CLINICAL TRIAL article
Front. Neurol.
Sec. Neurorehabilitation
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1622897
This article is part of the Research TopicNew methods in neurorehabilitationView all 13 articles
Sustained Symptom Reduction in Complex Regional Pain Syndrome with a Novel Home-Based Virtual Reality Program: A Pilot Study
Provisionally accepted
- 1Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, United States
- 2Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- 3Human Photonics Lab, Mechanical Engineering, Center for Human Neuroscience and Dept of Psychology, University of Washington, Seattle, United States
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Abstract. Background: Complex Regional Pain Syndrome (CRPS) often leads to limb disuse, pain catastrophizing, and depression. While physical movement of CRPS affected limbs is essential for improvement, pain discourages movement. Home-based virtual reality (VR) interventions may reduce movement-related pain, improve adherence, and promote sustained symptom reduction. Methods: In this exploratory pilot study, seven patients with CRPS completed a four-month home-based VR program integrating three treatment modules 1) embodied cyberhands VR physical movement treatment, 2) VR-Mindfulness-Based-Stress-Reduction, and 3) VR-Pain-Neuroscience-Education. The primary outcomes were patient-reported global impressions of change in CRPS-related pain and physical ability. Secondary outcomes included central sensitization, cold sensitivity, depression, pain catastrophizing, and upper-limb function. Results: On the Primary Outcome Global Impression of Change measures, six of seven patients reported sustained improvement in CRPS-related pain and physical ability, with three reporting being “much” or “very much” improved at four months. Gains were maintained at one-year follow-up. Secondary outcomes showed significant improvements at four months: central sensitization (CSI: 46.7 ± 11.97 to 38.4 ± 11.53), cold pain threshold (27.12 °C ± 3.89 to 24.56 °C ± 5.56), depression (CES-D: 23.0 ± 11.27 to 15.6 ± 8.85), pain catastrophizing (PCS: 24.3 ± 11.06 to 15.1 ± 9.67), and upper-limb function (QuickDASH: 47.7 ± 20.43 to 34.8 ± 17.47). Improvements were sustained at one-year followup. No serious adverse events occurred, and study adherence was 100%. Conclusion: Results provide preliminary evidence that a home-based VR program may produce sustained improvements in CRPS-related pain, physical ability, and associated symptoms. Larger randomized controlled trials are recommended.
Keywords: complex regional pain syndrome, virtual reality, home-based therapy, Pain catastrophizing, central sensitization, self-management
Received: 05 May 2025; Accepted: 15 Sep 2025.
Copyright: © 2025 Fontenot, Curatolo, Stacey, Flor and Hoffman. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Hunter G. Hoffman, Human Photonics Lab, Mechanical Engineering, Center for Human Neuroscience and Dept of Psychology, University of Washington, Seattle, United States
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