Factors Influencing the Efficacy of Virtual Reality Distraction Analgesia During Postburn Physical Therapy: Preliminary Results from 3 Ongoing Studies
Presented in part to the American Burn Association, April 2006, Las Vegas, NV.
Abstract
Sharar SR, Carrougher GJ, Nakamura D, Hoffman HG, Blough DK, Patterson DR. Factors influencing the efficacy of virtual reality distraction analgesia during postburn physical therapy: preliminary results from 3 ongoing studies.
Objective
To assess the efficacy and side effects of immersive virtual reality (VR) distraction analgesia, as well as patient factors associated with VR analgesic efficacy in burn patients who require passive range-of-motion (ROM) physical therapy (PT).
Regional level I burn center in a university-affiliated urban hospital.
Participants
Patients (age range, 6−65y) who required passive ROM PT in sessions lasting 3 to 15 minutes after cutaneous burn injury.
Interventions
Standard analgesic (opioid and/or benzodiazepine) care and standard analgesic care plus immersive VR distraction.
Main Outcome Measure
Self-reported subjective pain ratings (0 to 100 graphic rating scale).
Results
A total of 146 treatment comparisons were made in 88 subjects, 75% of whom were children ages 6 to 18 years. Compared with standard analgesic treatment alone, the addition of VR distraction resulted in significant reductions in subjective pain ratings for worst pain intensity (20% reduction), pain unpleasantness (26% reduction), and time spent thinking about pain (37% reduction). Subjects’ age, sex, ethnicity, size of initial burn injury, or duration of therapy session did not affect the analgesic effects of VR distraction. Nausea with the standard care plus VR distraction condition was infrequent (15%) and mild, with 85% of the subjects reporting no nausea. Children provided higher subjective reports of “presence” in the virtual environment and “realness” of the virtual environment than did adults, but age did not affect the analgesic effects of VR distraction.
Conclusions
When added to standard analgesic therapy, VR distraction provides a clinically meaningful degree of pain relief to burn patients undergoing passive ROM PT. Multiple patient factors do not appear to affect the analgesic effect. Immersive VR distraction is a safe and effective nonpharmacologic technique with which to provide adjunctive analgesia to facilitate patient participation in rehabilitation activities.
aDepartment of Anesthesiology, University of Washington, Seattle, WA
bDepartment of Surgery, University of Washington, Seattle, WA
cDepartment of Human Interface Technology Laboratory, University of Washington, Seattle, WA
dDepartment of Pharmacy, University of Washington, Seattle, WA
eDepartment of Rehabilitation Medicine, University of Washington, Seattle, WA.
Correspondence to Sam R. Sharar, MD, Dept of Anesthesiology, Box 359724, Harborview Medical Center, 325 Ninth Ave, Seattle, WA 98104
Supported by the National Institutes of Health (grant nos. HD37683, HD40954, GM42725), the National Institute on Disability and Rehabilitation Research (grant no. H133A020103), the Paul G. Allen Family Foundation, the Scan Design by Inger & Jens Bruun Foundation, and the Gustavus and Louise Pfeiffer Research Foundation.
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.
ABSTRACT