I am an African-Ameri-can living in the U.S. or Western Europe, painkillersmay be unavailable in my neighborhood. These bar-riers to effective treatment are greater in developingcountries and in resource-limited neighborhoodsworldwide.The cost of pain is both financial and emotional. "Painin itself probably costs the American population up-wards of $120 billion each year," says Marc Hahn, D.O.,president of the American Academy of Pain Medicine."That's not only in its medical treatment, but in itsimpact on society, in missed days, and decreased pro-ductivity at work." The International Association forthe Study of Pain estimates that the global cost isabout the same as the cost of cancer or cardiovascu-lar disease.We cannot ignore the emotional cost of chronic pain.Pan-European and Danish studies found:
From one-half to two-thirds of chronic pain patients were unable or less able to exercise, enjoy normal sleep patterns, perform household chores, attend social ac- tivities, drive a car, walk, or have sex.For one in four sufferers, relationships with family and friends were strained or broken.For one in three sufferers, an independent lifestyle was either no longer an option or difficult to maintain.For one in five sufferers, depression was a comorbid condition.Some days, 17% of sufferers wanted to die.Among chronic pain sufferers, 39% felt their pain was inadequately managed, and half of these individuals felt their doctor did not view their pain as a problem.
At CyberTherapy & Rehabilitation, we believe that vir-tual reality pain-management systems can be an im-portant part of the solution. Preliminary results froma study conducted by The Virtual Reality Medical Cen-ter (VRMC) showed a 75% drop in self-reported painratings, correlated with higher temperature ratings, in-dicating immersion and physiological stabilization. Instudies using VR software at the clinic with patientsexperiencing pain lasting longer than two years in du-ration, these patients achieved a 50% reduction in
 As we seek to reduce the cost of healthcare whileexpanding coverage to all, the editors look forward toincreased funding of large-scale clinical trials for pain-relief alternatives such as Virtual Reality.
 
President’s Note
(continued from page 1)
pain symptoms in addition to improvements inquality of life scores.How does it work? We do not have all the answersyet, but Hunter Hoffman has done the most workin this area. His brain imaging study showed thatdistraction has a real effect in decreasing the in-tensity of pain signals in the brain, and preliminaryresearch indicates that VR actually changes howthe brain physically registers pain, not just people’sperception of the incoming signals. His latest pub-lished research on the effect of VR on pain showsa reduction of 30% in reports of “worst pain” (sen-sory component of pain), 44% in “time spent think-ing about pain” (cognitive), and 45% in “pain un-pleasantness” (emotional). It is interesting to notethat this type of treatment can offer relief from themental affects of pain as well as the physical com-ponent of pain itself.Hoffman's work and others is further proving theadvantages of using VR as a nonpharmacologicaltreatment option for pain sufferers. Distraction of procedural pain in children appears to be the mostmainstreamed of the uses for VR pain distractionbecause of the desire to avert the risks of usinganesthesia with children, but as we gain more in-sight into the ways VR can provide distraction andpain relief, the applications will become more wide-spread.Additional very exciting work is ongoing by Dr. JoséMosso of Mexico City. Dr. Mosso has used VR toeliminate general anesthe-sia in over 500 patientsduring minimally invasivesurgical procedures. Thefact that VR can providesignificant improvementsin safety for patients is re-ally remarkable. Finally,many of these applicationscontinue to be supportedon mobile phones andother handheld platforms.This will go a long way in migrating the advantagesof VR in the clinic to outpatient settings and thepatient's home.With the worldwide trends of reduction of health-care costs and expansion of coverage to all citizens,we encourage increased funding of large-scale clin-ical trials for pain-relief alternatives. We look for-ward to the consequent acceleration of the main-streaming of VR to the millions worldwide who willthank us for easing their pain.
“...distraction has a real effect in decreas-ing the intensity of pain signals in the brain,and preliminary research indicates that VRactually changes how the brain physically registers pain, not just people’s perceptionof the incoming signals.”
Create your own reality!
Brenda Wiederhold
2

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