A Multi-Site Randomized Clinical Trial to Examine the Efficacy and Mechanisms of Immersive Virtual Walking Treatment for Neuropathic Pain in Spinal Cord Injury

Researchers: A/​Prof Sylvia Gustin, A/​Prof Zina Trost, Corey Shum, A/​Prof Mark Bolding, Dr Negin Hesam-Shariati, Prof Philip Siddall, Prof Scott Richards, Dr Elizabeth Richardson, Professor Victor Mark, Professor David Redden

Chronic neuropathic pain (NP) can be a debilitating secondary condition for persons with spinal cord injury (SCI) and effective pharmacological and non-pharmacological treatments remain elusive. This project brings together international experts in basic science and clinical approaches to SCI NP for a rigorous multisite randomized clinical trial to examine the efficacy and mechanisms of an advanced interactive virtual reality (VR) walking intervention (VRWalk). VR walking is a novel extension of established illusory walking/​visual feedback therapies and in preliminary studies shows promise to be among the only effective non-pharmacological treatments for SCI NP.

While understanding neurochemical, functional, and structural brain mediators is essential to validation, refinement, and generalization of promising interventions, no study combining SCI NP treatment with concurrent examination of underlying cortical processes has been conducted to date. Our project addresses this crucial gap in SCI NP treatment literature by implementing the first Multisite Randomized Controlled Trial (RCT) that will use novel virtual technology and brain imaging analysis to examine the efficacy of the virtual walking intervention and identify/​quantify the precise neuroplastic mechanisms through which the intervention exerts its effect.

The proposed study is a critical integration of clinical, biological, and technological advancements in SCI NP research and is expected to provide a foundation for a programmatic line of SCI NP and rehabilitation research that has tangible implications for the scientific community as well as individuals, including veterans, living with SCI NP.