The @tension system: a tool for protected graded exposure therapy of chronic pain
Function restoration is thought to be a most effective therapy for chronic pain, even for severe chronic pain (level 1 evidence). But the exposure to activities or stimuli that evoke pain needs to be very graded.
The patient might be a hero during training, and continue to practice despite severe pain. However, then there might be a severe aftereffect of pain and discomfort for hours, and at times for days, which will lead to lack of adherence to training.
The goal of the @tension system is one – to assist the patient not to be a hero during exercise. The purpose is to maintain graded practice within comfort range, to which the patient will adhere to and repeat consistently. With adherence the patient can achieve gradual function restoration.
The @tension system monitors the patient’s pain and stress on the one hand, and the patient’s attention level (which is usually not presented to avoid overload) on the other hand, both based on established easy-to-use real-time EEG markers.
Whenever the system identifies an increase in pain and stress, and at times also when it identifies a significant drop in the attention level, it suggests to stop the exercise and relax until the patient is ready to try again. This could be in a minute or two, later on during the day or on the next day. Gradual exposure is the key to progress.
The @tension system is not a polygraph. If the patient feels a significant increase in pain before the system identifies it, the exercise should be halted. There is no such problem as stopping too early. There is only a problem with stopping too late with too much pain and stress, which prevents from returning to practice once ready.
The process begins by identifying a target function the patient wants to regain. This could be:
Together with a therapist, the patient breaks down each target function into 3–5 graded levels—from their current ability to the end goal. For example:
The patient starts at level 1 and may stay there for several sessions. Once the patient maintains low pain and stress and demonstrates sustained attention for a set period (e.g., 2 minutes or more), the system recommends moving up a level. However, both the patient and therapist can override these suggestions based on clinical judgment. Setbacks are normal—what matters most is steady progress over time.
The session recordings are sent by the patient to the therapist, who assesses them offline and sends suggestions for better practice. It usually takes about 5-10 minutes of the therapist’s time to review a whole recording, and therefore much more practice could be obtained for each hour of therapist’s work.
If you wish to evaluate the applicability of the @tension system for gradual function restoration, please fill in the form below. Using @tension requires guidance by a trained therapist (e.g. an occupational therapist, or a physiotherapist). This could be your preferred therapist or a therapist from our recommended therapists list. As the therapist guidance is provided offline from afar, there is usually no need for frontal meeting sessions, unless you and the therapist feel otherwise.
If you’re interested in evaluating whether the @tension System is suitable for your recovery process, please fill out the form below. Guidance from a trained professional—such as an occupational or physical therapist—is required. You may work with your own therapist or select one from our recommended list.
Since guidance is provided remotely, in-person meetings are usually unnecessary unless otherwise preferred by you or your therapist.
Ready to take control of your focus? Leave your details and we’ll get you started with @tension
