BACKGROUND: Chronic post-stroke pain affects 40%-65% of stroke survivors, and increases the likelihood of functional dependence and cognitive decline, the risk of depression, anxiety, fatigue, and the risk of suicidality. Acceptance and Commitment Therapy (ACT) promotes awareness and acceptance of internal experiences, and engagement with valued activities through mindfulness and behavioural exercises, and is especially helpful in chronic health conditions, as its primary focus is not on changing symptoms, but rather on promoting acceptance of difficult internal experiences and behavioural changes towards a valued and meaningful life. Nonetheless, its feasibility and efficacy via immersive human-digital interaction technologies are underexplored.
METHOD: This funded pilot (2023.13402.PEX) has two objectives: to develop and test the feasibility and acceptability of an 8-week virtual reality (VR) ACT program (VR-ACT) in a sample of CPSP patients; to pilot test the efficacy of VR-ACT in improving pain, mental health, and adaptive psychological processes and skills, and in reducing the functional connectivity of the Triple Network (DMN, SN, and FPN), by comparing the experimental condition (VR-ACT) to a sham 2D non-immersive distracting video-animations control condition (Sham VR) pre- to post-intervention. The trial will start in December 2025.
EXPECTED RESULTS: the implementation of VR-ACT will be feasible, measured by adherence (i.e., attrition rate), engagement (number of VR usage; completion), and acceptability (qualitative post-intervention assessment); the VR-ACT program will be significantly more effective in reducing pain intensity and disability, and psychopathological symptoms, and in increasing quality of life and well-being (self-report measures), as well as in reducing functional connectivity of the triple network (fMRI), than the Sham VR.
CONCLUSION: The project will potentially open a new avenue of research in CPSP (i.e., the development of self-regulatory skills through digital solutions in CPSP rehabilitation) and reinforce the need for biopsychosocial multi-modal approaches to CPSP.