Virtual Reality Analgesia in Labor: The VRAIL Pilot Study—A Preliminary Randomized Controlled Trial Suggesting Benefit of Immersive Virtual Reality Analgesia in Unmedicated Laboring Women

Frey, D.P.; Bauer, Melissa E.; Bell, Colleen; Low, Lisa Kane; Hassett, Afton L.; Cassidy, Ruth; Boyer, Katherine D; Sharar, Sam R.

doi:10.1213/ane.0000000000003649

Cited by 102 publications

(64 citation statements)

References 14 publications

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“…One of the cornerstones of healthcare improvement, as formulated by the Institute of Healthcare Improvement, is with respect to the enhancement of patient experience 32 . In this regard, the findings of our pilot remain promising and in-line with other pregnancy-related studies which have demonstrated a high level of www.nature.com/scientificreports www.nature.com/scientificreports/ maternal satisfaction and acceptability for VR, with approval ratings between 77-82% 17,33 . This alludes to women being interested in and welcoming the addition of the technological medium into their pregnancy care.…”

Section: Discussionsupporting

confidence: 83%

A randomised controlled trial to assess the feasibility of utilising virtual reality to facilitate analgesia during external cephalic version

Smith

Warty

Kashyap

et al. 2020

Sci Rep

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external cephalic version (ecV) is associated with a moderate degree of pain. Virtual reality (VR) is a technology that has shown promise in offering procedural analgesia. We undertook a clinical pilot to assess the viability of VR to reduce pain during ECV. In an open randomised controlled trial (RCT), we randomised 50 women to either VR or standard care each (25 per group). Women receiving VR were administered VR content (Skylights) via a headset. Pre-and post-procedural measures of pain, anxiety, device experience and vital signs were measured. There were no significant differences between groups (VR/no VR) in pain scores (60.68 vs 49.76; p = 0.2), ECV success rates (80% vs 76%; p = 0.7) or anxiety levels. The women receiving VR had a significantly higher anticipation of pain pre-procedurally (70.0 vs 50.0; p = 0.03). 20 (80%) of the VR women indicated that they would use VR again and 22 (88%) indicated they would recommend it to a friend having ECV. There were no significant differences between groups for side effects encountered or changes in vital signs. We have shown that using VR during ecV is feasible and appears safe. our results inform the design of future Rcts. open Scientific RepoRtS | (2020) 10:3141 | https://doi.

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Section: Discussionsupporting

confidence: 83%

A randomised controlled trial to assess the feasibility of utilising virtual reality to facilitate analgesia during external cephalic version

Smith

Warty

Kashyap

et al. 2020

Sci Rep

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“…Another study found VR significantly reduced pain during multiple stages of episiotomy repairs (hymen repair ES=0.74, 95%CI: 0.43, 1.04 and skin repair ES=1.00, 95%CI: 0.65, 1.36) in women after having their first baby compared to repair with no VR 35. The third study found VR significantly reduced the worst pain experienced during labor contractions compared to no VR (ES = unable to calculate) 37. The fourth study found no significant change in either average or worst pain felt during a cystoscopy procedure with the addition of VR (ES = unable to calculate) 36.…”

Section: Resultsmentioning

confidence: 95%

“…The median Total Body Surface Area (TBSA) was 15% (range TBSA of 2–55%).BPAcutePEDro 7/10Low-cost ASUS F5SL Business Laptop and LOGIC PC ATTACK 3 joystick for input and a HMD (eMagin Z800 3D visor)Patients played “Walt Disney's Chicken Little” PC game with immersive visual feedback and ability to interact with the game via joystick.20 minutes each (VR plus meds or just meds)Same number of repetitions and same exercises performed in the same plane by the same Physical Therapist without VR. Medications provided for both groups as per standard care.No significant difference could be detected between the two sessions (p = 0.13; MD = 2.09; 95% CI: -0.67 to 4.85)Pain during treatment.unable to calculateunable to calculateunable to calculateunable to calculateFrey, 201837RCT, within subjects cross over design27Range: 19-38Eligible patients were otherwise healthy women at ≥32 weeks’ gestation giving birth for the first time and in the first stage of labor with an anticipated vaginal delivery. Subjects were recruited from Michigan Medicine's Von Voigtlander Women's Hospital.MPRPAcutePEDro 6/10Samsung Gear VR HMD powered by a Galaxy S7 phone.…”

Section: Resultsmentioning

confidence: 98%

“…Four studies evaluated the impact of VR on pain during various medical procedures (MPRP) 34–37. One study found VR significantly reduced pain during periodontist procedures compared to both a control (standard care) (ES=0.95, 95%CI: 0.64, 1.26) and watching a movie during the procedure (ES=0.44, 95%CI: 0.23, 0.65) 34.…”

Section: Resultsmentioning

confidence: 99%

“…Meta-analysis was not performed due to the heterogeneity of these patient populations and medical procedures. All four of these studies used a HMD for VR application and had a dosage of 10 minutes,37 11 minutes,35 20 minutes34 or the length of the procedure, which was not specified 36. Quality assessment scores for these studies were between 6–7 and 10 on the PEDro scale and 22 and 27 on the MD&B scale indicating high quality and low risk of bias.…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

<p>Virtual reality as an analgesic for acute and chronic pain in adults: a systematic review and meta-analysis</p>

Mallari

Spaeth

Goh

et al. 2019

JPR

274

181

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Background: Previous studies have shown that virtual reality (VR) is effective in reducing acute and chronic pain both in adults and in children. Given the emergence of new VR technology, and the growing body of research surrounding VR and pain management, an updated systematic review is warranted. Purpose: The purpose of this systematic review is to compare the effectiveness of VR in reducing acute and chronic pain in adults. Data Sources: A search was conducted in three databases (PubMed, CINAHL, Trip) using standardized search terms. Study Selection: Twenty experimental and quasi-experimental trials published between January 2007 and December 2018 were included based on prespecified inclusion and exclusion criteria. Pain intensity was the primary outcome. Data Extraction: We extracted data and appraised the quality of articles using either the PEDro or Modified Downs and Black risk of bias tools. Data Synthesis: The majority of studies supported the use of VR to reduce acute pain both during the procedure and immediately after. Numerous studies found VR reduced chronic pain during VR exposure but there is insufficient evidence to support lasting analgesia. There was considerable variability in patient population, pain condition and dosage of VR exposure. Limitations: Due to heterogeneity, we were unable to perform meta-analyses for all study populations and pain conditions. Conclusions: VR is an effective treatment for reducing acute pain. There is some research that suggests VR can reduce chronic pain during the intervention; however, more evidence is needed to conclude that VR is effective for lasting reductions in chronic pain.

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Addressing virtual reality misclassification: A hardware‐based qualification matrix for virtual reality technology

Takac

Collett

Conduit

et al. 2021

Clin Psychology and Psychoth

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Through its unique sensory synchronized design, virtual reality (VR) provides a convincing, user-centred experience of highly controllable scenarios. Importantly, VR is a promising modality for healthcare, where treatment efficacy has been recognized for a range of conditions. It is equally valuable across wider research disciplines. However, there is a lack of suitable criteria and consistent terminology with which to define VR technology. A considerable number of studies have misclassified VR hardware (e.g. defining laptops as VR), hindering validity and research comparisons. This review addresses these limitations and establishes a standardized VR qualification framework. As a result of a comprehensive theoretical and literature review, the hardware-based VR qualification matrix is proposed.The matrix criteria consist of (1) three-dimensional (3D) synchronized sensory stimulation; (2) degrees of freedom tracking; and (3) visual suppression of physical stimuli. To validate the model and quantify the current scale/diversity of VR misclassification, a 2019 sectional review of health-related studies was conducted.Of the 115 studies examined against standardized criteria, 35.7% utilized VR, 31.3% misclassified VR, 18.3% were considered quasi-VR, and 14.8% omitted critical specifications. The proposed model demonstrates good validity and reliability for qualifying and classifying VR.

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Virtual Reality Analgesia in Labor: The VRAIL Pilot Study—A Preliminary Randomized Controlled Trial Suggesting Benefit of Immersive Virtual Reality Analgesia in Unmedicated Laboring Women

Cited by 102 publications

References 14 publications

A randomised controlled trial to assess the feasibility of utilising virtual reality to facilitate analgesia during external cephalic version

A randomised controlled trial to assess the feasibility of utilising virtual reality to facilitate analgesia during external cephalic version

<p>Virtual reality as an analgesic for acute and chronic pain in adults: a systematic review and meta-analysis</p>

Addressing virtual reality misclassification: A hardware‐based qualification matrix for virtual reality technology

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