Patients play their way to pain control

Tonight after work, Sean will do just what his doctor ordered-he will go home, turn on his computer, and spend two hours playing video games.

Think this scenario sounds far-fetched? Not according to a new study led by Bryan Raudenbush, an associate professor of psychology at Wheeling Jesuit University in Wheeling, West Virginia. "Most of the studies you see in the media report the detrimental effects of video games, perhaps because that is tied to a specific agenda; I'm not sure," Raudenbush tells the Georgia Straight in a phone interview. "But video games have been found to increase hand-eye coordination, promote healthy competition, aid in some aspects of therapy, and now”¦decrease pain responses."

This is not exactly a new field. For decades, doctors have used video games as a way to treat behavioural problems in children and adolescents. A 1986 study by G.H. Lawrence in the journal Computers in Human Behavior showed that playing the games can help patients overcome phobias (such as fear of heights, driving, and spiders), obsessive-compulsive disorder, anxiety, and attention-deficit hyperactivity disorder. Known as Virtual Reality Therapy, virtual environments allow patients to immerse themselves in a computer-generated situation and play their way through their fears. These programs once required expensive virtual- reality systems, but programmers are now creating new environments for lower-end hardware, using game engines like Half-Life, Max Payne, and Unreal. The Cyberpsychology Lab at the University of Quebec in Outaouais has developed a virtual game called Overcoming Arachnophobia, which is available for free to owners of Max Payne titles.

Game developers are taking things to the next level. One example is the Games for Health Conference, part of the Serious Games Initiative, a Woodrow Wilson International Center for Scholars effort. The annual event, which took place last September at the University of Maryland school of medicine, attracts academics, doctors, and other health professionals as both attendees and speakers. "We feel there are some excellent opportunities, resources, and technologies in the games field that we can apply to achieving potential breakthroughs in health and health care," says last year's event codirector, Ben Sawyer, interviewed by phone. Sawyer is president of Digitalmill, Inc., a Maine-based consulting firm.

Raudenbush is playing a big part in bringing together video games and health care. In a groundbreaking study presented at the Society for Psychophysiological Research conference in Portugal last September, Raudenbush set out to assess whether video games can significantly distract participants from painful stimuli. Participants played for 10 minutes through six video-game genres (action, fighting, mental/puzzle, sports, arcade, and boxing), and then took a cold-pressor test for pain. (The patient immerses a hand in a bucket of ice-cold water for five minutes or until he or she can no longer stand it.) Raudenbush checked oxygen saturation, pulse, and blood pressure in his subjects both before they started playing the games and after the pain tests. Pain tolerance was greatest among those distracted by games (and significantly higher for players of sports and fighting genres). "These results indicate games produce a great level of distraction, which has implications for the medical field as an adjunct to pain management," Raudenbush says. "Such distractions may be most helpful for individuals undergoing painful procedures or suffering from chronic pain."

If you're wondering how serious this research is, you're in for a surprise. Sawyer explains that recent studies include using the core systems behind Full Spectrum Warrior (a tactical-strategy war game) to treat post-traumatic stress disorder in veterans of Iraq and Afghanistan, and an action-adventure role-playing game to help remedy substance abuse. "Good medical professionals are committed to turning over every stone," Sawyer says. One of his favourite moments at the last Games for Health Conference was when a well-known doctor from Boston got up and said he loved Sam Fisher, the lead character in Ubisoft's Splinter Cell series. The doctor added that the game features enviable technologies he could use in teaching pain- control techniques to medical students. "There are more doctors who are gamers than we probably realize," Sawyer enthuses.

When it comes to using video games for pain control, there's still a long way to go, but researchers are making giant strides. Raudenbush's current lab head, a graduate student, is doing his thesis on using video games to help children through chemotherapy. In Seattle, Hunter Hoffman and David Patterson of the department of psychology at the University of Washington are exploring the use of virtual-reality games for daily wound care of burn victims. Preliminary results show that patients who distract themselves with video games need significantly less opioid analgesics during wound care. According to Raudenbush, that's because during games, participants take a first-person fighting or running role against the computer. "It's almost like a competitive task, where they seem to push themselves to win."

Personality and prior video-game-playing habits don't seem to have a significant influence when it comes to pain control, which means people of all ages can benefit from the distraction. However, Raudenbush emphasizes the importance of children using games. "These gaming distractions may be most helpful in children and young adults undergoing painful procedures or suffering from chronic pain, as these individuals comprise the largest gamer demographics."

Raudenbush and his colleagues see video games becoming standard equipment in medical offices within the next 10 years. "They could even be used in waiting rooms to distract patients from upcoming surgical procedures," he says.