Effect of Virtual Reality-Based Interventions on Pain During Wound Care in Burn Patients; a Systematic Review and Meta-Analysis

Virtual Reality in Acute and Chronic Pain Medicine: An Updated Review

PURPOSE OF REVIEW

This review critically analyzes the recent literature on virtual reality's (VR) use in acute and chronic pain management, offering insights into its efficacy, applications, and limitations.

RECENT FINDINGS

Recent studies, including meta-analyses and randomized controlled trials, have demonstrated VR's effectiveness in reducing pain intensity in various acute pain scenarios, such as procedural/acute pain and in chronic pain conditions. The role of factors such as immersion and presence in enhancing VR's efficacy has been emphasized. Further benefits have been identified in the use of VR for assessment as well as symptom gathering through conversational avatars. However, studies are limited, and strong conclusions will require further investigation. VR is emerging as a promising non-pharmacological intervention in pain management for acute and chronic pain. However, its long-term efficacy, particularly in chronic pain management, remains an area requiring further research. Key findings highlight that VR programs vary in efficacy depending on the specificity of the origin of pain.

Prevalence of anxiety and its risk factors in burn patients: A systematic review and meta-analysis

The primary objective of this systematic review and meta-analysis was to ascertain the prevalence of anxiety and identify associated risk factors among individuals who have suffered burn injuries. We conducted a thorough and systematic search across various international electronic databases, including Scopus, PubMed and Web of Science, as well as Persian electronic databases like Iranmedex and the scientific information database (SID). Our search encompassed the period from the earliest available records up to 8 August 2023. We employed keywords derived from Medical Subject Headings (MeSH) such as "Prevalence", "Anxiety" and "Burns". In total, 2586 burn patients participated in 13 cross-sectional studies. The mean age of the participants was 32.88 (SD = 2.51). In a compilation of 13 studies, the documented overall occurrence rate of anxiety among burn patients stood at 16.1% (95% CI: 10.0% to 24.7%; I2  = 93.138%; p < 0.001). The outcomes of a meta-regression analysis, which examined the association between anxiety in burn patients and the year of publication, did not uncover any significant correlation (p = 0.442). Furthermore, there was a notable association between anxiety in burn patients and factors such as gender, TBSA affected, educational level and the types of burn injuries. Therefore, healthcare providers need to recognize the substantial prevalence of anxiety in burn patients as a fundamental consideration. This recognition should prompt a proactive approach toward early detection and timely intervention. Developing personalized intervention strategies tailored to each patient's unique risk factors and needs is paramount. These strategies may encompass a range of therapeutic options such as counselling, psychotherapy or consultations with mental health specialists.

Evaluating the role of Shujing Tongdu massage in enhancing wound recovery and alleviating spinal disease symptoms: A randomized controlled trial

A randomized, controlled clinical trial was conducted from 2022 to 2023 at a hospital specializing in Traditional Chinese Medicine in Shanghai. A total of 564 participants were allocated into control and intervention groups in order to determine the effectiveness of Shujing Tongdu massage on patients with chronic lesions or spinal disorders. No significant differences were observed in baseline characteristics between the groups; age, gender and condition type were all distributed in a comparable manner. Following the implementation of Shujing Tongdu massage therapy twice weekly for the duration of 12 weeks, intervention group exhibited noteworthy enhancements. Significantly, rate of lesion healing achieved in the intervention group increased by 30%, while it merely improved by 10% in the control group. The intervention group exhibited decrease in pain intensity from 6.5 to 4.2, whereas control group demonstrated comparatively smaller reduction from 6.7 to 6.0. Range of motion in the intervention group increased substantially from 45 to 60 degrees, whereas it increased from 44 to 46 degrees in the control group. In the intervention group, Quality of Life scores increased from 50 to 75, exceeding the increase of 58 in the control group. There was significant rise in the Mental Well-being Index for intervention group, from 60 to 80, in contrast to rise of 64 from 62 in the control group. Statistically significant outcomes were determined, establishing the massage therapy's efficacy. Mild discomfort and muscle soreness were the most frequent adverse effects in the intervention group, whereas vertigo was more prevalent in the control group. Based on the findings of this research, Shujing Tongdu massage therapy effectively promoted wound healing and mitigated symptoms associated with spinal disorders, indicating its potential as the supplementary therapeutic modality in clinical environments.

Muscimol as a treatment for nerve injury-related neuropathic pain: a systematic review and meta-analysis of preclinical studies

Background

: Muscimol's quick onset and GABAergic properties make it a promising candidate for the treatment of pain. This systematic review and meta-analysis of preclinical studies aimed at summarizing the evidence regarding the efficacy of muscimol administration in the amelioration of nerve injury-related neuropathic pain.

Methods

: Two independent researchers performed the screening process in Medline, Embase, Scopus and Web of Science extracting data were extracted into a checklist designed according to the PRISMA guideline. A standardized mean difference (SMD [95% confidence interval]) was calculated for each. To assess the heterogeneity between studies, I2 and chi-square tests were utilized. In the case of heterogeneity, meta-regression and subgroup analyses were performed to identify the potential source.

Results

: Twenty-two articles met the inclusion criteria. Pooled data analysis showed that the administration of muscimol during the peak effect causes a significant reduction in mechanical allodynia (SMD = 1.78 [1.45-2.11]; P < 0.0001; I2 = 72.70%), mechanical hyperalgesia (SMD = 1.62 [1.28-1.96]; P < 0.0001; I2 = 40.66%), and thermal hyperalgesia (SMD = 2.59 [1.79-3.39]; P < 0.0001; I2 = 80.33%). This significant amendment of pain was observed at a declining rate from 15 minutes to at least 180 minutes post-treatment in mechanical allodynia and mechanical hyperalgesia, and up to 30 minutes in thermal hyperalgesia (P < 0 .0001).

Conclusions

: Muscimol is effective in the amelioration of mechanical allodynia, mechanical hyperalgesia, and thermal hyperalgesia, exerting its analgesic effects 15 minutes after administration for up to at least 3 hours.