Evaluating the efficacy of pain apprehension re-activation of movement (PARAM) using virtual reality for kinesiophobia among silk weavers with long COVID symptoms

BackgroundWeaving is a key livelihood in Erode, Tamil Nadu. Long COVID-19 symptoms, especially kinesiophobia, hinder weavers' ability to work, necessitating better interventions.ObjectiveTo study the impact of Pain Apprehension Re-Activation of Movement (PARAM) VR intervention compared to conventional exercises in mitigating kinesiophobia among the target population.MethodsA quasi-experimental design involved 84 silk weavers from southern India divided into Ex-Groups (n = 42) that received conventional exercises and VR-Group (n = 42) that received the same set of exercises in virtual ambience in PARAM protocol which is a novel approach where the patient compares video graphs taken in virtual ambience with physical environment for self-realization on their movement capacity. Totally 48 males and 36 females participated, with an average age of 45.2 (4.7). Tampa Scale for Kinesiophobia (TSK), Visual Analogue Scale (VAS) for pain, and SF-12 scale for health-related quality of life were used at baseline, after two weeks and at the end of the 4 weeks of intervention.ResultsBoth groups showed significant improvements (VR-Group- TSK:χ²= 18.42, <i>p</i> < 0.001;VAS:χ²= 16.21, <i>p</i> < 0.001;SF-12:χ²= 19.55, <i>p</i> < 0.001 and Ex-Group TSK:χ²= 10.67, <i>p</i> = 0.005, VAS:χ²= 8.49, <i>p</i> = 0.014, SF-12:χ²= 12.34, <i>p</i> = 0.002). Improvement in the VR-Group was immediate and consistently better than the Ex-group. (Post-test-1, TSK:U = 45, <i>p</i> = 0.002; VAS: U = 50.5, <i>p</i> = 0.004; SF-12: U = 42, <i>p</i> = 0.001, Post-test-2-TSK: U = 60, <i>p</i> = 0.048; VAS: U = 65.5, <i>p</i> = 0.036; SF-12: U = 58, <i>p</i> = 0.044).ConclusionPARAM and conventional exercises were effective in reducing apprehension to movement among silk weavers with long-term COVID-19. However, PARAM training resulted in a significantly better improvement that was faster and more consistent.