Virtual Reality Respiratory Biofeedback in an Outpatient Pediatric Pain Rehabilitation Program: Mixed Methods Pilot Study.

The sample was very small: 9 adolescents consented, and 7 completed at least 80% of the VR sessions. The study had no control group, so it cannot show whether the virtual reality sessions caused any change beyond the usual pain program. Virtual reality was delivered inside a multidisciplinary program that also included physical therapy, occupational therapy, individual psychotherapy, family therapy, pain medicine adjustments, and team care conferences, so the effect of any single component cannot be separated. The virtual reality product was developed for adults and not validated for adolescents. Medical students ran the sessions as part of the research study, which may not reflect how a routine pain program would deliver it. Recruitment was affected by reduced clinical volume during the pandemic, and the sample was predominantly female. Open-ended responses were typically short, one-sentence answers from 9 participants. The study used self-reported pain interference and quality-of-life measures, and blood pressure and heart rate changes were not significant.

The authors declared no conflicts of interest. The supplied text does not report external funding, although the intervention was AppliedVR's RelieVRx product.

Do not read this as proof that virtual reality respiratory biofeedback reduced pain, improved function, or lowered blood pressure or heart rate. The functional improvements occurred across the whole 4-week multidisciplinary program, and no session showed a significant blood pressure or heart-rate change.