The efficacy of playing a virtual reality game in modulating pain for children with acute burn injuries: A randomized controlled trial [ISRCTN87413556]

Abstract

BackgroundThe management of burn injuries is reported as painful, distressing and a cause of anxiety in children and their parents. Child's and parents' pain and anxiety, often contributes to extended time required for burns management procedures, in particular the process of changing dressings. The traditional method of pharmacologic analgesia is often insufficient to cover the burnt child's pain, and it can have deleterious side effects [1,2]. Intervention with Virtual Reality (VR) games is based on distraction or interruption in the way current thoughts, including pain, are processed by the brain. Research on adults supports the hypothesis that virtual reality has a positive influence on burns pain modulation.MethodsThis study investigates whether playing a virtual reality game, decreases procedural pain in children aged 5–18 years with acute burn injuries. The paper reports on the findings of a pilot study, a randomised trial, in which seven children acted as their own controls though a series of 11 trials. Outcomes were pain measured using the self-report Faces Scale and findings of interviews with parent/carer and nurses.ResultsThe average pain scores (from the Faces Scale) for pharmacological analgesia only was, 4.1 (SD 2.9), while VR coupled with pharmacological analgesia, the average pain score was 1.3 (SD 1.8)ConclusionThe study provides strong evidence supporting VR based games in providing analgesia with minimal side effects and little impact on the physical hospital environment, as well as its reusability and versatility, suggesting another option in the management of children's acute pain.

Stress-induced analgesia

“…In addition, human studies with patients who were experiencing procedural dental/periodontal pain showed a marked reduction in their subjective pain ratings when placed in a virtual reality environment (Hoffman et al, 2001). There is also a study which shows that children which have suffered acute burn injuries have reduced pain levels when pharmacological management of pain is coupled with virtual reality game playing (Das et al, 2005). A recent study from our laboratory using a rat model utilised a novel arena or novel object as stimuli to distract attention away from formalin-induced pain (Ford et al, 2008).…”

A Novel Application of Virtual Reality for Pain Control: Virtual Reality-Mirror Visual Feedback Therapy

“…Hoffman et al first reported that VR could alleviate pain perception during painful burn care in adolescent patients [6]. The application of VR for pain control during burn care has been the most intensively studied application [7][8]. Other procedures to which VR has been applied include dental procedures [9] and intravenous placement [10].…”

Patient perspectives on virtual reality-based rehabilitation after knee surgery: Importance of level of difficulty

“…Because of such characteristics, many researchers have tried to use VR-based games as a rehabilitation tool for patients with neurological [3][4][5][6] and musculoskeletal [7] conditions and burn injuries [8][9][10]. Recently, the Nintendo Wii Fit Plus (NWFP) was evaluated as an adjunct to conventional physical therapy for outpatients following total knee replacement, and it showed similar effects as conventional physical therapy in improving lower-limb and balance outcomes [11].…”