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Trial registered on ANZCTR
Registration number
ACTRN12623001063606p
Ethics application status
Submitted, not yet approved
Date submitted
13/09/2023
Date registered
4/10/2023
Date last updated
4/10/2023
Date data sharing statement initially provided
4/10/2023
Type of registration
Prospectively registered
Titles & IDs
Public title
Out Of This World: Virtual Reality Meditation for Migraine Management.
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Scientific title
Investigating the feasibility, usability and preliminary effectiveness of home-based virtual reality (VR) meditation for the management of migraine in adults.
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Secondary ID [1]
310595
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Nil
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Migraine
331471
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Condition category
Condition code
Neurological
328199
328199
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0
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Other neurological disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
A multiple baseline, replicated Single Case Experimental Design using an ABA (A-baseline, B-treatment, A-follow-up) procedure. A N=1 design comprising 12 participants will involve serial observations before, during and post intervention. Participants will attend an initial 1-hour session at City East Campus at The University of South Australia (UniSA) and informed consent to be obtained.
During the baseline phase, participants will be asked to record a daily symptom diary which will establish ‘usual’ symptoms. Following this, treatment will commence in the mid luteal phase of menstrual cycle 2.
The VR intervention will be delivered in their home using a Meta Quest ProTM VR HMD (Meta, Sunnyvale, CA). Tripp meditation software will be utilised, which has a wide range of material and a user friendly interface. Daily diary entries and menstrual cycle will be tracked on N1-Headache™ phone app, a clinically validated tool recommended by Migraine and Headache Australia (2023). ( This will also be utilised to establish baseline daily symptoms)
Participants will be instructed to use the VR meditation:1-As a prophylactic technique by employing VR at the first sign of stress or other personal migraine pre-cursers/indicators, and 2-During each migraine episode. The treatment will be withdrawn in mid luteal phase of menstrual cycle 3 and the daily symptom diary to continue throughout the follow-up phase. On completion participants will complete a closing session at UniSA which should take around 30 minutes.
During the initial meeting participants will be given a demonstration of the technology. They will have the chance to set the technology up themselves and ask any questions regarding use. They will also be provided with a written instructions for use. They will also be provided with a helpline number to call for troubleshooting advice throughout the intervention.
The meditation application we will use is called Tripp which will be preloaded onto the head mounted display. They will be guided through a meditation through visual and auditory cues via the app. The meditations will last no longer than 10 minutes each.
The intervention will be self administered by the participants in their home environment.
The overall duration of the study will be dependant on the individual participants menstrual cycle. It will run over 4 menstrual cycles. As part of the inclusion criteria we are looking for participants with a regular menstrual cycle of between 25-35 days. Therefore with a cycle of 35 days the overall study duration would be approximately 17 weeks.
Phase A (Base line period) will commence day 1 of menstrual cycle 1 until the mid luteal phase of menstrual cycle 2 ( day 18-23)
Phase B-( Intervention)will be introduced day 18-23 menstrual cycle 2 and will continue until the mid luteal phase of menstrual cycle 3
Phase A- (Follow up)- Intervention is removed at the mid luteal phase of menstrual cycle 3 and follow up phase will continue until mid luteal phase of menstrual cycle 4.
To check adherence to the VR intervention the primary researcher will make a weekly phone call to participants. We can also check device analytics to observe use. The participants will additionally be required to send a copy of the daily symptom diary to the research team weekly.
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Intervention code [1]
327004
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Treatment: Devices
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Intervention code [2]
327005
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Lifestyle
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Intervention code [3]
327069
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Behaviour
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Comparator / control treatment
The participants will serve as their own control.
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Control group
Active
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Outcomes
Primary outcome [1]
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System usability
Measurement tool-System Usability Scale.
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Assessment method [1]
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Timepoint [1]
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Study Completion
Completion would be at the mid luteal phase of menstrual cycle 4. We aim to complete outcome measure within 7 days of study completion.
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Primary outcome [2]
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Adherence.
Measurement tool-Adherence self report questionnaire.
Usage logged automatically by head mounted display.
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Assessment method [2]
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Timepoint [2]
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End of intervention phase ( within 7 days)
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Secondary outcome [1]
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Self reported pain intensity using numerical pain rating scale.
Recorded via a daily symptom diary.
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Assessment method [1]
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Timepoint [1]
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Daily.
Participants will be asked to record daily- ( will score zero if they are not experiencing pain on that day) They will be required to record this from day one of the study to study completion. ( mid luteal phase menstrual cycle 4)
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Secondary outcome [2]
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Headache Frequency
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Assessment method [2]
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Timepoint [2]
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Using the daily diary. They will record on a daily basis.
They will be required to complete the daily diary from day 1 of the study to study completion ( mid luteal phase of menstrual cycle 4)
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Eligibility
Key inclusion criteria
-Meet ICHD criteria for chronic OR episodic migraine
-Sufficient upper limb and neck mobility to install head mounted display (HMD) and navigate software.
-Smart phone access.
-Fluent English.
-Pre-menopausal females, aged 18-45 with a regular menstrual cycle of 25-35 days.
-Must have headache as a main symptom.
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Minimum age
18
Years
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Maximum age
45
Years
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Exclusion criteria:
-Hearing/vision difficulties sufficient to impair VR experience.
-Epilepsy or claustrophobia.
-Severe psychiatric co- morbidities.
-Significant change in treatment in 3 months preceding study.
-Self-reported susceptibility to motion sickness
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
Other
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Other design features
Single Case Experimental Design
A multiple baseline, replicated Single Case Experimental Design (SCED) using an ABA (A-baseline, B-treatment, A-follow-up) procedure. A N=1 design comprising 4 participants will involve serial observations before, during and post intervention. Key strengths of this design include improved statistical power because more data points are collected, providing better indications of the stability of outcome variables and a more reliable estimates of symptoms within and across phases.
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/11/2023
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
12
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
SA
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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The University of South Australia
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Address [1]
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GPO Box 2471 Adelaide South Australia 5001
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Country [1]
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Australia
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Primary sponsor type
University
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Name
The University of South Australia
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Address
GPO Box 2471 Adelaide South Australia 5001
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Country
Australia
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Secondary sponsor category [1]
316796
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None
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Name [1]
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Address [1]
316796
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Country [1]
316796
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Ethics approval
Ethics application status
Submitted, not yet approved
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Ethics committee name [1]
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UniSA Human Research Ethics Committee
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Ethics committee address [1]
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Human Research Ethics Committee. The University of South Australia. GPO Box 2471 Adelaide. 5001
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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11/09/2023
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Approval date [1]
313815
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Ethics approval number [1]
313815
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Summary
Brief summary
This study will seek to explore potential benefits of meditation delivered via a virtual reality (VR) headset to people living with chronic or episodic migraine. It will also seek to identify avenues and challenges for further research in this area. A multiple baseline, replicated Single Case Experimental Design using an ABA (A-baseline, B-treatment, A-follow-up) procedure. A N=1 design comprising 12 participants will involve serial observations before, during and post intervention.
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Trial website
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Trial related presentations / publications
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Public notes
Safety considerations include cybersickness (Sevinc & Berkman, 2020), with symptoms such as nausea, vomiting, disorientation and postural instability (Ramaseri Chandra et al., 2022). Susceptibility to cybersickness will be assessed with a trial of the VR at the initial meeting. Participants will be exposed to low visual simulation environments without quickly changing images or rapid acceleration/deceleration to reduce visual/vestibular conflict (Saredakis et al., 2020). Studies have also shown that nausea and disorientation may increase when VR exposure is >10minutes per session (Saredakis et al., 2020). This study will utilise short meditations of <10 minutes and participants will be encouraged to only use the VR technology when seated. With the use of a high quality VR device and careful selection of content, research shows that risk can be reduced and easily managed (Saredakis et al., 2020). It is recognised that the pressure of the strap and the weight of the HMD might also present a barrier. To help mitigate this, deluxe straps have been purchased to improve comfort. Furthermore, ‘Pro’ Meta Quest range will be used, which is lighter weight and more balanced on the head.
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Contacts
Principal investigator
Name
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Mrs Laura Bell
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Address
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The University of South Australia. City East Campus. Corner of North Terrace and Frome Road. Adelaide.5000
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Country
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Australia
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Phone
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+61 8 830 21265
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Laura Bell
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Address
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The University of South Australia. City East Campus. Corner of North Terrace and Frome Road. Adelaide.5000
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Country
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Australia
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Phone
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+61 8 830 21265
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Laura Bell
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Address
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The University of South Australia. City East Campus. Corner of North Terrace and Frome Road. Adelaide.5000
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Country
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Australia
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Phone
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+61 8 830 21265
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Fax
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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