Fear Avoidance Belief Training (FABT)

At Home for Workers’ Compensation Patients

Benefits

  • Decrease Fear Avoidance Beliefs, improve function
  • Decrease medication usage
  • Decrease medical utilization for high medical utilizers, decreasing open claim time and moving patient to MMI more quickly

Program Features

  • Fear Avoidance Beliefs Training recommended in MTUS Chronic Pain Guidelines
  • Behavioral health coaches trained in motivational interviewing
  • Opioid-sparing, evidence-based pain neuroscience education program
  • Digital health tools to track patient progress

12-week program

Non-pharmacological

Fun and engaging

Providers Track Patient Progress Online

 

  • Remotely monitor patient progress

  • Access pain educational media

  • View key analytics

  • Custom experiences for providers, clinicians, and pain coaches

Trusted by

Patient Journey

 

KarunaHOME patient experience

Patient engages in Fear Avoidance Belief Training (FABT) at home, while progress data is sent back to their providers.

Getting started

Patient meets with a clinician (either in person or over video chat) to determine a plan of care for Fear Avoidance Beliefs Training (FABT).

The KarunaHOME kit is then sent to the patient’s house.

Training and coaching begin
Patient begins activities and meets with coach once per week to go review goals, progress, and educational materials.

 

Program continues
Patient continues regular training acitivities and meets with coach once per week.
Real world application
Patient applies functional progress to real world.
Finish program
Patient finishes program and returns kit to provider.

Clinical Evidence on VR and Rehabilitation

480

Journal articles *

93

Randomized

controlled trials *

26

Meta-analyses articles *

Research

KarunaHOME Publications

Case Series

Embodiment in Virtual Reality for the Treatment of Chronic Low Back Pain: A Case Series

Michael Trujillo, PhD, Anthony Alvarez, BS,  Lincoln Nguyen, BS, James Petros, MD, MBA

This case series provides evidence that embodiment in virtual reality improves symptoms of persistent chronic low back pain. We propose a mechanism by which virtual embodiment may improve chronic pain symptoms by recontextualizing sensory feedback from the body as patients engage in functional rehabilitation exercises while in virtual reality.

Citation: Trujillo MS, Alvarez AF, Nguyen L, Petros J. Embodiment in Virtual Reality for the Treatment of Chronic Low Back Pain: A Case Series. J Pain Res. 2020;13:3131-3137. Published 2020 Nov 25. doi:10.2147/JPR.S275312

Pilot Study

Virtual reality is a feasible intervention platform in multiple sclerosis: A pilot protocol and acute improvements in affect

Michael Trujillo, PhD, Anthony Alvarez, BS,  Lincoln Nguyen, BS, James Petros, MD, MBA

This pilot study demonstrated improvements in pain symptoms in patients with multiple sclerosis.

Citation: Shaw MT, Palmeri MJ, Malik M, Dobbs B, Charvet LE. Virtual reality is a feasible intervention platform in multiple sclerosis: A pilot protocol and acute improvements in affect. Multiple Sclerosis Journal – Experimental, Translational and Clinical. April 2021. doi:10.1177/20552173211006139

Whitepaper

Embodiment in Virtual Reality as a Digital Therapeutic for the Treatment of Low Back Pain

Michael Trujillo, PhD, Anthony Alvarez, BS,  Lincoln Nguyen, BS, Jon Weinberg, MBA, James Petros, MD, MBA

Karuna Labs Inc. has developed the Karuna Virtual Embodiment Training™ (KVET™) system to address the need for alternative, non-invasive, non-addictive methods to treat chronic pain. KVET™ uses a combination of virtual environments and avatars that provide visual feedback during chronic pain functional rehabilitation. Our key innovation is the application of virtualreality (VR) to improve patients’ willingness and ability to perform physical therapy (PT) and to improve the effectiveness of PT for the treatment of chronic pain.

Selected Fear Avoidance Beliefs Training (FABT)

Fear Avoidance Beliefs are associated with disability, reduced function, and impairment in chronic pain patients. FABT has demonstrated improvements in disability, function, impairment, and return to work in chronic pain patients
TITLE
DESIGN
DESCRIPTION
The Effect of a Fear-Avoidance–Based Physical Therapy Intervention for Patients With Acute Low Back Pain: Results of a Randomized Clinical Trial

Randomized Controlled Trial

Fear Avoidance Beliefs Training improves disability and pain intensity in patient’s low back pain

Ten weeks of physical-cognitive-mindfulness training reduces fear-avoidance beliefs about work-related activity: Randomized controlled trial

Randomized Controlled Trial

Fear Avoidance Beliefs Training significantly improved work related fear avoidance beliefs in workers with chronic pain

High Fear-Avoiders of Physical Activity Benefit From an Exercise Program for Patients With Back Pain

Comparative Study

Patients with high fear avoidance benefit from functional rehabilitation programs that include Fear Avoidance Beliefs Training

A randomized controlled trial of exposure in vivo for patients with spinal pain reporting fear of work-related activities

Randomized Controlled Trial

Chronic low back pain patients with reduced function demonstrated superior benefits over treatment as usual on function, fear, and pain

Fear-Avoidance Behavior and Anticipation of Pain in Patients With Chronic Low Back Pain: A Randomized Controlled Study

Randomized Controlled Trial

Function in chronic pain patients is significantly reduced in patients with high Fear Avoidance Beliefs

Preventing progression to chronicity in first onset, subacute low back pain: an exploratory study

Exploratory Study

Early Fear Avoidance Training prevents the onset of chronic pain

Fear avoidance beliefs as a predictor for long-term sick leave, disability and pain in patients with chronic low back pain

Randomized Controlled Trial

High fear avoidance beliefs is associated with sustained impairments in returning to work in chronic pain patients

Manual Therapy, Therapeutic Patient Education, and Therapeutic Exercise, an Effective Multimodal Treatment of Nonspecific Chronic Neck Pain: A Randomized Controlled Trial

Randomized Controlled Trial

Therapeutic patient education

Research Pipeline

INSTITUTION
DESIGN | STATUS
PI

Penn Medicine

A randomized controlled trial on patients with chronic low back pain

Status: Ongoing, actively recruiting
Dr. Michael Ashburn, MD, MPH, MBA.
Director, Pain Medicine and Palliative Care Professor of Anesthesiology and Critical Care at the Hospital of the University of Pennsylvania

Karuna Labs

A randomized controlled trial on KarunaHOME for patients with general chronic shoulder pain 

Status: Ongoing, actively recruiting
Dr. Michael Trujillo, PhD
VP of Clinical Affairs, Karuna Labs

UCSF

Inpatient Trial: PRISM (Pain Relief with Individualized brain StiMulation)

Status: Ongoing, actively recruiting
Dr. Prasad Shirvalkar, MD, PhD
Neurologist and Pain Medicine Specialist UCSF Dept. of Anesthesia

Georgia State University

Validation and feasibility of KarunaHOME for use in physical therapy

Status: Ongoing, actively recruiting
Dr. Sujay Galen, PhD

Chair, Department of Physical Therapy, Georgia State University

Santa Clara University

Validating biomarkers of chronic pain and digital therapeutics

Status: Pending
Julia A. Scott, Ph.D.

Senior Research Associate BioInnovation and Design Lab, Santa Clara University

Conference Abstracts & Posters

01.

Karuna Society for Neuroscience 2019 Poster

02.

Karuna CALSIPP 2019 Poster

03.

Karuna Pain Week 2019 Poster

04.

Immersive Virtual Embodiment in Pain Relief

Additional Peer Reviewed Research

TITLE
DESIGN
DESCRIPTION

Virtual reality for management of pain in hospitalized patients: A randomized comparative effectiveness trial

Randomized Controlled Trial

VR significantly reduces pain versus an active control condition in hospitalized patients (N = 120; 61 VR; 59 Control)

Virtual Reality as a Therapy Adjunct for Fear of Movement in Veterans With Chronic Pain: Single-Arm Feasibility Study

Feasibility

Findings support the feasibility of VR as an adjunct for Veterans with chronic pain.

Virtual reality distraction induces hypoalgesia in patients with chronic low back pain: a randomized controlled trial

Randomized Controlled Trial

Virtual reality had large significant effect in reducing sensitivity to pain in patients with chronic nonspecific low back pain (N = 84; 42 VR; 42 control

Effect of fully immersive virtual reality treatment combined with exercise in fibromyalgia patients: a randomized controlled trial

Randomized Controlled Trial

Immersive VR significantly improved pain, kinesiophobia, fatigue, physical activity and quality of life in fibromyalgia patients

Altered visual feedback from an embodied avatar unconsciously influences movement amplitude and muscle activity

Experimental

Visual augmentation in VR induced compensation and unconscious motor adaptation

Body Movement Reduces Pain Intensity in Virtual Reality–Based Analgesia

Experimental

Moving in immersive virtual reality increases the analgesic effects of VR