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News from American Pain Society’s 29th Annual Scientific Conference

Video Games and Virtual Reality Experiences Prove Helpful as Pain Relievers in Children and Adults

BALTIMORE, MD, May 6, 2010 – When children and adults with acute and chronic pain become immersed in video game action, they receive some analgesic benefit, and pain researchers presenting at the American Pain Society’s (www.ampainsoc.org) annual scientific meeting here today reported that virtual reality is proving to be effective in reducing anxiety and acute pain caused by painful medical procedures and could be useful for treating chronic pain.

“Virtual reality produces a modulating effect that is endogenous, so the analgesic influence is not simply a result of distraction but may also impact how the brain responds to painful stimuli,” said Jeffrey I. Gold, Ph.D., associate professor of anesthesiology and pediatrics, Keck School of Medicine, University of Southern California and director of the Pediatric Pain Management Clinic at Children’s Hospital of Los Angeles. “The focus is drawn to the game not the pain or the medical procedure, while the virtual reality experience engages visual and other senses.”

While moderating a symposium entitled “Virtual Reality and Pain Management,” Dr. Gold noted that the exact mechanistic/neurobiological basis responsible for the VR analgesic effect of video games is unknown, but a likely explanation is the immersive, attention-grabbing, multi-sensory and gaming nature of VR.  These aspects of VR may produce an endogenous modulatory effect, which involves a network of higher cortical (e.g., anterior cingulate cortex) and subcortical (e.g., the amygdale, hypothalamus) regions known to be associated with attention, distraction and emotion.  Studies measuring the benefit of virtual reality pain management, therefore, have employed experimental pain stimuli, such as thermal pain and cold pressure tests, to turn pain responses on and off as subjects participate in virtual reality experiences.

“In my current NIH-funded study, I am using functional magnetic resonance imaging (fMRI) to measure the effects of VR on experimental pain,” Dr. Gold explained.  “The objective is to measure the cortical regions of interest involved in VR, while exposing the participant to video racing games with and without experimental pain stimuli.”

Lynnda M. Dahlquist, Ph.D., a clinical child psychologist and professor of psychology at the University of Maryland, Baltimore County, reviewed her most recent laboratory research studies

examining the use of virtual reality and other computer/videogame technologies to provide distraction-based acute pain management.

The use of video games and virtual reality distraction (VRD) technology for procedural pain management in both pre-schoolers and elementary to middle school children, reported Dr. Dahlquist, yielded promising results in increasing pain tolerance “with potentially significant future clinical applications for more effective pain reduction techniques for youth with chronic and acute pain.  However, more research is needed to know for certain if there is real world VRD application in such pain-generating procedures as cleansing wounds, cancer treatment, immunization, injections and burn care.”

Children interacting with a virtual environment by watching video games demonstrated a small pain tolerance improvement during exposure to ice cold water stimulation, according to Dr. Dahlquist, but she recorded significantly greater pain tolerance for kids wearing specially-equipped video helmets when they actually interacted with the virtual environment.

“Our aim is to know what about VRD makes it effective in pain tolerance lab studies with children and what are the best ways to use it for optimum results,” explained Dr. Dahlquist, noting that any distraction is better than none at all in pain minimization.  “Is it just the amazing graphics in the video games or is it because youngsters are truly more distracted through their direct interaction with the virtual environment?”

VRD’s impact on pain tolerance levels varied by children’s ages, indicating that age may influence how effective video game interaction will be.  “We must better understand at what ages VRD provides the greatest benefit in moderating acute pain and at what age, if any, that it can be too much or be limiting.”

In one study using video helmets for virtual environment interactivity, the special equipment had little positive impact with children ages six to ten, but for those over ten years of age, “there was a much longer tolerance of the pain of the cold water exposure, leading us to further study to determine what aspect or aspects of cognitive development and neurological function account for this difference among youth.

“Having dealt clinically for more than 15 years with children with acute and chronic illness,” Dr. Dahlquist summed up, “my genuine hope is that virtual reality activity can alleviate the anxiety of approaching pain and the pain experience itself.”

About the American Pain Society

Based in Glenview, Ill., the American Pain Society (APS) is a multidisciplinary community that brings together a diverse group of scientists, clinicians and other professionals to increase the knowledge of pain and transform public policy and clinical practice to reduce pain-related suffering.  APS was founded in 1978 with 510 charter members.  From the outset, the group was conceived as a multidisciplinary organization.  APS has enjoyed solid growth since its early days and today has approximately 3,200 members.  The Board of Directors includes physicians, nurses, psychologists, basic scientists, pharmacists, policy analysts and more.

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What I Want to See in the National Gallery of Writing

By now, you’ve probably heard about the National Gallery of Writing that NCTE is building online by inviting people to select and post one thing they have written that is important to them. Anyone can share any composition. It can be any format—from word processing to photography, audio recording to text messages—and any type of writing—from letters to lists, memoirs to memos.

I found a great example of the kind of writing that belongs in the Gallery. Read “Video Games: Play and Learn” from this week’s Minneapolis-St. Paul Star Tribune. The article describes a project, created by at the Seward Montessori, that tackles reading comprehension, STEM, analytical skills, and community building:

Over a three-week period, the kids split up into groups and play video games. They also take notes. The goal is to explain how the game is played, how a player might win and how the game is designed. By the end of the session, the students will have created a multimedia presentation, including lots of writing, about their games that is then uploaded to the Web.

Students at Seward Montessori and their teacher Brock Dubbels describe the fun and engagement that are part of this video game unit, but there’s more than just fun going on. Jess Sanchez, one of the students, explains that he likes “learning how the games can help you in the future and how they’re made, instead of just playing them. . . . . It makes me think of them in a different way.” Could a teacher ask for a better recognition of the critical thinking behind a classroom activity?

Dubbels has designed a great assignment, and what makes it work is that underneath it adheres to the basic principles outlined in the NCTE Beliefs about the Teaching of Writing. The students in the middle school class are positioned as authorities in an authentic research project. Their project is personally relevant, and they have a real audience of peers who want to hear what they have to say. The presentations students publish at the end of the unit are precisely the kind of work that belongs in the National Gallery of Writing.

So why do I want to see those presentations in the Gallery? The Gallery invitation asks writers to share one piece of writing, anything that they “deem important or significant.” Those multimedia presentations are perfect because, in them, the writers are exploring something that they know and care about. The presentations are “important or significant” because they matter to the people who wrote them. That’s the kind of writing I hope people will share—and the kind of writing I hope all teachers will encourage others to submit.

Do your part. Register a local gallery in the National Gallery of Writing today, and make plans to submit your own writing and to encourage students, families, colleagues, local community members, and even your state and federal politicians to do the same. I want to see compositions that you really care about in the Gallery when it opens in October!