XR Body Illusion for Managing Pain in Fibromyalgia: Examining Optimal Duration

Todd, Jennifer, Woolford, Kirk, Cheng, Lee, Lee, Michael C, de Villiers, Elsje, Finn, Deanna and Aspell, Jane E (2025) XR Body Illusion for Managing Pain in Fibromyalgia: Examining Optimal Duration. Virtual Reality. ISSN 1434-9957 (In Press)

Abstract

Background: Fibromyalgia is a chronic condition characterised by widespread pain, as well as sleep disturbances, fatigue, and memory and concentration difficulties. Research suggests that an alteration in how the brain represents multisensory inputs from the body may cause or maintain chronic pain conditions, including fibromyalgia. Extended reality (XR) and virtual reality setups generating multisensory conflicts have been shown to alleviate pain, however, the optimal duration for such interventions remains unexplored. Here, we aimed to determine an optimal duration for the cardio-visual full body illusion (FBI) in fibromyalgia, considering both tolerability and changes in pain. Methods: Participants wore headsets to view a video of their own body, filmed from behind, and their body flashed in synchrony with their heartbeat. We used an established dose-finding protocol to determine the ideal duration (balancing benefit and tolerability). Seven cohorts of participants (N = 20) were exposed to different durations of the FBI, with adjustments to duration made according to predefined criteria. Measures included a numeric rating scale for pain intensity, pressure pain thresholds, and scales measuring fibromyalgia symptom severity and impact. Results: We found a quadratic relationship between session duration and changes in self-reported pain-intensity, with 8–16-minute durations yielding the most significant improvements. Notably, in the 12-minute cohorts pain relief was sustained at 24-hour follow-up, and this is the recommended duration for future research. Conclusions: These findings represent a key step towards developing an effective non-pharmacological intervention for fibromyalgia. Future dose-optimisation research should explore the optimum number of sessions and spacing between sessions. Keywords: Dose finding, virtual reality, fibromyalgia, full body illusion, cardio-visual, pain management

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