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Published on: January 10, 2013
A Scoping Review of Flotation-REST (Restricted Environmental Stimulation Therapy) for Chronic Pain and Associated
Sam J Stuart1, Lizeth K Achury2, Matthew Kline3
1Indiana University School of Medicine - Terre Haute, Terre Haute, IN, USA.
Background:
Flotation-Restricted Environmental Stimulation Therapy (flotation-REST) is a novel nonpharmacologic intervention for chronic pain. Previous reviews have examined the effects of flotation-REST on other outcomes, but a comprehensive review centered on chronic pain has not been conducted.
Objective:
To describe the extent, range, and nature of research evaluating flotation-REST for chronic pain and associated comorbidities, including psychological, physiological, and biomarker outcomes.
Eligibility Criteria:
No restrictions were placed on study design or setting. Studies conducted in animals, not published in English, or assessing outcomes outside the scope of the review were excluded.
Sources Of Evidence:
Ovid MEDLINE, the Cochrane Library, Embase, and PsycINFO were searched from inception to January 2025. Reference lists of relevant studies and reviews were screened.
Charting Methods:
Two reviewers independently screened titles, abstracts, and full texts. One reviewer extracted data. Variables included study design, population, controls, outcomes, and intervention parameters. Risk of bias for randomized trials was assessed using the Cochrane RoB 2 tool.
Results:
Eight studies (6 randomized controlled trials, and 2 single-arm pre/post) comprising 401 participants met inclusion criteria. Studies consistently reported improvements in pain intensity and frequency, fewer pain locations, and greater pain tolerance and detection. Anxiety and depression were substantially reduced in most studies. Sleep quality and latency improved in some studies, though others reported no benefit. Stress consistently declined, and optimism increased. Physiological outcomes were variable. Biomarker analysis demonstrated a post-treatment reduction in 3 methoxy-4-hydroxyphenylethyleneglycol (MHPG), a norepinephrine metabolite, and increased prolactin. Considerable heterogeneity in study designs, intervention protocols, outcome measures, and follow-up duration precluded meta-analysis.
Conclusion:
Flotation-REST appears promising for reducing chronic pain and enhancing psychological well-being. Physiological and biomarker effects remain unclear. High-quality randomized trials with standardized interventions and longitudinal follow-up are needed to confirm efficacy, sustainability, and clinical applicability.
