PR-VR At-home Program During and After COVID-19

Inclusion Criteria: 1. able to speak and read English, 2. 12-18 years old, 3. diagnosed with chronic pain, 4. under active care at the interprofessional out-patient Chronic Pain Clinic at SickKids, 5. on stabilized medication/therapy (no new pain medications/therapies for 1 week prior to the initial PT assessment and treatment) according to medical chart, 6. independently mobile and able to safely engage in physical activity, 7. requiring a minimum of 4 treatments (1-hour sessions of virtual PT) typically once per week, 8. able to have access to an Internet-enabled smartphone, computer or tablet at home (typically once per week for 4 weeks) according to self-report for Zoom for Healthcare visits with PT, and 9. willing to have Zoom for Healthcare visits with PT recorded during the study period and, if selected, individual telephone interview with research assistant (RA) audio recorded following the study period. Exclusion Criteria: 1. visual, auditory or cognitive impairments precluding interaction with the PR-VR intervention and/or control equipment (Internet) as assessed by reviewing the patient's medical chart and consultation with the patient's PT. 2. diagnosis of seizure disorder, history of seizure, or increased risk of seizure. 3. new onset of headaches/migraines, motion sickness, nausea or vomiting or history/symptoms of possible concussion. 4. diagnosis of major, untreated, concurrent psychiatric illness (e.g., depression, anxiety, conversion disorder, PTSD) or personality disorder as assessed by reviewing the patient's medical chart and in consultation by their health care team. 5. currently receiving sedating medications 6. claustrophobia or previous intolerance of virtual reality (e.g. nausea, vomiting, motion sickness, eye strain, false memory formation) as assessed by health care team.