Feasibility and Efficacy of Commercial-off-the-shelf Virtual Reality Applications for Managing Chronic Pain and Enhancing Well-being among Older Adults in the Community: A Mixed-methods Pilot Study (Preprint)
Authors: Leung Rachel Yim Fong , Ye Megan Zichen , Zhang Flora Ya Qian , Kwok Tyrone Tai-On , Sun Yuying , LAI Agnes Yuen Kwan , Jiang Juming , Tse Mimi Mun Yee 
Published: November 2024

BACKGROUND

Older adults may experience chronic pain as they age, which can affect their physical and psychological well-being. Virtual reality (VR) becomes a novel and non-pharmacological intervention that offers pain relief and mood enhancement through immersive experiences. However, the feasibility and effectiveness of using non-localized and commercial VR applications for chronic pain relief and mood enhancement among community older adults remain underexplored.

OBJECTIVE

The main objectives of this study were to: (1) evaluate the feasibility of using commercial-off-the-shelf VR applications for managing chronic pain among older adults; (2) assess the efficacy of VR in alleviating chronic pain; and (3) examine its impact on the well-being of older adults in a community setting.

METHODS

The study was a single-armed mixed-methods pilot study. It was divided into two stages, including preparation and implementation. A total of 13 older adults (8 with chronic pain and 5 without) were recruited to participate in a 3-week VR intervention. Participants engaged in VR sessions followed a step-by-step adaptation process. Each session included 360-degree relaxation videos and interactive boxing exercises via Les Mills BodyCombat, lasting 15 minutes. Pain intensity, pain self-efficacy, well-being, and mood were measured pre- and post-intervention using the Numeric Pain Rating Scale (NPRS), a pain self-efficacy questionnaire, the World Health Organization-Five Well-Being Index (WHO-5), and the Mood Assessment Scale. VR feasibility was evaluated based on completion rates, adverse outcomes, and qualitative feedback from semi-structured interviews.

RESULTS

Of the 13 participants recruited, 11 completed the intervention (84.6% completion rate). The mean age was 79.2 years (SD 9.2). The study found a significant 16.32% improvement in the mean mood score, with a large effect size (p < .001, Cohen's d = 1.82). The pain self-efficacy median score decreased significantly by 2.0 (Z = -2.236, p = .025). However, we observed no significant changes in pain intensity or overall well-being. The study demonstrated the high feasibility of commercial-off-the-shelf VR technology for older adults. Minor adverse effects were reported, including back pain and headset discomfort. Additionally, 90.9% of participants enjoyed the VR experience, and all were willing to join future sessions.

CONCLUSIONS

The pilot study demonstrated that commercial-off-the-shelf VR applications could effectively enhance mood and pain self-efficacy. Additional procedures, such as pre-briefing, real-time interpretation, and a gradual adaptation process, were essential to overcoming barriers like language, cultural nuances, and the digital literacy of older adults.	Despite the lack of significant changes in pain intensity or overall well-being, the psychological benefits suggest that VR could be a valuable adjunct tool in chronic pain management. Future research should focus on larger sample sizes, longer intervention duration, randomized controlled trials, and the development of localized commercial VR to further explore its efficacy.