Examining the Feasibility of Early Mobilization With Virtual Reality Gaming Using Head-Mounted Display and Adaptive Software With Adolescents in the Pediatric Intensive Care Unit: Case Report

Lai, Byron; Powell, Maegen; Clement, Anne Grace; Davis, Drew; Swanson-Kimani, Erin; Hayes, Leslie

doi:10.2196/28210

Cited by 13 publications

(21 citation statements)

References 23 publications

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“…92% of parents reported that VR calmed their children, and 78% of participants felt that VR was calming. HRVi Minimum scores were significantly higher during VR Lai et al (2021, United States) * [ 58 ] 2 Case report 4 PICU patients Case 1:15 Case 2: 13 Case 1: 18 min (SD 11) per session, 4 sessions Case 2: 35 min (SD 7) per session, 2 sessions Between usual care, when tolerable and requested by the participant VR gaming sessions with active games (e.g., boxing, rhythmic movement to music, and exploratory adventure) and nonactive games (e.g., racing and narrative adventure) n/a The findings of this study suggest that VR gaming with HMDs and adaptive software is likely a feasible supplement to usual care for adolescents within the PICU, and these findings warrant further investigation. Recommendations for future studies aimed at incorporating VR gaming during early mobilization are presented herein Hemphill et al (2021, United States) [ 73 ] 1 Case report 4 Pediatric ICU patient n/a n/a During physical therapy sessions VR to encourage the child to engage in physical therapy sessions n/a Virtual reality encouraged the child to engage in physical therapy sessions, participate for greater durations, and directly address barriers to discharge Scapin et al (2017, Brazil) [ 84 ] 2 Case report 4 Pediatric burn patients 8, 9 15 min, 35 min, 25 min Dressing change during balneotherapy The child used VR to watch a game that simulated a roller coaster n/a The use of goggles was easy to apply and well-accepted by the children, and had a relevant effect reducing pain (pain face: case 1: 10/10 during a dressing change, 4 during VR use vs. case 2: 4 during dressing; 0 during use VR,) Kucher et al (2020, United States) * [ 56 ] 6 (6/0) Proof-of-concept study ...…”

Section: Resultsmentioning

confidence: 99%

Virtual and augmented reality in intensive care medicine: a systematic review

Kanschik,

Bruno,

Wolff

et al. 2023

Ann. Intensive Care

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Background Virtual reality (VR) and augmented reality (AR) are rapidly developing technologies that offer a wide range of applications and enable users to experience digitally rendered content in both physical and virtual space. Although the number of studies about the different use of VR and AR increases year by year, a systematic overview of the applications of these innovative technologies in intensive care medicine is lacking. The aim of this systematic review was to provide a detailed summary of how VR and AR are currently being used in various areas of intensive care medicine. Methods We systematically searched PubMed until 1st March 2023 to identify the currently existing evidence for different applications of VR and AR for both health care providers in the intensive care unit and children or adults, who were in an intensive care unit because of a critical illness. Results After screening the literature, a total of 59 studies were included. Of note, a substantial number of publications consists of case reports, study plans or are lacking a control group. Furthermore, study designs are seldom comparable. However, there have been a variety of use cases for VR and AR that researchers have explored. They can help intensive care unit (ICU) personnel train, plan, and perform difficult procedures such as cardiopulmonary resuscitation, vascular punctures, endotracheal intubation or percutaneous dilatational tracheostomy. Patients might benefit from VR during invasive interventions and ICU stay by alleviating stress or pain. Furthermore, it enables contact with relatives and can also assist patients in their rehabilitation programs. Conclusion Both, VR and AR, offer multiple possibilities to improve current care, both from the perspective of the healthcare professional and the patient. It can be assumed that VR and AR will develop further and their application in health care will increase. Graphic Abstract

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Section: Resultsmentioning

confidence: 99%

Virtual and augmented reality in intensive care medicine: a systematic review

Kanschik,

Bruno,

Wolff

et al. 2023

Ann. Intensive Care

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“…Increasing peak oxygen uptake values with AVGs could prevent the disease-associated loss of autonomy and allow the patient to live independently as a healthy individual. AVGs, through their repetitive and rapid movements, lead to PA of sufficient intensity to generate adaptations in pathological individuals, demonstrating the relevance of AVGs as a rehabilitation strategy [ 23 , 26 , 56 ].…”

Section: Discussionmentioning

confidence: 99%

Effects of Active Video Games in Patients With Cancer: Systematic Review

Peyrachon,

Rébillard

2023

JMIR Cancer

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Background Physical activity (PA) is now considered an adjuvant therapy in cancer treatment; nevertheless, multiple barriers could reduce PA engagement during treatment. Active video games (AVGs) lead to the achievement of mild- to moderate-intensity PA and represent a promising tool for regular movement and exercise. Objective This paper aims to review the current literature and provide updated content on the physiological and psychological effects of AVG-based interventions in patients with cancer undergoing treatment. Methods Four electronic databases were investigated. Studies reporting on AVG interventions delivered to patients undergoing treatment were included. A total of 21 articles (17 interventions) were identified for data extraction and quality assessment. Results A total of 362 patients with cancer participated in the studies (number of participants 3-70). The majority underwent treatment for breast, lung, prostate, hematologic, or oral or laryngeal cancer. The types and stages of cancer varied in all studies. Participants ranged in age from 3 to 93 years. Four studies included patients with pediatric cancer. The duration of interventions ranged from 2 to 16 weeks, with a minimum of 2 sessions per week and a maximum of 1 daily session. Sessions were supervised in 10 studies, and 7 included home-based interventions. AVG interventions improved endurance, quality of life, cancer-related fatigue, and self-efficacy. Effects were mixed on strength, physical function, and depression. AVGs did not affect activity level, body composition, or anxiety. Compared with standard physiotherapy, physiological effects were lower or similar, and psychological effects were higher or similar. Conclusions Overall, our results suggest that AVGs can be recommended to patients undergoing cancer treatment, given the physiological and psychological benefits. When AVGs are proposed, supervision of the sessions should be considered as it can limit dropouts. In the future, it is important to develop AVGs that combine endurance and muscle strengthening, with the possibility of achieving moderate to high exercise intensity, depending on the physical abilities of the patients, as indicated in the World Health Organization’s recommendations.

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“…Although VR has been used in a variety of clinical settings for symptoms management (eg, pain and anxiety) [ 36 , 37 ], to the best of our knowledge, this study was the first to test the Meta Quest 2 as a home-based method for web-based group socialization among adolescents with physical disabilities. The implementation of the intervention was successful.…”

Section: Discussionmentioning

confidence: 99%

Improving Social Isolation and Loneliness Among Adolescents With Physical Disabilities Through Group-Based Virtual Reality Gaming: Feasibility Pre-Post Trial Study

Lai,

Young,

Craig

et al. 2023

JMIR Form Res

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Background Adolescents with disabilities experience alarmingly higher rates of depression and isolation than peers without disabilities. There is a need to identify interventions that can improve mental health and isolation among this underserved population. Innovations in virtual reality (VR) gaming “standalone” headsets allow greater access to immersive high-quality digital experiences, due to their relatively low cost. Objective This study had three purposes, which were to (1) examine the preliminary effects of a low-cost, home-based VR multiplayer recreation and socialization on depression, socialization, and loneliness; (2) quantify the acceptability of the program as measured by participant adherence, total play time, and exercise time; and (3) identify and describe behavioral mechanisms that affected participant engagement. Methods This was a single-group, pre- to postdesign trial. The intervention was conducted at home. Participants were recruited from a children’s hospital. The intervention lasted 4 weeks and included 2×1-hour sessions per week of supervised peer-to-peer gaming. Participants used the Meta Quest 2 headset to meet peers and 2 coaches in a private party held digitally. Aim 1 was evaluated with the Children’s Depression Inventory 2 Short Form and the University of California, Los Angeles Loneliness Scale 20 items, which are measures of social isolation and loneliness, respectively. Aim 2 was evaluated through the following metrics: participant adherence, the types of games played, friendship building and playtime, and program satisfaction and enjoyment. Results In total, 12 people enrolled (mean age 16.6, SD 1.8 years; male: n=9 and female: n=3), and 8 people completed the program. Mean attendance for the 8 participants was 77% (49 sessions of 64 total possible sessions; mean 6, SD 2 sessions). A trend was observed for improved Children’s Depression Inventory 2 Short Form scores (mean preintervention score 7.25, SD 4.2; mean postintervention score 5.38, SD 4.1; P=.06; effect size=0.45, 95% CI –0.15 to 3.9), but this was not statistically significant; no difference was observed for University of California, Los Angeles Loneliness Scale 20 items scores. Most participants (7/8, 88%) stated that they became friends with a peer in class; 50% (4/8) reported that they played with other people. Participants reported high levels of enjoyment and satisfaction with how the program was implemented. Qualitative analysis resulted in 4 qualitative themes that explained behavioral mechanisms that determined engagement in the program. Conclusions The study findings demonstrated that a brief VR group program could be valuable for potentially improving mental health among adolescents with physical disabilities. Participants built friendships with peers and other players on the web, using low-cost consumer equipment that provided easy access and strong scale-up potential. Study findings identified factors that can be addressed to enhance the program within a larger clinical trial. Trial Registration ClinicalTrials.gov NCT05259462; https://clinicaltrials.gov/study/NCT05259462 International Registered Report Identifier (IRRID) RR2-10.2196/42651

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Examining the Feasibility of Early Mobilization With Virtual Reality Gaming Using Head-Mounted Display and Adaptive Software With Adolescents in the Pediatric Intensive Care Unit: Case Report

Cited by 13 publications

References 23 publications

Virtual and augmented reality in intensive care medicine: a systematic review

Virtual and augmented reality in intensive care medicine: a systematic review

Effects of Active Video Games in Patients With Cancer: Systematic Review

Improving Social Isolation and Loneliness Among Adolescents With Physical Disabilities Through Group-Based Virtual Reality Gaming: Feasibility Pre-Post Trial Study

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