Virtual Reality Exercise May Provide Short-term Pain Relief for Women With Endometriosis

Pain management for endometriosis typically involves a combination of pharmacological and surgical interventions. However, a virtual reality (VR) exercise session may be just as effective as telehealth appointments at providing short-term pain for women with endometriosis, a debilitating disease that affects approximately 10% of reproductive aged women worldwide, according to one study.

“These findings 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,” said Joyce S. Ramos, PhD, study author, senior lecturer, and exercise physiologist at Flinders University, in a statement. “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.”

This randomized control study is the first of its kind to compare the impacts of a single session of VR exercise and telehealth in women with mild to moderate pelvic pain due to endometriosis. The full results of this study were published in the International Journal of Environmental Research and Public Health.

A total of 85 participants aged 18-45 years diagnosed with endometriosis were screened from January 2021 to September 2022 for eligibility. Participants with uncontrolled asthma, unstable respiratory, or cardiac conditions; diagnosed with epilepsy or recent history of seizures; limited arm and hand movement that would make it difficult to use VR technology; and those with visual impairments were excluded from the study. Finally, 22 eligible participants were included in this study.

Participants were separated into groups: telehealth-delivered exercise (n=8), VR-delivered exercise (n = 8), and a control group (n = 6). Participants in the intervention groups were required to undergo at least 1 exercise training session, while the control group were told to continue with their daily life activities.

Telehealth-delivered exercise consisted of a 1 hour supervised session, measuring the participant’s heart rate, Borg Rating of Perceived Exertion (RPE), and exercise intensity and duration volume.

In the VR-delivered exercise group, participants completed 1 hour of unsupervised exercises, including cardiorespiratory exercise, stretching, and specific stabilizing exercise (SSE) of lumbopelvic muscles.

As a result, 19 participants completed the assessment (telehealth, n = 7; VR, n = 8; control, n = 4). The researchers found no significant difference in visual analogue scale (VAS) score changes between groups after undergoing acute training interventions. Both the telehealth (+10 ± 12mm) and VR-delivered exercise (+9 ± 24mm) intervention groups showed a lower magnitude of pain score increase from baseline compared to the control (+16 ± 12mm) group.

Furthermore, a ‘medium-to-large’ group x time interaction effect (η²=0.10) the VAS scores suggests that increased pain due to VR and telehealth exercise may have been less severe than in the control group.

While this study showed significant difference in pain scored between groups, the researchers believe that this study was able to provide insight on the potential benefits of digital health interventions, such as virtual reality and telehealth. This is particularly important for patients with busy lifestyles or those living in rural areas with limited access to contemporary healthcare.

“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 (CNS)," said Ramos in a statement. “So, performing a task that consumes a lot of attention and resource, such as exercise, reduces the capacity for the processing of pain.”

References

Endometriosis. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/endometriosis/symptoms-causes/syc-20354656#:~:text=Endometriosis%20is%20a%20condition%20in,including%20the%20bowel%20and%20bladder. Published July 24, 2018. Accessed February 21, 2023.

A 'self-managed' virtual reality exercise session may provide short-term pain relief for women with endometriosis. EurekAlert! https://www.eurekalert.org/news-releases/979343. Published February 9, 2023. Accessed February 21, 2023.

Lutfi M, Dalleck LC, Drummond C, et al. A single session of a digital health tool-delivered exercise intervention may provide immediate relief from pelvic pain in women with endometriosis: A pilot randomized controlled study. International Journal of Environmental Research and Public Health. 2023;20(3):1665. doi:10.3390/ijerph20031665