Effect of Wii-habilitation on spatiotemporal parameters and upper limb function post-burn in children

Patient Experience in Adjunct Controller-Free Hand Tracking Virtual Reality Tasks for Upper-Limb Occupational Therapy Rehabilitation

Benefits of immersive virtual reality rehabilitation (VRR) include increased motivation and improved transfer of skills to real-world tasks. The introduction of Oculus hand-tracking technology allowed for the development of VRR games that do not need virtual reality (VR) hand controllers. This is beneficial as participants with upper limb impairments/injuries may have difficulties with/be limited in using/manipulating VR hand controllers. In this project, a VRR game was developed and evaluated. The aim of this study was to determine patient experience when using VRR as an adjunct to upper-limb rehabilitation. N  =  20 participants receiving upper limb rehabilitation completed a series of VRR tasks by playing the "smoothie bar" VRR game. After the completion of the VRR tasks, the participant experience was evaluated via a study-specific questionnaire. Key findings include 95% agreement that VRR tasks were fun and engaging and 75% agreed that VR tasks will be helpful to include in their rehabilitation. Hands-tracking VRR has a high potential to be used as an adjunct intervention in upper limb rehabilitation.

A Systematic Review of the Effectiveness of Virtual Reality-Based Interventions on Pain and Range of Joint Movement Associated with Burn Injuries

Background: Burns are mild or severe lesions produced in living tissue, due to the action of different agents. This pathology is considered the third cause of accidental death in the world by the World Health Organization. Among the most disabling sequelae in these patients, pain and range of motion have the greatest impact. A recommended tool to complement the treatment or management of the symptoms associated with burns is virtual reality. Objective: The objective of this study was to analyse the effectiveness of virtual-reality therapy for pain relief and the improvement of the range of joint movement in patients who have suffered burns. Methodology: This study is a systematic review conducted following the PRISMA statements. An electronic literature search was performed in the following databases: PubMed, Cochrane, Dialnet, Scopus and Science Direct. The inclusion criteria were: participants with burns in any part of the body, interventions with virtual reality with or without complementary treatment, studies in both Spanish and English, and outcome measures of pain and range of motion. Results: Finally, 10 studies were included in the review. The sample consisted of one pilot study, three randomized controlled clinical trials, one prospective randomized controlled clinical trial, one control group and treatment group trial, one interventional clinical trial and three comparative studies. The most commonly used assessment tools for pain were the graphic rating scale (GRS) and for range of motion the goniometer. The use of virtual-reality games significantly reduced pain scores during physiotherapy and occupational therapy treatments as well as in nursing care. The range of motion improved significantly during virtual-reality exercises performed during a physiotherapy treatment in 33% of studies included in this review. Conclusion: The results of the studies analysed in this systematic review suggest that the use of virtual reality for the management of pain and range of movement limitations associated with burn injuries could control these symptoms and decrease their negative consequences on the person.

Effect of precise partial scab removal on the repair of deep partial-thickness burn wounds in children: a retrospective study

BACKGROUND

The choice of treatment methods for children with deep partial-thickness burn wounds (DPBWs) is an issue that requires careful consideration from surgeons. The purpose of this study was to evaluate the efficacy of precise partial scab removal (PPSR) in the treatment of DPBWs in children.

METHODS

We retrospectively analyzed the clinical data of 78 children with DPBWs. The children were divided into a PPSR group (n=37) and a routine dressing change (RDC) group (n=41). In the PPSR group, an electric dermatome was used to cut the scab in the early post-injury period. The thickness scale of the electric dermatome was set to 0.1 mm. The scab was removed to the base with scattered bleeding points. There was still a small amount of necrotic tissue in the base of the wound. For the acellular dermal matrix, the first dressing change was about 1 week after surgery. The RDC group was given conventional wound-dressing treatment. The wound dressing was changed with epidermal growth factor, silver-zinc antibacterial cream, and dressing change. The frequency of dressing change was adjusted once a day or once every other day depending on the condition of wound secretions. The hospitalization time, wound-healing time, fever duration, antibiotic use time, number of subsequent operations, and overall hospitalization expenses were compared between the two groups.

RESULTS

The wound-healing time of the PPSR group was 19.86±6.4 days, and the wound-healing time of the RDC group was 24.15±7.12 days (P=0.0068). The duration of fever in the PPSR group and RDC group was 2.62±1.99 and 4.44±3.10 days, respectively (P=0.0032). The antibiotic use time in the PPSR group and RDC group was 4.0±1.33 and 4.83±1.88 days, respectively (P=0.0292). The overall hospitalization cost of the PPSR group and RDC group was yuan renminbi ¥37,852.84±10,894.64 and ¥38,047.46±19,450.37, respectively (P=0.9573).

CONCLUSIONS

PPSR can shorten wound-healing time, reduce the frequency of dressing changes, shorten the time of fever in children, lower the frequency of antibiotic use, and decrease number of dressing changes on the wound.