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Updated: May 11, 2026
The use of Biofeedback in Clinical Virtual Reality: The INTREPID Project
Published on: November 12, 2009
A virtual reality system combined with biofeedback for treating pediatric chronic headache--a pilot study
Shimon Shiri1, Uri Feintuch, Nilly Weiss
1Department of Physical Medicine and Rehabilitation, Hadassah Hebrew University Medical Center, Jerusalem, Israel. shimonshiri@hadassah.org.il
Insights
A new virtual reality and biofeedback system shows promise for treating pediatric chronic headache. This approach improved pain, daily function, and quality of life in a pilot study.
Area of Science:
- Neurology
- Pediatrics
- Biomedical Engineering
Background:
- Pediatric headache is a prevalent condition causing significant distress and reduced quality of life.
- Current pharmacological treatments for chronic headache in children are often limited in efficacy and can be counterproductive, highlighting the need for alternative therapies.
Purpose of the Study:
- To evaluate the feasibility and preliminary efficacy of a novel system combining virtual reality (VR) and biofeedback as an abortive treatment for pediatric chronic headache.
Main Methods:
- A prospective, single-arm, open-label pilot study involving ten children treated with the VR and biofeedback system.
- Participants engaged in relaxation exercises with biofeedback, associating successful relaxation with positive virtual imagery.
Main Results:
- Nine out of ten participants completed the 10-session intervention.
- Significant improvements were observed in pain ratings, daily functioning, and quality of life at 1 and 3 months post-treatment.
- Most children reported using learned relaxation and imagery skills to manage headaches outside of the clinical setting.
Conclusions:
- The combined VR and biofeedback system is a feasible treatment option for pediatric chronic headache.
- Further randomized controlled studies with larger populations are warranted to confirm the system's utility in reducing headache and improving patient outcomes.
Objective:
Pediatric headache is highly widespread and is associated with distress and reduced quality of life. Pharmacological treatment of chronic headache in children has been only partially effective and, as in medication-overuse headache, can sometimes be counterproductive. Therefore, there is a substantial need to develop other effective methods of treatment. Here we present the rationale, feasibility, and preliminary results of a pilot study applying a novel system, combining virtual reality and biofeedback, aimed as an abortive treatment of pediatric chronic headache.
Design:
A prospective single-arm open-label, pilot study. Ten children attending an outpatient pediatric neurology clinic were treated by the proposed system. Participants practiced relaxation with biofeedback and learned to associate successful relaxation with positive pain-free virtual images of themselves.
Results:
Nine patients completed the 10-session intervention. Ratings of pain, daily functioning, and quality of life improved significantly at 1 and at 3 months posttreatment. Most patients reported applying their newly acquired relaxation and imagery skills to relieve headache outside the lab.
Conclusion:
This novel system, combining biofeedback and virtual reality, is feasible for pediatric use. Randomized controlled studies in larger populations are needed in order to determine the utility of the system in reducing headache, improving daily functioning, and elevating quality of life.
