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Effects of Virtual Walking Treatment on Spinal Cord Injury-Related Neuropathic Pain: Pilot Results and Trends Related to Location of Pain and at-level Neuronal Hypersensitivity.

American journal of physical medicine & rehabilitation
May 1, 2016
Melissa Jordan et al. (2 authors)
Journal ArticleRandomized Controlled TrialResearch Support, Non-U.S. Gov'tResearch Support, U.S. Gov't, Non-P.H.S.Human StudyClinical
Study Details

Study Goal

The researchers aimed to determine the effect of pain location on outcomes after virtual walking treatment for SCI-related neuropathic pain and examine the relationship between neuronal hyperexcitability and pain reduction.

Results Summary

The study found that virtual walking reduced neuropathic pain regardless of location, with a trend toward greater reduction in at-level pain. Certain sensory profiles (cold, cool, and pressure hypersensitivity) may attenuate benefits for below-level pain.

Population

Individuals with spinal cord injury-related neuropathic pain (SCI-NP).

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (3)
InterventionDirectionEndpointPopulationDosageImpactClaim #
virtual walking treatment
decrease
SCI-NP
participants with SCI-NP
F1, 44 = 4.82, P = 0.03
was responsive to treatment
#1
virtual walking treatment
decrease
at-level SCI-NP
participants with SCI-NP
F1, 44 = 3.18, P = 0.08
the greatest reduction occurring
#2
virtual walking treatment
no change
below-level pain
participants with SCI-NP
-
attenuating the benefits
#3
Abstract

Previous studies have shown that virtual walking to treat spinal cord injury-related neuropathic pain (SCI-NP) can be beneficial, although the type of SCI-NP that may benefit the most is unclear. This study's aims were to (1) determine the effect of location of SCI-NP on pain outcomes after virtual walking treatment and (2) examine the potential relationship between neuronal hyperexcitability, as measured by quantitative sensory testing, and pain reduction after virtual walking treatment. Participants were recruited from a larger ongoing trial examining the benefits of virtual walking in SCI-NP. Neuropathic pain was classified according to location of pain (at- or below-level). In addition, quantitative sensory testing was performed on a subset of individuals at a nonpainful area corresponding to the level of their injury before virtual walking treatment and was used to characterize treatment response. These pilot results suggest that when considered as a group, SCI-NP was responsive to treatment irrespective of the location of pain (F1, 44 = 4.82, P = 0.03), with a trend for the greatest reduction occurring in at-level SCI-NP (F1, 44 = 3.18, P = 0.08). These pilot results also potentially implicate cold, innocuous cool, and pressure hypersensitivity at the level of injury in attenuating the benefits of virtual walking to below-level pain, suggesting certain SCI-NP sensory profiles may be less responsive to virtual walking.

Medical Subject Headings (MeSH)
FemaleHumansHyperalgesiaMaleMiddle AgedNeuralgiaPain MeasurementPilot ProjectsSpinal Cord InjuriesVirtual Reality Exposure TherapyWalking
Study Links
Quality Scores
SafetyNot Assessed
Efficacy70/10
Quality75/10
Citation Metrics
Total Citations21
Citations/Year2.3
Relative Citation Ratio1.26
NIH Percentile58.8%
Research Impact Scores
APT Score0.75
Weight Score1.80
Normalized Score0.63
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