Integrating Physiologic Assessment into Virtual Reality-Based Pediatric Pain Intervention: A Feasibility Study

This feasibility study explored the integration of physiological monitoring into a virtual reality (VR) intervention for pediatric pain management. The goal of this study is to identify a feasible strategy for collecting physiologic data in the context of a VR intervention currently being developed for youth with chronic pain. We assess the potential of Cognitive Load (CL)—derived from heart rate and pupillometry/eye-tracking data—as a marker of arousal and user engagement in a VR simulation to promote school functioning in youth with chronic pain. The HP Reverb G2 Omnicept headset and Polar H10 heart-rate sensor were utilized. The Child Presence Questionnaire (CPQ) assessed participants’ self-reported immersion and engagement. Data collection focused on feasibility and utility of physiologic data in assessing arousal and correlations with self-reported experience. Nine participants engaged in the simulation, with eight yielding complete data. The simulation and headset were well tolerated. CPQ Transportation subscale showed trend-level correlation with mean CL. Due to small sample and feasibility focus, individual-level results were examined. Combining multiple physiologic markers into a construct like CL is intriguing, but data interpretability was limited. Pupillometry and related metrics show promise as feasible markers of engagement and arousal for VR-based intervention but require appropriate expertise to fully interpret. The study found that integration of physiologic monitoring is feasible, but further work is needed to standardize metrics and identify the most useful and user-friendly markers.