Virtual reality intervention may alleviate endometriosis pain

A virtual reality exercise session might be as effective as telehealth-delivered exercise sessions in providing immediate, short-term pain relief for people with endometriosis, according to study results.

The findings were recently published in the International Journal of Environmental Research and Public Health.

Joyce Ramos, PhD, a senior lecturer and exercise physiologist at Flinders University, and colleagues wrote that pharmacological and surgical interventions are both involved in the general principle of pain management for endometriosis.

However, there is now a rising interest in alternative nonpharmacological treatments such as exercise, the researchers wrote.

Ramos and colleagues conducted a pilot randomized controlled study to assess the immediate effects of one self-managed, virtual reality (VR)-delivered exercise session and a telehealth-delivered exercise session on endometriosis-associated pelvic pain.

They randomly assigned 22 women with endometriosis who experienced pelvic pain into one of three groups: control, telehealth-delivered exercise and VR-delivered exercise.

For the telehealth intervention, participants underwent a 1-hour supervised session of exercise. The session included 19 minutes of cardiorespiratory exercises: a 3-minute warm up followed by an interval training consisting of 4-minute exercise bouts, repeated three times and separated by 2 minutes of active recovery. It also included stretching and specific stabilizing exercise of muscles in the lumbopelvic area.

In contrast, the VR-delivered group completed a 1-hour unsupervised session consisting of a 10-minute VR pain-distraction experience from “a list of applications previously shown to reduce pain” and 50 minutes of exercise using an application depending on the participants’ preference and goals. The apps ranged from Fruit Ninja and Table Tennis VR to Dance Central.

Ramos and colleagues found no statistically significant differences in the pain scores between groups after one session of the study interventions — either telehealth, VR or control. However, they did note a “medium-to-large” time interaction effect, which suggests a more favorable pain score change after one VR- and telehealth-delivered exercise session, compared with control.

“It should be noted that there was no statistically significant difference in pain scores between all three groups in our study,” Ramos said in the release. “Nevertheless, this pilot study provides important information on the potential benefits of these digital health interventions, and the feasibility of a larger and more expensive full-scale study on assessing future treatment options.”

The findings, Ramos said in the release, “are consistent with a previous study which demonstrated that a 10- to 20-minute VR session was able to alleviate pain in participants with chronic pain and endometriosis.”

“The previous study results show the VR group had a 36.7% reduction in global pain scores during the intervention period when compared to the control group,” he said in the release.

Ramos added that “a plausible mechanism to explain the pain-relieving effect of VR- and telehealth-delivered exercise interventions may be their capacity to alter how pain is processed in the central nervous system” — meaning that performing a task like exercise, that requires a lot of attention, “reduces the capacity for the processing of pain.”

“The availability of an efficacious self-managed digital health tool is particularly important among those with busy lifestyles or those who live in rural and remote areas with limited access to synchronous health care,” Ramos said.

References:

• A ‘self-managed’ virtual reality exercise session may provide short-term pain relief for women with endometriosis. https://www.eurekalert.org/news-releases/979343. Published Feb. 9, 2023. Accessed Feb. 15, 2023.
• Ramos J, et al. Int. J. Environ. Res. Public Health. 2023;doi:10.3390/ijerph20031665.