Pain Studies Lab Collaborates with Faculty at Harvard’s Medical School & Boston Children’s Hospital

By | Study, Research, Collaborations, Lab Updates, Other News

Dr. Diane Gromala and Dr. Chris Shaw are collaborating with Dr. Deirdre Logan at Harvard’s medical school. The group is adding an immersive Virtual Reality (VR) component to a new program that treats Young Adults who live with chronic pain at Boston Children’s Hospital.

Researchers in the Pain Studies Lab — neuroscientist Dr. Zahra Ofoghi, Biomedical Engineers Armin Froozanfar and Sara Khalilipicha, and Computer Scientist Efe Erhan — have updated the lab’s Virtual Meditative Walk (VMW) for this purpose. Initially built and tested in 2011, the Virtual Meditative Walk has been consistently updated according to their on-going co-design work with patient-partners and their research findings.

The VMW integrates VR with biosensors, data visualization, and AI, all of which work together to help chronic pain patients learn to better manage their persistent pain via MBSR (Mindfulness-based Stress Reduction). It has been tested in multiple research studies in health research, computer science, and UXUI design. As it evolved, the VMW was continually tested in clinical and home contexts, and in short and longitudinal research studies.
Dr. Logan and Dr. Gromala met at a Consensus Meeting at Sick Kids in Toronto. There, with ~30 pediatric pain experts, they co-developed guidelines that researchers are encouraged to follow as VR is quickly being adopted for clinical use. At the recent vMED conference at Cedars Sinai Hospital in Los Angeles, for example, presenters demonstrated that the number of research papers about VR has grown in the past 10 years to over 30,000 papers worldwide.

Given that the opioid crisis has not abated, such “non-pharmacological” methods of managing chronic pain, such as VR, are promising. Similarly, the use of VR to treat PTSD (post-traumatic stress disorder) by the Veterans Administration (VA) has been so successful that the VA recently announced its widespread adoption in the U.S. (Bailey et al.), from an initial 5 sites to 147 sites.

Because MBSR is a skill that takes regular practice to learn, the researchers are exploring the feasibility of using VR in the program at Boston Children’s Hospital. They are also exploring any specialized needs that Young Adults may face if they use VR or MBSR on a regular basis. The pilot study phase is already underway.

  1. To access the 20+ peer-reviewed, evidence-based research papers published about the VMW, please refer to painstudieslab.com/publications
  2. Bailey AL, Kirsh S, Rawlins C, Persky S, Clancy C. Early Scaling of Immersive Technology within the Veterans Health Administration. NEJM Catal Innov Care Deliv. 2024 Apr;5(4):10.1056/CAT.23.0356. doi: 10.1056/CAT.23.0356. Epub 2024 Mar 20. PMID: 39474356; PMCID: PMC11521419.

Dr. Diane Gromala to Present at the vMED Conference 2024

By | Research, Demos, Conferences, Events, Lab Updates, Other News

We are thrilled to announce that Dr. Diane Gromala, the Canada Research Chair in Computational Technologies for Transforming Pain and the Founding Director of the Chronic Pain Research Institute and the Pain Studies Lab at Simon Fraser University, will be leading the Pain Studies Lab in presenting at the upcoming vMED Conference on March 28-29, 2024. A Distinguished Professor in the School of Interactive Arts and Technology (SIAT), Dr. Gromala brings extensive expertise and insights into the intersection of pain management and technology.

The vMED Conference, hosted by Cedars-Sinai, is a highly anticipated event in the field of virtual medicine, gathering experts and innovators from around the globe. It provides a unique platform for professionals to share their research, insights, and virtual and digital health technology advancements. Dr. Gromala’s participation underlines our commitment to being at the forefront of research and innovation in pain management.

Cedars-Sinai, the host of the vMED Conference, continues to be recognized for its excellence in healthcare. Cedars-Sinai has been named to the Honor Roll for the eighth consecutive year and tied for #1 in California and Los Angeles in the U.S. News & World Report’s “Best Hospitals 2023-24” rankings and ranked #2 in specialties such as Cardiology, Heart & Vascular Surgery, and Gastroenterology & GI Surgery​​​.

Our work is pivotal in shaping how technology can transform how we understand and manage chronic pain. The vMED Conference is an excellent opportunity for our team to learn, collaborate, and contribute to the evolving landscape of virtual medicine.

Participants include clinicians using MXR for patient care, patients exploring the benefits of MXR as a complementary therapy, and hospitals and clinics evaluating the health economics of starting an MXR program.

Pain Studies Lab Research at the Annual Scientific Meeting of the Canadian Pain Society(CPS)

By | Study, Research, Conferences, Events

On May 10-12, 2023, members of the Pain Studies Lab presented two posters at the Annual Scientific Meeting of the Canadian Pain Society in Banff, Canada. The Canadian Pain Society connects healthcare professionals, scientists, researchers, policymakers, and people with lived experience through evidence-based education. Each poster articulates the results of scientific and clinical studies conducted by members of the Pain Studies Lab in collaboration with other organizations in British Columbia.

Poster 1: Diversity of Social Presence in VR

Yuemei Wu presented a poster about the Diverse Forms of Social Presence in VR for Chronic Pain in a number of our immersive virtual environments. “Social Presence” is often assumed to involve two users sharing the same Virtual Environment (VE), and each user inhabits an avatar communicating in real-time. However, we argue that other forms of social presence can be experienced in multiple ways for multiple purposes. For example, a number of our VEs have humanoid, animal or robotic characters who help users navigate or interact.

Wu Y, Chong K, Gromala D, Shaw C, Kagiri T, Williamson O,  Li R, Kim D, Hortsing S, Wilson M. Diverse Forms of Social Presence in VR for Chronic Pain.  In the Annual Scientific Meeting of the Canadian Pain Society, Banff, Canada, 10-12 May 2023.

Graduate student Yuemei Wu introduces the VEs to someone with lived experience.

Poster 2: Neuroscience: essential for the Design of VR for Chronic Pain

In this poster, neuroscientist Dr. Zahra Ofoghi demonstrates an intriguing method she developed to help partially automate structured reviews. Her approach also enables researchers to gain an immediate sense of interdisciplinary differences of the resulting research papers that met the search criteria. That a neuroscientist learns to integrate visualization apps for purposes of pain research may appear to be novel, we take pride in such interdisciplinary achievements, especially for knowledge translation that may be useful for others, building bridges across disciplines.  

Ofoghi Z, Gromala D, Kagiri T. Neuroscientific Implication for the Design and Development of Virtual Reality for Patients with Chronic Pain. In the Annual Scientific Meeting of the Canadian Pain Society, Banff, Canada, 10-12 May 2023

Bridging the Gap: Dr. Zahra Ofoghi’s Innovative Neuroscience Approach Unveiled in VR for Chronic Pain.

Title: Toward a collective understanding of chronic pain journeys through Perspectives of diverse healthcare professionals

Kit-Ying Angela Chong conducted a pre-research early investigative activity developed from a co-design and co-speculation course. The goal was to explore co-design methodologies and understand the barriers chronic pain patients may face from a healthcare professional or researcher’s perspective. The early investigative activity resulted in several learning outcomes. For instance, the journey map as an intervention tool in a conference setting was not as effective as expected, however, it was a successful conversation starter. Angela planned to iterate the activity and further develop it into a research study that contributes to the chronic pain community.

Unveiling Insights: Kit-Ying Angela Chong Explores Chronic Pain Journeys from Diverse Healthcare Perspectives.

Chronic Pain Research Institute appoints Design Director

By | Collaborations, Events, Lab Updates, Other News

New Design Director at the CP Research Institute

We are pleased to announce that our very own Tim, who has diligently served as a research assistant with us, has been appointed the Design Director of the Chronic Pain Research Institute!

Tim will actively work at the nexus of design, health, and technology in his new role. His key responsibilities will be to closely collaborate with a diverse team comprising health professionals, tech experts, design researchers, patient-partners, and international luminaries. Their collective goal? To metamorphose our invaluable research findings into easy-to-understand, accessible formats. This will span reports, visualizations, media narratives, comprehensive toolkits, and workshop instruments.

It is the ambition of our institute to relay our research in a manner that is both actionable and coherent. Under Tim’s guidance, we anticipate further enhancement in our efforts, not merely through our established digital platforms and publications but also innovative channels. It is imperative to Tim and all of us at the Pain Studies Lab that we remain cognizant of and sensitive to the lived experiences of individuals with chronic conditions.

To elucidate this approach, Mr. Tim will present at the forthcoming INFO+ 2023 conference scheduled this fall in Edinburgh, Scotland.

The Pain Studies Lab is excited about this new chapter, and we wholeheartedly believe that Tim’s design leadership will amplify our work and deeply enrich the lives of those we aim to serve.

Tim Kagiri, Design Director, CP Research Institute.

Pain Studies Lab Researchers present at the International Association on the Study of Pain’s (IASP) World Congress on Pain 2022 in Toronto

By | Research, Conferences

On Sept 19-23, 2022, members of the Pain Studies Lab presented two posters at the International Association on the Study of Pain’s (IASP) World Congress on Pain 2022 in Toronto. IASP World Congress is a multidisciplinary conference for frontline clinicians focusing on pain diagnosis, treatment and management. Each poster articulates the results of scientific and clinical studies conducted by members of the Pain Studies Lab in collaboration with other organizations in British Columbia.

Graduate student, Bhairavi Warke discussing a poster with at attendee at the IASP World Congress on Pain 2022.

Poster 1: Patient-Centered Approach to Researching Burdens of Pain

In collaboration with the Arthritis Research Centre of Canada (ARC) and the BC Support Unit, the Pain Studies Lab deployed participatory methods to effectively engage long-time patient-partners and members of the public in developing a web-platform. This web-platform uses a Citizen Science approach to explore the Burdens of Pain. The goal of this project is to invite citizens of British Columbia to contribute information about living with pain from their own experiences and be active members in advancing research in this area. The data collected will help foster a sense of community amongst people with shared experiences of pain and help researchers in identifying research questions that may need further investigation. This poster describes the patient-centered approaches that we used to include patient-partners and other end users in the development process as co-creators, participants and decision makers.
Warke B, Gromala D, Gupta A, Shaw C, and Li L. A Diverse Patient-Centered Approach to Researching Burdens of Pain: a Citizen Science project in British Columbia. In the International Association for the Study of Pain’s (IASP) World Congress on Pain 2022, Toronto, Canada, 19-23 Sep 2022

Graduate student, Pegah Kiaei presenting one of the posters at the the IASP World Congress on Pain 2022.

Poster 2: State-of-the-art review of commercial virtual reality applications

Arthritis Patients and We Win an Inaugural Ideator Award

By | Awards, Projects

In April, “four Canadian innovators received prestigious and valuable awards from the Arthritis Society to bring to life their solutions for fighting the fire of arthritis” — one is a project that Dr. Diane Gromala and Dr. Chris Shaw collaborate on with the Arthritis Research Centre (ARC), called OPERAS.

At the inaugural Arthritis Ideator Awards, Dr. Linda Li accepted the Olga Munari Arthritis Ideator Award for OPERAS at MaRS in Toronto. The award was based partly on the originality of the innovation, potential for significant and lasting outcomes for people with arthritis, and readiness for market.

Left to right: Winners Michelle Laflamme and Alex Fuentes of KneeKG, Matthew Rosato of PROVA Innovations, Lianna Genovese of Guided Hands, and Linda Li of OPERAS.

In addition to the $50,000 grant, the Arthritis Ideator Program gives innovators access to expert advice from the Arthritis Society and the broader arthritis ecosystem as they continue to develop their innovations, as well as to people living with arthritis who can support testing or provide feedback through focus groups or surveys.

“Arthritis is a huge challenge looking for bold solutions and we want to support bright minds as they create those solutions,” says Trish Barbato, President and CEO of the Arthritis Society. “We are embracing innovation like never before because we believe it is key to changing the lives of the six million Canadians living with arthritis.”     

OPERAS is an app-based program to empower active self-care, capturing information on the go, and providing trends on symptoms, disease activity and treatments. Says creator Linda Li, “With OPERAS, people with arthritis can monitor disease activity, keep track of medications, create action plans and collect and display physical activity data through an integrated physical activity tracker. It gives a detailed picture to help users lead healthier, pain-free lives.” 

OPERAS described: https://arthritis.rehab.med.ubc.ca/ 

https://arthritis.ca/about-arthritis/arthritis-in-the-news/news/arthritis-society-awards-$200,000-in-first-ever-arthritis-ideator-awards

https://www.globenewswire.com/en/news-release/2022/04/22/2427551/0/en/Arthritis-Society-awards-200-000-in-first-ever-Arthritis-Ideator-Awards.html

Dr. Xin Tong Earns a Doctorate, Postdoc at Stanford, and Canada’s Bill Buxton Award

By | Research, Awards, Graduation

In 2021, the Pain Studies Lab member Dr. Xin Tong had 3 significant achievements:

  1. she earned her Ph.D.,
  2. was awarded a postdoctoral fellowship affiliated with the Pervasive Wellbeing Technology Lab at Stanford University, and
  3. was the recipient of Canada’s prestigious Bill Buxton Best Canadian HCI Dissertation Award.
    This award recognizes the most outstanding doctoral dissertation completed at a Canadian university in the field of Human-Computer Interaction.

The Pain Studies Lab’s most recent Ph.D. graduate is Dr. Tong, is currently an Assistant Professor in Computation and Design at Duke Kunshan University (DKU).

Dr. Tong’s dissertation, Bodily Resonance: Exploring the Effects of Virtual Embodiment on Pain Modulation and the Fostering of Empathy toward Pain Sufferers, combined both technical and human aspects of research to explore how virtual embodiment — through the use of VR technology — can affect people’s perception of pain and address the biological, psychological and social challenges that chronic pain patients face. This work identifies factors that impact the effect of VR embodiment on pain, including features of avatars, combinations of multiple modalities to communicate pain, and the integration of narratives into games.

Findings from Dr. Tong’s studies led to a series of important design recommendations for using embodied VR to generate empathy. Building on those results, Dr. Tong proposes Bodily Resonance, a design framework for pain and VR for empathy. The framework connects the real body that is in pain, the VR content, the illusion of presence in the virtual world and the narrative to mediate the perception of pain and empathy.

The Pain Studies Lab Responds to Ensure Access to COVID-19 Vaccinations

By | Study, Research, Collaborations

We responded to the call to help with COVID-related vaccination software, especially for vulnerable and at-risk people, such as those who live with chronic conditions. What also differentiated our system was its technical integration with Electronic Health Records (EHR).

As the researchers on a Canada-wide project funded by the Supercluster, MITACS, and the Digital Health Circle, we collaborated with health tech companies Cambian, IBM, LifeLabs, TickIt, Well Health, and the non-profit Providence Health Care.
Our job as researchers was twofold:

  1. to identify the real needs of people identified as “vulnerable and at-risk” &
  2. to ensure the system was as inclusive and usable as possible.

We built on our technical and design expertise in designing, building and testing health tech for people who live with long-term, chronic conditions, their caregivers and their healthcare professionals.

Our patient-centred approaches and our interests in inclusive, individualized healthcare enabled us to uncover many of the specialized contexts and needs that would have otherwise remained invisible. 

To interact with as many people as possible, we first contacted numerous non-profit organizations, interviewed their organizers and staff, and focused on in-depth interviews, usability studies and discussions with their many members.

Next, we conducted usability studies to make sure the vaccination scheduling system would be usable by those who are aging, immuno-compromised, differently abled, living in remote areas, living with chronic conditions, or who could only access the online system via mobile phones.

Clockwise: Dr. Diane Gromala, PhD students Bahiravi Warke, Xin Tong and MSc student Amal Vincent worked with people who are considered “vulnerable and at-risk” to severe illness from COVID-19 as identified by Canada’s and BC’s Ministry of Health. This included seniors, those who have cancer, are immuno-compromised, or have chronic conditions such as insulin-dependent diabetes, cardiovascular disease, kidney conditions, blood and rare diseases, significant developmental disabilities or require respiratory support.

Our discoveries:

    • the crucial and diverse roles of diverse caregivers (a family member, friend or neighbor);
    • the roles and centrality of extended families, especially among many people new to Canada;
    • important gender, cultural and linguistic differences; and
    • that ease-of-use is essential, not a mere luxury.

An unexpected outcome was developing a just-in-time, rapid response method to communicate the results of our research in an accelerated but scientifically trustworthy way.

Project focus and findings:

UXUI:
Needs Analyses
Usability Studies
Patient-centred Design
Inclusive Design

Frontiers in Virtual Reality: Virtual Reality in Medicine

By | Study, Publications

In addition to our longitudinal fMRI studies with chronic pain patients who use our immersive VR for months, we are also conducting EEG studies.

For example, Pegah Kiaei worked with neuroscience experts to develop an EEG study that will form the basis of her MSc thesis.

This study was published in the journal Frontiers in Virtual Reality: Virtual Reality in Medicine.

Although chronic pain does not have biomarkers per se, integrating EEG data in biopsychosocial research methods that pervade pain research may enable us to make inferences about patients’ brain states before, during and after using VR.

This is important because although hundreds of studies show that VR can have analgesic effects, we aren’t sure yet how and why that happens.

If you are a chronic pain patient living in the greater Vancouver area and you would like to participate in such studies, please email:
Dr. Zahra Ofoghi – zahra_ofoghi@sfu.ca

Kiaei Ziabari, S., Ofoghi, Z., A. Rodrigues E., Gromala, D. & Moreno, S. (2021). “Investigating the role of having an avatar in virtual reality on pain alleviation and embodiment in patients with pain using electroencephalogram: a neuroimaging protocol,” in Frontiers in Virtual Reality, Special Issue: Virtual Reality in Medicine. 10 January 2022  https://doi.org/10.3389/frvir.2021.775764

FitViz: How objective data affects physiotherapist-patient conversations for arthritis patients

By | Study, Research, Projects

Dr. Linda Li, Professor Harold Robinson/Arthritis Society Chair, Canada Research Chair, UBC & Arthritis Research Centre.

We developed a web application called FitViz. It allows physiotherapists and patients to use the physical activity data collected from Fitbit fitness trackers during consultations.

Next, we conducted a four-week study with 20 patients (inflammatory and knee osteo-arthritis arthritis) and 7 physiotherapists to evaluate the feasibility of FitViz, and understand the experiences of the physiotherapists and the patients.

We used semi-structured interviews to understand how physiotherapists used FitViz, and if and how it changed the nature of their consultation.

“Oh, I didn’t do a good job: How objective data affects physiotherapist-patient conversations for arthritis patients.”

We found that the use of objective data allowed the physiotherapist-patient conversations to be patient-driven, and allowed goals to be realistic and data-driven. However, the use of objective data also caused some patients to feel guilty, which has implications on the use of pervasive healthcare technology in clinical settings.

After iterative improvements, we initiated a larger, longitudinal study.

 

References:

Ankit Gupta, Tim Heng, Chris Shaw, Diane Gromala, Jenny Leese and Linda Li. 2020.
“Oh, I didn’t do a good job: How objective data affects physiotherapist-patient conversations for arthritis patients.”
Proceedings of the 14th EAI International Conference on Pervasive Computing Technologies for Healthcare.
Association for Computing Machinery, New York, NY, USA, 156–165. DOI: https://doi.org/10.1145/3421937.3421991

Li LC., Feehan LM., Xie H., Lu N., Shaw C., Gromala D., Aviña-Zubieta JA., Koehn C., Hoens AM., English K., Tam J., Therrien S., Townsend AF., Noonan G., Backman CL. (2020). “Efficacy of a Physical Activity Counseling Program With Use of a Wearable Tracker in People With Inflammatory Arthritis: A Randomized Controlled Trial.”Arthritis Care & Research (Hoboken).
2020 Dec;72(12):1755-1765.    DOI: 10.1002/acr.24199.   PMID: 32248626 Clinical Trial.