Evaluation of the Effects of Virtual Reality in Patients With Chronic Neck Pain
Condition: Chronic Pain; Pain, Neck
MeSH terms: Chronic Pain; Neck Pain
Study type: Interventional

Summary: 
      The main objective of this research is to assess the effectiveness of virtual reality as a
      treatment to reduce pain and disability in patients with chronic neck pain compared to a
      regular exercise program for the neck.
    

Detailed description: 
      Chronic neck pain is one of the most common causes of pain and disability. Its prevalence is
      approximately 15% in adults and it is one of the main causes of medical leave and the
      increase of drug consumption. Recent research has found that neck pain is a common pathology
      among the population. Among the variables associated with neck pain, besides rheumatology,
      include genetic, psychopathological variables (such as depression, anxiety, coping skills,
      somatization), sleep disorders, smoking and a sedentary lifestyle, among others. All those
      variables alter the nervous system in a proprioceptive level, so that deep and superficial
      flexor, as well as the rest of the muscles, they do not receive correct information that
      prevents them from processing properly the obtained information. Therefore, alterations also
      occur at central nervous system levels as in the processing of pain and its control by
      inhibitory descending systems.

      One of the most effective treatments for this pathology is active exercise. The main
      objective is the activation and strengthening of the deep flexor muscles by craniocervical
      flexion. It is also important to re-educate all the movements performed with the neck;
      extension, rotation and inclination are essential movements that also require good initial
      control of deep flexor muscles and its dynamism is essential to interact with our
      surroundings.

      The action observation which consists of observing an action carried out by another person is
      based on the ability of the nervous system to assimilate the images seen and process them
      until they reach the motor cortex, and thanks to the mirror neurons, the painful pattern
      decreases until it disappears. Thus, visualising a painful situation provokes and evokes in
      the brain, a painful experience, even when this is not actually happening. Therefore, it has
      been proved that it can produce changes in the motor cortex since the observation reinforces
      the cortical representation of the action, thus achieving an improvement in strength and
      functionality in patients with chronic pain.

      Taking all this into account, in this study the investigators propose the idea of working
      with virtual reality headset in patients with chronic neck pain. This treatment offers great
      visual, auditory and vestibular feedback that makes it an attractive and stimulating exercise
      for the patient. It has the ability to individualize treatments and patient needs. These
      virtual environments can graduate and increase the complexity of the task while decreasing
      the help and feedback provided by the therapist. The goal of a virtual reality based
      treatment is to make patients more participatory in their real environments as independently
      as possible. It is an innovative treatment that does not demand a great financial cost for
      its use.
    

Intervention name(s): Virtual Reality Headset; Exercise
Intervention type(s): Device; Behavioral
Intervention description(s): The subjects will wear the Virtual Reality Headset with a mobile phone inserted into it with the applications Full Dive VR and VR Ocean Aquarium 3D.; The subjects will perform evidence-based exercises for the neck.
Allocation: Randomized
Intervention model: Sequential Assignment
Masking: Single (Investigator)
Primary purpose: Treatment
Keywords: Virtual reality; Chronic pain; Neck pain; Physiotherapy; Exercise