Functional uncoupling of pain neuromatrix underling rehabilitation of patients with chronic pain

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OBJECTIVE

To analyze virtual reality technology in rehabilitation of patients with chronic pain and theoretically justify this approach for these patients.

MATERIAL AND METHODS

We reviewed available literature in the Scopus, Web of Science and PubMed databases using the keywords «chronic pain» and «virtual reality technology». To create an original questionnaire for selecting a personal simulation scene, we surveyed 100 patients with chronic pain.

RESULTS

According to available literature, virtual reality technology is potentially advisable in rehabilitation of patients with chronic pain. Analgesic effect is achieved through activation of antinociceptive system following immersion into simulation scene in combination with other rehabilitation methods. A theory of functional uncoupling of pain neuromatrix was proposed. The last one is based on theories of pain neuromatrix (R. Melzack, 2001) and functional systems (P.K. Anokhin, 1939). Separation of cognitive, affective and sensory components in pain neuromatrix is due to simultaneous impact of positive stimuli from all analyzers (visual, auditory, tactile, gustatory, olfactory), afferent synthesis (memory, motivation, situational afferentation, trigger afferentation) and correct coping strategy based on personal scenario of simulation environment. Finally, this leads to reduction or elimination of chronic pain.

CONCLUSION

Virtual reality technology is perspective in rehabilitation of patients with chronic pain. Original questionnaire for selection of individual simulation scene may be used in national clinical studies.

Keywords:

chronic pain

virtual reality technology

medical rehabilitation

Authors:

Bofanova N.S.

Penza State University

ORCID: 0000-0002-5455-4987

Received:

17.04.2024

Accepted:

10.07.2024

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