Virtual Reality for Pain and Well-Being in Older Adults

Brief Summary

Chronic pain is common among adults aged 65 and older and can reduce mobility, independence, mood, and quality of life. Many older adults also develop a fear of movement because they worry that physical activity will increase their pain or cause injury. This fear can lead to reduced activity, physical deconditioning, and further loss of independence. This study aims to evaluate the feasibility, acceptability, and potential impact of Moving Without Fear or Pain, a program combining structured pain education (Empowered Relief) with immersive virtual reality rehabilitation to gradually reintroduce movement in a safe and engaging way. Empowered Relief is a single-session, two-hour online pain education class delivered by a trained health professional. It explains how chronic pain affects the brain and nervous system and teaches strategies to calm the nervous system, manage pain flare-ups, reduce pain-related worry and catastrophizing, and increase confidence in movement and daily activities. The virtual reality intervention includes up to eight individualized sessions over approximately one month. Sessions last 5 to 30 minutes and are supervised by a trained clinician. Participants wear a virtual reality headset and are immersed in calming or engaging environments, such as nature settings. Depending on their comfort and abilities, sessions may begin with passive guided motor imagery and progress to active movement within interactive virtual environments. Some applications allow participants to control movement in the virtual world through gentle physical activity, such as stepping or upper-body movement. The intervention is personalized to each participant's physical capacity, preferences, and rehabilitation goals. The aim is to reduce fear of movement, increase confidence, and promote safe re-engagement in physical activity. In this pilot randomized controlled trial, 24 older adults with chronic pain will be randomly assigned to one of two groups: 1) Experimental Group: Participants will receive the Empowered Relief pain education course, usual care, and up to eight immersive virtual reality rehabilitation sessions. 2) Control Group: Participants will receive the Empowered Relief pain education course and usual care, without virtual reality sessions. The findings will inform a larger future study.