Developing a VR Training Program for Geriatric Patients with Chronic Back Pain

A Process Analysis
  • Rebecca DahmsEmail author
  • Oskar Stamm
  • Ursula Müller-Werdan
Conference paper
Part of the Lecture Notes in Computer Science book series (LNCS, volume 11575)


Back pain is increasing with age. Current studies have shown positive effects of virtual reality (VR) interventions for patients with neuropsychiatric diseases such as anxiety and chronic pain. However, little is known about the use of VR by geriatric patients with chronic back pain. This study was conducted as part of the research project “ViRST” (virtual reality for pain therapy). This approach intends to provide a new non-pharmacological therapy concept. The aim of this study was to learn more about the administrative efforts and business goals of physiotherapeutic and psychotherapeutic institutions. Additionally, we wanted to identify daily strategies of geriatric patients for dealing with their back pain to identify current therapies and possible training programs for VR. A process analysis with two physiotherapists and two psychotherapists in an executive position of a hospital and rehabilitation center was conducted. All interviews were performed according to a semi-structured guideline. The data were analyzed to the principles of systematic structured content analysis by Mayring using a data analysis program. Regarding multimorbidity and in contrast to the psychotherapists, the physiotherapists recommended an individual therapy for back pain at patients’ homes. Regardless, the VR system should support geriatric users by complementing long-term postural correction and muscular strengthening to prevent fear-avoidance behavior. In terms of everyday practice, interventions for the VR treatment of back pain problems in geriatric patients are rarely implemented. Nevertheless, for most of the interviewees the back pain training via VR under the instruction of competent therapists was conceivable at patients’ homes.


Virtual reality Chronic back pain patients Training program Process analysis 


  1. 1.
    Statistisches Bundesamt: Gesundheitspersonal - Fachserie 12 Reihe 7.3.1. 48 (2017)Google Scholar
  2. 2.
    Physiotherapie in Deutschland - Berufliche Tätigkeit Physiotherapeut/in.
  3. 3.
    Deutscher Verband für Physiotherapie (ZVK) - Definition Physiotherapie.
  4. 4.
  5. 5.
    Berufsverband Deutscher Psychologinnen und Psychologen (BDP) - Berufsbild Psychologischer Psychotherapeut.
  6. 6.
  7. 7.
    Verband Psychologischer Psychotherapeutinnen und Psychotherapeuten (VPP) - Die Psychotherapeutenausbildung.
  8. 8.
    Robert Koch-Institut: Inanspruchnahme physiotherapeutischer Leistungen in Deutschland. RKI-Bib1 Robert Koch-Inst. (2017).
  9. 9.
    Wong, A.Y., Karppinen, J., Samartzis, D.: Low back pain in older adults: risk factors, management options and future directions. Scoliosis Spinal Disord. 12 (2017).
  10. 10.
    Statista - TOP 10 Diagnosen für Verordnungen von Krankengymnastik im Jahr 2016.
  11. 11.
    Senf, W., Broda, M.: Praxis der Psychotherapie - Ein integratives Lehrbuch. Thieme Verlag KG, Stuttgart, New York, Delhi, Rio (2012)Google Scholar
  12. 12.
    Wittchen, H.-U., Hoyer, J. (eds.): Klinische Psychologie & Psychotherapie. Springer, Berlin Heidelberg (2011). Scholar
  13. 13.
    Peters, M.: Psychosoziale Beratung und Psychotherapie im Alter. Vandenhoeck & Ruprecht (2006)Google Scholar
  14. 14.
    Robert-Koch-Institut: Gesundheitsberichterstattung des Bundes. Heft 53. Rückenschmerzen. 36Google Scholar
  15. 15.
    König, H.-H.: Health status of the advanced elderly in six european countries: results from a representative survey using EQ-5D and SF-12. 11 (2010)Google Scholar
  16. 16.
    Gesundheitsberichterstattung des Bundes, Gesundheit in Deutschland - Prävalenz ausgewählter Muskel-Skelett-Erkrankungen.
  17. 17.
    Emmelkamp, P.M., Krijn, M., Hulsbosch, A., de Vries, S., Schuemie, M., van der Mast, C.A.P.: Virtual reality treatment versus exposure in vivo: a comparative evaluation in acrophobia. Behav. Res. Ther. 40, 509–516 (2002). Scholar
  18. 18.
    Wiederhold, B.K., Gevirtz, R.N., Spira, J.L.: 14 Virtual Reality Exposure Therapy vs. Imagery Desensitization Therapy in the Treatment of Flying Phobia. 21Google Scholar
  19. 19.
    Klinger, E., et al.: Virtual reality therapy versus cognitive behavior therapy for social phobia: a preliminary controlled study. Cyberpsychol. Behav. 8, 76–88 (2005). Scholar
  20. 20.
    Falconer, C.J., et al.: Embodying self-compassion within virtual reality and its effects on patients with depression. BJPsych Open. 2, 74–80 (2016). Scholar
  21. 21.
    Chirico, A., Lucidi, F., Laurentiis, M.D., Milanese, C., Napoli, A., Giordano, A.: Virtual reality in health system: beyond entertainment. a mini-review on the efficacy of VR during cancer treatment. J. Cell. Physiol. 231, 275–287 (2016). Scholar
  22. 22.
    Lewis, T., Writer, S.: Virtual Reality Treatment Relieves Amputee’s Phantom Pain.
  23. 23.
    Maani, C., Hoffman, H.G., Magula, J., Maiers, A., Gaylord, K.: Pain control during wound care for combat-related burn injuries using custom articulated arm mounted virtual reality goggles. 6 (2008)Google Scholar
  24. 24.
    Ambron, E., Miller, A., Kuchenbecker, K.J., Buxbaum, L.J., Coslett, H.B.: Immersive low-cost virtual reality treatment for phantom limb pain: evidence from two cases. Front. Neurol. 9 (2018).
  25. 25.
    Merskey, H., International Association for the Study of Pain (eds.): Classification of Chronic Pain: Descriptions of Chronic Pain Syndromes and Definitions of Pain Terms. IASP Press, Seattle (1994)Google Scholar
  26. 26.
    Engel, G.L.: The need for a new medical model: a challenge for biomedicine. Science 196, 129–136 (1977). Scholar
  27. 27.
    Kröner-Herwig, B.: Schmerz als biopsychosoziales Phänomen – eine Einführung. In: Kröner-Herwig, B., Frettlöh, J., Klinger, R., Nilges, P. (eds.) Schmerzpsychotherapie, pp. 3–16. Springer, Heidelberg (2017). Scholar
  28. 28.
    Neustadt, K., Kaiser, U., Sabatowski, R.: Das biopsychosoziale Schmerzmodell: Entwicklung, Definition und Implikationen. In: Langenmayr, A., Radbruch, L. (eds.) Was hält Leib und Seele zusammen? pp. 49–54. Vandenhoeck & Ruprecht, Göttingen (2017)Google Scholar
  29. 29.
    Casser, H.-R., et al.: Interdisziplinäres Assessment zur multimodalen Schmerztherapie: Indikation und Leistungsumfang. Schmerz. 27, 363–370 (2013). Scholar
  30. 30.
    Hildebrandt, J., Pfingsten, M., Franz, C., Saur, P., Seeger, D.: Das Göttinger Rücken Intensiv Programm (GRIP)—ein multimodales Behandlungsprogramm für Patienten mit chronischen Rückenschmerzen, Teil 1. Schmerz. 10, 190–203 (1996). Scholar
  31. 31.
    Mayring, P.: Qualitative Inhaltsanalyse: Grundlagen und Techniken. Beltz (2010)Google Scholar
  32. 32.
    Schubert, T., Regenbrecht, H.: Wer hat Angst vor virtueller Realität? 35Google Scholar
  33. 33.
    Emmelkamp, P.M.G., Bruynzeel, M., Drost, L., van der Mast, C.A.P.G.: Virtual reality treatment in acrophobia: a comparison with exposure in vivo. Cyberpsychol. Behav. 4, 335–339 (2001). Scholar
  34. 34.
    Nationale VersorgungsLeitlinie Nicht-spezifischer Kreuzschmerz – Kurzfassung, 2. Auflage. Version 1. 43 (2017)Google Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Rebecca Dahms
    • 1
    Email author
  • Oskar Stamm
    • 1
  • Ursula Müller-Werdan
    • 1
  1. 1.Geriatric Research GroupCharité – Universitätsmedizin BerlinBerlinGermany

Personalised recommendations