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Trial registered on ANZCTR
Registration number
ACTRN12624000700538
Ethics application status
Approved
Date submitted
23/05/2024
Date registered
4/06/2024
Date last updated
4/06/2024
Date data sharing statement initially provided
4/06/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
Usability and acceptability of a virtual reality treatment for complex regional pain syndrome in adults
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Scientific title
Usability and acceptability of a virtual reality intervention for complex regional pain syndrome in adults
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Secondary ID [1]
312179
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Complex regional pain syndrome
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Condition category
Condition code
Anaesthesiology
330509
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0
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Pain management
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Participants will attend 4 x 30-minute individual face-to-face intervention sessions over 2 weeks in a clinical environment. For ~15 minutes at the end of each intervention session, participants will use a Meta Quest 3 virtual reality headset to view a 3-dimensional model of their upper limbs while in a virtual environment and, using a custom-designed software application, be able to manipulate the size, transparency, and colour of their (virtual) affected limb, according to their individual preferences. Once the appearance of the virtual limb has been adjusted to their satisfaction, participants will spend 5 minutes viewing and attending to the (visually altered) virtual limb under the guidance of a New Zealand registered specialist pain physiotherapist. During this time they will be asked by the physiotherapist to perform simple functional movements of their affected hand and/or arm, which will be reflected by the virtual limb (e.g. making a fist). These movements will be individually tailored for each participant by the physiotherapist. A session attendance checklist will be used to monitor adherence.
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Intervention code [1]
328622
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Treatment: Other
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Intervention code [2]
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Rehabilitation
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Intervention code [3]
328624
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Treatment: Devices
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Usability
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Assessment method [1]
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Usability will be assessed as a composite outcome, using the following:
1. Semi-structured interview with participants, using custom questions designed for this study
2. Task completion index, scored by the physiotherapist using a custom-developed index, designed for this study.
3. Semi-structured interview with physiotherapist, using custom questions designed for this study
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Timepoint [1]
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1. Semi-structured interview with participants: After 1st and 4th intervention sessions.
2. Task completion index: After 1st intervention session.
3. Semi-structured interview with physiotherapist: At trial completion, after all participants have completed the intervention.
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Primary outcome [2]
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Acceptability
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Assessment method [2]
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Acceptability will be assessed a composite outcome, using the following:
1. Semi-structured interview with participants, using custom questions designed for this study
2. Semi-structured interview with physiotherapist, using custom questions designed for this study.
3. Custom acceptability questionnaire for participants, designed for this study, based on the theoretical framework of acceptability.
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Timepoint [2]
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1. Semi-structured interview with participants: After 1st and 4th intervention sessions.
2. Semi-structured interview with physiotherapist: At trial completion, after all participants have completed the intervention.
3. Acceptability questionnaire: After 4th intervention session.
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Secondary outcome [1]
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Average pain intensity in the complex regional pain syndrome (CRPS)-affected limb in the last 24 hours.
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Assessment method [1]
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Scored on a 0-10 point numerical rating scale with anchors of 0=no pain and 10=worst pain imaginable, collected face-to-face (on the days of intervention sessions) or by text message (all other days).
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Timepoint [1]
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Daily, from 7 days before the baseline assessment to Day 28 (post-intervention follow-up).
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Secondary outcome [2]
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Average pain unpleasantness in the CRPS-affected limb in the last 24 hours.
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Assessment method [2]
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Scored on a 0-10 point numerical rating scale, with anchors of 0=not at all unpleasant and 10=most unpleasant imaginable, collected face-to-face (days of intervention sessions) or by text message (all other days).
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Timepoint [2]
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Daily, from 7 days before the baseline assessment to Day 28 (post-intervention follow-up).
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Secondary outcome [3]
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Pain Interference
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Assessment method [3]
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Brief Pain Inventory (BPI) Interference Scale
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Timepoint [3]
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Day 1 (baseline/pre-intervention), Day 14 (post-intervention) and Day 28 (post-intervention follow-up)
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Secondary outcome [4]
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Psychological distress
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Assessment method [4]
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Depression, Anxiety and Stress Scale (DASS)-21 (total score)
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Timepoint [4]
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Day 1 (pre-intervention), Day 14 (post-intervention), Day 28 (post-intervention follow-up)
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Secondary outcome [5]
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Body Perceptual Disturbances
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Assessment method [5]
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Bath Body Perceptual Disturbance Scale
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Timepoint [5]
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Day 1 (pre-intervention), Day 14 (post-intervention), Day 28 (post-intervention follow-up)
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Secondary outcome [6]
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Perceptual changes in CRPS-affected hand
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Assessment method [6]
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Perceptual Statement Ratings Questionnaire (Lewis et al, 2021)
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Timepoint [6]
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Day 1 (pre-intervention), Day 14 (post-intervention), Day 28 (post-intervention follow-up), and also immediately before and immediately after 5 minute VR intervention in all 4 intervention sessions.
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Secondary outcome [7]
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Neglect like symptoms
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Assessment method [7]
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Neurobehavioural questionnaire
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Timepoint [7]
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Day 1 (pre-intervention), Day 14 (post-intervention), Day 28 (post-intervention follow-up), and also immediately before and immediately after 5 minute VR intervention in all 4 intervention sessions.
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Secondary outcome [8]
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Current pain intensity in the CRPS-affected limb
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Assessment method [8]
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Scored on a 0-10 point numerical rating scale with anchors of 0=no pain and 10=worst pain imaginable, collected face-to-face.
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Timepoint [8]
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Immediately before and immediately after 5 minute VR intervention in all 4 intervention sessions.
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Secondary outcome [9]
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Current pain unpleasantness in the CRPS-affected limb.
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Assessment method [9]
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Scored on a 0-10 point numerical rating scale, with anchors of 0=not at all unpleasant and 10=most unpleasant imaginable, collected face-to-face.
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Timepoint [9]
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Immediately before and immediately after 5 minute VR intervention in all 4 intervention sessions.
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Secondary outcome [10]
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Limb circumference
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Assessment method [10]
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Sum of the measured circumference (mm) of the 2nd and 3rd digits, and the wrist of the CRPS-affected limb
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Timepoint [10]
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Immediately before and immediately after 5 minute VR intervention in all 4 intervention sessions.
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Secondary outcome [11]
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Limb temperature
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Assessment method [11]
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Average skin temperature (deg/c) from the dorsum and plantar surface of the CRPS-affected hand, measured using an infrared thermometer.
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Timepoint [11]
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Immediately before and immediately after 5 minute VR intervention in all 4 intervention sessions.
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Secondary outcome [12]
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Treatment emergent adverse events
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Assessment method [12]
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Any reported adverse events will be recorded and have a code and severity rating assigned according to the Common Terminology Criteria for Coding Adverse Events V5.0.
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Timepoint [12]
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Participants will be explicitly questioned about any adverse events experienced at each intervention session.
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Eligibility
Key inclusion criteria
1. Aged 18 or over
2. Pain intensity greater than or equal to 4/10 on average in the last week
3. Formal diagnosis of CRPS in one upper limb only as per Budapest clinical criteria
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Any co-morbidity that might affect CRPS symptoms (e.g. stroke, diabetes, fibromyalgia)
2. Inability to communicate in English
3. A history of severe motion sickness, epilepsy or (uncorrected) visual impairment
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
10/06/2024
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Actual
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Date of last participant enrolment
Anticipated
4/11/2024
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Actual
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Date of last data collection
Anticipated
2/12/2024
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Actual
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Sample size
Target
5
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
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New Zealand
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State/province [1]
26332
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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Te Titoki Mataora
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Address [1]
316546
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Country [1]
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New Zealand
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Primary sponsor type
University
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Name
Auckland University of Technology
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Address
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Country
New Zealand
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
318756
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Country [1]
318756
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Central Health and Disability Ethics Committee
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Ethics committee address [1]
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https://ethics.health.govt.nz/about/central-health-and-disability-ethics-committee/
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
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16/04/2024
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Approval date [1]
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08/05/2024
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Ethics approval number [1]
315339
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Summary
Brief summary
This single arm, open-label intervention study in people with complex regional pain syndrome (CRPS) affecting their hand/arm will assess the usability and acceptability of new custom-designed virtual reality software that allows the user to alter the size, colour and transparency of their (virtual) limb when viewing it through a Meta Quest 3 virtual reality headset. All participants will receive 4 virtual reality treatment sessions over a 2 week period under the guidance of a specialist pain physiotherapist. Questionnaires and semi-structured interviews with participants and the physiotherapist will be used to evaluate the usability and acceptability of the new virtual reality treatment. In addition, initial information about how the virtual reality treatment changes signs and symptoms of CRPS (e.g. pain intensity, the way the arm feels and hand swelling and temperature) will be collected before and after each intervention session, during the 2 week treatment period, and during a 2 week follow up period, after the treatment has finished.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Debbie Bean
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Address
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Auckland University of Technology, 90 Akoranga Drive, Northcote, Auckland
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Country
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New Zealand
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Phone
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+6499217157
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Debbie Bean
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Address
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Auckland University of Technology, 90 Akoranga Drive, Northcote, Auckland
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Country
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New Zealand
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Phone
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+6499217157
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Debbie Bean
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Address
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Auckland University of Technology, 90 Akoranga Drive, Northcote, Auckland
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Country
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New Zealand
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Phone
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+6499217157
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Fax
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
IPD will not be publicly available as 1) participants have not consented to this, and 2) to protect potential intellectual property.
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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