Virtual Reality as a Tool for Anxiety Regulation During Botulinum Toxin Injections for Spasticity Management

Background. Spasticity commonly affects individuals with neurological conditions, impacting mobility, daily activities, and quality of life. Although Botulinum Toxin (BoNT) injections are widely used to manage spasticity, needle-related anxiety can negatively affect treatment experiences and adherence. Virtual Reality (VR) has shown promise as a non-pharmacological distraction tool to reduce anxiety and pain, but its use during BoNT injections in adults remains underexplored. Purpose. This study investigates whether VR affects anxiety levels in adults undergoing BoNT injections for spasticity management. Methods. This study is an embedded mixed-methods study. Participants receiving BoNT injections for spasticity at the GF Strong Spasticity Clinic will engage with non-immersive VR content during treatment. Quantitative and qualitative data shows participants' experience with VR. A focus group with clinician researchers will be conducted to understand clinical implementation. Findings. Participants reported reduced anxiety with VR and a willingness to use it again. However, participants and researcher-clinicians alike identified potential challenges and areas for improvement. Conclusion. Participants reported positive experiences with VR and found it to be a meaningful distraction tool during BoNT injections. This supports its potential use as a client-centered, non-pharmacological intervention. Further research is needed to evaluate its effectiveness and implementation in clinical practice.