• Shimon Shiri, Uri Feintuch, Nilly Weiss, Alex Pustilnik, Tal Geffen, Barrie Kay, Zeev Meiner, and Itai Berger.
• Department of Physical Medicine and Rehabilitation, Hadassah Hebrew University Medical Center, Jerusalem, Israel. shimonshiri@hadassah.org.il
• Pain Med. 2013 May 1;14(5):621-7.

ObjectivePediatric 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.DesignA 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.ResultsNine 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.ConclusionThis 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.Wiley Periodicals, Inc.

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