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Tabacof L, Salazar SI, Breyman E, Nasr L, Dewill S, Aitken A, Canori A, Kypros M, Cortes M, Fry A, Wood J, Putrino D. Immersive virtual reality for chronic neuropathic pain after spinal cord injury: a pilot, randomized, controlled trial. Pain Rep 2024; 9:e1173. [PMID: 39391768 PMCID: PMC11463206 DOI: 10.1097/pr9.0000000000001173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 05/22/2024] [Accepted: 06/01/2024] [Indexed: 10/12/2024] Open
Abstract
Introduction Neuropathic pain (NP) poses significant challenges for individuals with spinal cord injury (SCI), often inadequately managed by current interventions. Immersive virtual reality (IVR) has emerged as a promising approach for pain modulation, yet robust evidence is lacking. Objectives This pilot study investigated the analgesic effects of different IVR environments (scenic, somatic) compared with a control environment, and explored psychomotor properties influencing pain attenuation. Methods Twenty-two participants with NP caused by SCI were randomized into 3 IVR environments: somatic (n = 8), scenic (n = 7), and control (n = 8), undergoing 3 weekly sessions over 4 weeks with baseline, postintervention, and one-month follow-ups. Results There was a significant interaction effect between VR environment and time point on Neuropathic Pain Symptom Inventory scores (F(4,37.0) = 2.80, P = 0.04). Scenic VR participants exhibited reduced scores postintervention and at follow-up, with no significant changes in somatic VR or control environments. Similar trends were observed in secondary measures, such as Neuropathic Pain Scale and pain numeric rating scale. Enjoyment and presence were associated with decreased pain-change scores (F(1, 252) = 4.68, P = 0.03 for enjoyment; F(1, 223.342) = 7.92, P = 0.005 for presence), although not significantly influenced by VR environment or time point. Conclusion Both environments showed reduced pain outcomes, underscoring the need for personalized IVR pain therapies and informing further technology development for NP management.
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Affiliation(s)
- Laura Tabacof
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sophia I. Salazar
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Erica Breyman
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Leila Nasr
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sophie Dewill
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Annie Aitken
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alexandra Canori
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Michael Kypros
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mar Cortes
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Adam Fry
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jamie Wood
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - David Putrino
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Suchak KK, Almario CV, Liran O, Chernoff R, Spiegel BR. The Role of Virtual Reality in the Management of Irritable Bowel Syndrome. Curr Gastroenterol Rep 2024; 26:294-303. [PMID: 39136889 PMCID: PMC11401788 DOI: 10.1007/s11894-024-00940-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2024] [Indexed: 09/15/2024]
Abstract
PURPOSE OF REVIEW Irritable bowel syndrome (IBS) is a disorder of gut-brain interaction that significantly impacts health-related quality of life (HRQOL). This article explores the potential role of virtual reality (VR)-based cognitive behavioral therapy (CBT) in treating patients with IBS. RECENT FINDINGS While CBT is a proven, skills-based therapy approach that modifies behaviors and alters dysfunctional thinking patterns to influence the gut-brain axis and improve IBS symptoms, it is rarely prescribed given a paucity of CBT-trained clinicians. We developed a novel VR program that delivers a standardized CBT program over an 8-week period to help patients manage their symptoms. In initial qualitative validation testing, patients expressed positive perceptions about using VR CBT for IBS. Home-based, standardized VR CBT has the potential to be an effective and scalable treatment option for patients with IBS. While initial studies have shown proof-of-concept definitive randomized controlled trials are needed to demonstrate the efficacy of self-administered VR CBT in IBS.
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Affiliation(s)
- Karisma K Suchak
- Division of Health Sciences Research, Department of Medicine, Cedars-Sinai Health System, Pacific Theatre Building 116 N. Robertson Blvd, Suite 800, Los Angeles, CA, 90048, USA.
- Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, CA, USA.
| | - Christopher V Almario
- Division of Health Sciences Research, Department of Medicine, Cedars-Sinai Health System, Pacific Theatre Building 116 N. Robertson Blvd, Suite 800, Los Angeles, CA, 90048, USA
- Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, CA, USA
- Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai, Los Angeles, CA, USA
| | - Omer Liran
- Division of Health Sciences Research, Department of Medicine, Cedars-Sinai Health System, Pacific Theatre Building 116 N. Robertson Blvd, Suite 800, Los Angeles, CA, 90048, USA
- Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, CA, USA
- Cedars-Sinai Department of Psychiatry and Behavioral Sciences, Los Angeles, CA, USA
| | - Robert Chernoff
- Cedars-Sinai Department of Psychiatry and Behavioral Sciences, Los Angeles, CA, USA
| | - Brennan R Spiegel
- Division of Health Sciences Research, Department of Medicine, Cedars-Sinai Health System, Pacific Theatre Building 116 N. Robertson Blvd, Suite 800, Los Angeles, CA, 90048, USA
- Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, CA, USA
- Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai, Los Angeles, CA, USA
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Steinkraus KC, Feldmann H, Hunold LS, Graf S, Dörr-Harim C, Nasir N, Michalski CW, Hüttner FJ. Impact of virtual reality hypnosedation on perioperative pain and anxiety in port implantation under local anesthesia: a randomized controlled pilot trial (VIP Trial). Perioper Med (Lond) 2024; 13:101. [PMID: 39390587 PMCID: PMC11465779 DOI: 10.1186/s13741-024-00454-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Accepted: 09/26/2024] [Indexed: 10/12/2024] Open
Abstract
BACKGROUND This monocentric randomized controlled pilot trial investigates the impact of virtual reality (VR) hypnosedation on perioperative anxiety, pain, patient satisfaction, and medication usage during port implantation under local anesthesia. METHODS A total of 120 patients undergoing elective port implantation between January 2022 and August 2023 were enrolled and randomized in a 1:1 ratio to either a VR hypnosedation group or a control group. The VR group used a commercially available VR headset with the HypnoVR application, providing various environments, musical backgrounds, and a guiding voice, while the control group underwent the procedure without VR. Patients with ASA > 3, chronic pain, cognitive issues, and contraindications against VR use were excluded. The main outcomes measured were perioperative pain and anxiety scores, with secondary outcomes including perioperative medication usage. Due to the nature of the interventions, blinding of patients and physicians was not feasible. Statistical analysis was primarily descriptive and exploratory, focusing on estimating effect sizes for future trials. RESULTS The study found no significant differences in immediate postoperative pain with 1.43 ± 1.63 vs. 1.6 ± 2.05 (p = 0.62) or anxiety scores 30.65 ± 9.13 vs. 31.78 ± 13.34 (p = 0.60) between the no VR and VR group, respectively. Additionally, there was a trend to less usage of certain medications, particularly remifentanil (mean dose of 200 mg vs. 100 mg (p = 0.12)) and novaminsulfon (mean dose of 1250 mg vs. 900 mg (p = 0.26)) in the VR group vs. no VR group, respectively. However, these differences were not statistically significant and therefore no definitive conclusions can be drawn regarding medication usage based on this data. CONCLUSION While VR hypnosedation did not significantly reduce perioperative pain or anxiety in this pilot trial, the observed trends in reduced medication usage suggest potential benefits. These findings warrant further investigation in larger, confirmatory trials to better understand the role of VR in enhancing patient comfort and potentially reducing reliance on pharmacological interventions during surgical procedures. TRIAL REGISTRATION German Clinical Trials Register: DRKS00028508; registration date 15 March 2022; Universal Trial Number: U1111-1275-4995.
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Affiliation(s)
- Kira C Steinkraus
- Department of General and Visceral Surgery, Ulm University Hospital, Ulm, Germany
- Clinical Trial Centre, Department of Surgery ulmCARES, Ulm University Hospital, Ulm, Germany
| | - Hannah Feldmann
- Department of General and Visceral Surgery, Ulm University Hospital, Ulm, Germany
| | - Lisa S Hunold
- Department of General and Visceral Surgery, Ulm University Hospital, Ulm, Germany
- Present address: Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Sandra Graf
- Department of General and Visceral Surgery, Ulm University Hospital, Ulm, Germany
- Present address: Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Colette Dörr-Harim
- Clinical Trial Centre, Department of Surgery ulmCARES, Ulm University Hospital, Ulm, Germany
- Present address: Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Nadir Nasir
- Department of General and Visceral Surgery, Ulm University Hospital, Ulm, Germany
- Clinical Trial Centre, Department of Surgery ulmCARES, Ulm University Hospital, Ulm, Germany
| | - Christoph W Michalski
- Department of General and Visceral Surgery, Ulm University Hospital, Ulm, Germany
- Present address: Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Felix J Hüttner
- Department of General and Visceral Surgery, Ulm University Hospital, Ulm, Germany.
- Present address: Department of General, Visceral and Thoracic Surgery, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany.
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Toraman RL, Eskici Ilgin V. Effect of Virtual Reality Glasses Application on Pain, Anxiety, and Patient Satisfaction During a Transrectal Prostate Biopsy: A Randomized Controlled Trial. Biol Res Nurs 2024; 26:485-497. [PMID: 38418943 DOI: 10.1177/10998004241236154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
BACKGROUND This study aims to determine the effect of virtual reality glasses application on pain, anxiety, and patient satisfaction during a transrectal prostate biopsy. MATERIALS AND METHODS The study was conducted with pre-tests, post-tests, and a control group, using a randomized controlled experimental research design. A total of 70 patients (35 in the intervention group and 35 in the control group) were included in the study. The intervention group watched a video with virtual reality glasses during the biopsy process. A Descriptive Information Form, State-Trait Anxiety Inventory (STAI-I, STAI-II), Scale of Patient Perception of Hospital Experience with Nursing Care (PPHEN), and Visual Analog Scale for Pain (VAS) were used for data collection. To evaluate the data, numbers, percentages, mean, standard deviation, chi-square, paired sample t test, independent samples t test, regression analysis, and Cronbach's alpha Reliability Coefficient were used. RESULTS There was no significant difference between the groups in terms of descriptive and clinical characteristics (p > .05). The mean VAS and STAI post-test scores of the patients in the intervention group were lower than the control group, and the difference between them was statistically significant (p < .05). The mean PPHEN post-test scores of the patients in the intervention group were significantly higher than those in the control group (p < .05). CONCLUSION The application of virtual reality glasses during a transrectal prostate biopsy significantly reduced the level of pain and anxiety and increased patient satisfaction.
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Affiliation(s)
- Rumeysa Lale Toraman
- Department of Surgical Diseases Nursing, Faculty of Health Sciences, Ardahan University, Ardahan, Turkey
| | - Vesile Eskici Ilgin
- Department of Surgical Diseases Nursing, Faculty of Nursing, Atatürk University, Erzurum, Turkey
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Louras M, Vanhaudenhuyse A, Panda R, Rousseaux F, Carella M, Gosseries O, Bonhomme V, Faymonville ME, Bicego A. Virtual Reality Combined with Mind-Body Therapies for the Management of Pain: A Scoping Review. Int J Clin Exp Hypn 2024; 72:435-471. [PMID: 39347979 DOI: 10.1080/00207144.2024.2391365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 03/22/2024] [Accepted: 04/04/2024] [Indexed: 10/01/2024]
Abstract
When used separately, virtual reality (VR) and mind-body therapies (MBTs) have the potential to reduce pain across various acute and chronic conditions. While their combination is increasingly used, no study offers a consolidated presentation of VR and MBTs. This study aims to propose an overview of the effectiveness of VR combined with MBTs (i.e., meditation, mindfulness, relaxation, and hypnosis) to decrease the pain experienced by healthy volunteers or patients. We conducted a scoping review of the literature using PubMed, Science Direct and Google Scholar and included 43 studies. Findings across studies support that VR combined with MBTs is a feasible, well-tolerated, and potentially useful to reduce pain. Their combination also had a positive effect on anxiety, mood, and relaxation. However, insufficient research on this VR/MBTs combination and the lack of multidimensional studies impede a comprehensive understanding of their full potential. More randomized controlled studies are thus needed, with usability evaluation protocols to better understand the effects of VR/MBTs on patients wellbeing and to incorporate them into routine clinical practice.
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Affiliation(s)
- Mélanie Louras
- Sensation and Perception Research Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium
| | - Audrey Vanhaudenhuyse
- Sensation and Perception Research Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- Interdisciplinary Algology Center, University Hospital of Liège, Liège, Belgium
| | - Rajanikant Panda
- Sensation and Perception Research Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium
- Coma Neuroscience Lab, Department of Neurology, University of California San Francisco, San Francisco, USA
| | - Floriane Rousseaux
- Sensation and Perception Research Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- Medical Hypnosis Laboratory, MaisonNeuve-Rosemont Hospital Research Center, University of Montreal, Montreal, Québec, Canada
| | - Michele Carella
- Inflammation and Enhanced Rehabilitation Laboratory (Regional Anaesthesia and Analgesia), GIGA-I3 Thematic Unit, GIGA-Research, Liege University, Liege, Belgium
- Department of Anesthesia and Intensive Care Medicine, Liege University Hospital, Liege, Belgium
| | - Olivia Gosseries
- Sensation and Perception Research Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau2, Liege University Hospital, Liege, Belgium
| | - Vincent Bonhomme
- Inflammation and Enhanced Rehabilitation Laboratory (Regional Anaesthesia and Analgesia), GIGA-I3 Thematic Unit, GIGA-Research, Liege University, Liege, Belgium
- Department of Anesthesia and Intensive Care Medicine, Liege University Hospital, Liege, Belgium
| | - Marie-Elisabeth Faymonville
- Sensation and Perception Research Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- Oncology Integrated Arsene Bury Center, University Hospital of Liège, Liège, Belgium
| | - Aminata Bicego
- Sensation and Perception Research Group, GIGA-Consciousness, University of Liège, Liège, Belgium
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Brown T, Dee A, McCullough M, Santos P, Kulber D. Analgesic Use of Virtual Reality for Burn Dressing Changes in Low- and Middle-income Countries: A Feasibility Study. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2024; 12:e6226. [PMID: 39399809 PMCID: PMC11469908 DOI: 10.1097/gox.0000000000006226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Accepted: 08/27/2024] [Indexed: 10/15/2024]
Abstract
Background The paucity of pain management options in resource-limited settings is a significant and systemically unaddressed problem. To improve global health equity, it is important to bridge this gap in care without introducing the peril of opioid dependence. We present a proof-of-concept case series wherein virtual reality (VR) was successfully used to manage discomfort in patients undergoing burn dressing changes in sub-Saharan Africa. Methods Nine patients presenting with burn injuries of variable severity underwent routine stabilization and dressing as part of standard-of-care treatment. During dressing changes, a VR intervention consisting of the Dream Flight interactive game displayed on an Oculus Quest 2 headset was offered to patients. Patient mood scores were collected before VR initiation and at the conclusion of the dressing change by a translator using the Youth Feelings Scale. Results There were no adverse events associated with use of the VR headset and no patients elected to terminate the VR during their procedure. Patients and physicians subjectively reported satisfaction with the device's utility in the procedure. Before VR initiation, the 95% confidence interval for patient mood score was 4.89 ± 1.725. After VR initiation, the 95% confidence interval for patient mood score was 8.78 ± 1.40. Conclusions Our results of this proof-of-concept case series to suggest both feasibility of use and positive influence on patient discomfort and periprocedural satisfaction. We propose that VR should be explored as an analgesic alternative and/or adjunct to narcotics in resource-limited countries, particularly for high-pain, low-duration procedures.
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Affiliation(s)
- Theodore Brown
- From the Department of Orthopaedic Surgery, Cedars Sinai Medical Center, Los Angeles, Calif
| | - Alli Dee
- Ohana One, International Surgical Aid and Education, Los Angeles, Calif
| | - Meghan McCullough
- From the Department of Orthopaedic Surgery, Cedars Sinai Medical Center, Los Angeles, Calif
| | - Pedro Santos
- Ohana One, International Aid and Education, Maputo, Mozambique
| | - David Kulber
- From the Department of Orthopaedic Surgery, Cedars Sinai Medical Center, Los Angeles, Calif
- Division of Plastic and Reconstructive Surgery, University of Southern California, Los Angeles, Calif
- Division of Plastic Surgery, Cedars Sinai Medical Center, Los Angeles, Calif
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Sharma A, Sharma N, Chahal A. Impact of Virtual Reality on Pain, ROM, Muscle Strength and Quality of Life among Breast Cancer Patients: An Integrative Review of Literature. Pain Manag Nurs 2024; 25:538-548. [PMID: 38719655 DOI: 10.1016/j.pmn.2024.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 03/26/2024] [Accepted: 04/07/2024] [Indexed: 09/11/2024]
Abstract
BACKGROUND Breast cancer is the most commonly diagnosed cancer among women globally, with significant impacts on physical, emotional, and functional well-being. Traditional rehabilitation methods may not fully address the multifaceted challenges faced by breast cancer survivors (BCSs), prompting exploration into innovative approaches such as Virtual Reality (VR) technology. OBJECTIVE The present review aims to assess the effectiveness of VR in alleviating pain, improving Range of Motion (ROM), enhancing muscle strength, and augmenting the overall quality of life in patients undergoing breast cancer rehabilitation. METHODS A comprehensive review of existing literature was conducted, focusing on studies investigating the use of VR in breast cancer rehabilitation. PubMed, Scopus, PEDro and Google scholar were searched for articles addressing VR interventions targeting pain management, ROM improvement, muscle strength enhancement, and quality of life enhancement in breast cancer patients. RESULTS Findings yielded total 12 articles matching the selection criteria. VR technology has shown promising results in addressing the multifaceted needs of breast cancer patients. VR also serves as a distraction tool, positively impacting psychological well-being and mitigating negative psychological symptoms associated with the disease. CONCLUSION VR represents a non-pharmacological approach to pain management and rehabilitation in breast cancer patients. Its ability to engage emotional, cognitive, and attention processes contributes to its effectiveness in enhancing overall quality of life. Further research is warranted to elucidate the long-term benefits and optimal utilization of VR technology in breast cancer rehabilitation programs.
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Affiliation(s)
- Abhishek Sharma
- Department of Physiotherapy, Arogyam Institute of Paramedical and Allied Sciences (Affiliated to H.N.B. Uttarakhand Medical Education University) Roorkee, Uttarakhand, India.
| | - Nidhi Sharma
- Department of Health Science, Uttaranchal College of Health Sciences, Uttaranchal University, Dehradun, Uttarakhand, India
| | - Aksh Chahal
- Department of Physiotherapy, School of Allied Health Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India
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Checcucci E, Veccia A, Puliatti S, De Backer P, Piazza P, Kowalewski KF, Rodler S, Taratkin M, Belenchon IR, Baekelandt L, De Cillis S, Piana A, Eissa A, Rivas JG, Cacciamani G, Porpiglia F. Metaverse in surgery - origins and future potential. Nat Rev Urol 2024:10.1038/s41585-024-00941-4. [PMID: 39349948 DOI: 10.1038/s41585-024-00941-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2024] [Indexed: 10/25/2024]
Abstract
The metaverse refers to a collective virtual space that combines physical and digital realities to create immersive, interactive environments. This space is powered by technologies such as augmented reality (AR), virtual reality (VR), artificial intelligence (AI) and blockchain. In healthcare, the metaverse can offer many applications. Specifically in surgery, potential uses of the metaverse include the possibility of conducting immersive surgical training in a VR or AR setting, and enhancing surgical planning through the adoption of three-dimensional virtual models and simulated procedures. At the intraoperative level, AR-guided surgery can assist the surgeon in real time to increase surgical precision in tumour identification and selective management of vessels. In post-operative care, potential uses of the metaverse include recovery monitoring and patient education. In urology, AR and VR have been widely explored in the past decade, mainly for surgical navigation in prostate and kidney cancer surgery, whereas only anecdotal metaverse experiences have been reported to date, specifically in partial nephrectomy. In the future, further integration of AI will improve the metaverse experience, potentially increasing the possibility of carrying out surgical navigation, data collection and virtual trials within the metaverse. However, challenges concerning data security and regulatory compliance must be addressed before the metaverse can be used to improve patient care.
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Affiliation(s)
- Enrico Checcucci
- Department of Surgery, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Turin, Italy.
| | - Alessandro Veccia
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Borgo Trento Hospital, Verona, Italy
| | - Stefano Puliatti
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - Pieter De Backer
- Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Pietro Piazza
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Karl-Friedrich Kowalewski
- Department of Urology, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany
| | - Severin Rodler
- Department of Urology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Mark Taratkin
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Ines Rivero Belenchon
- Urology and Nephrology Department, Virgen del Rocío University Hospital, Manuel Siurot s/n, Seville, Spain
| | - Loic Baekelandt
- University Hospitals Leuven, Department of Urology, Leuven, Belgium
| | - Sabrina De Cillis
- Department of Oncology, Division of Urology, University of Turin, San Luigi Gonzaga Hospital, Turin, Italy
| | - Alberto Piana
- Department of Oncology, Division of Urology, University of Turin, San Luigi Gonzaga Hospital, Turin, Italy
| | - Ahmed Eissa
- Urology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Juan Gomez Rivas
- Department of Urology, Hospital Clinico San Carlos, Madrid, Spain
| | - Giovanni Cacciamani
- USC Institute of Urology, University of Southern California, Los Angeles, CA, USA
| | - Francesco Porpiglia
- Department of Oncology, Division of Urology, University of Turin, San Luigi Gonzaga Hospital, Turin, Italy
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Morone G, Papaioannou F, Alberti A, Ciancarelli I, Bonanno M, Calabrò RS. Efficacy of Sensor-Based Training Using Exergaming or Virtual Reality in Patients with Chronic Low Back Pain: A Systematic Review. SENSORS (BASEL, SWITZERLAND) 2024; 24:6269. [PMID: 39409307 PMCID: PMC11479095 DOI: 10.3390/s24196269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2024] [Revised: 09/19/2024] [Accepted: 09/26/2024] [Indexed: 10/20/2024]
Abstract
In its chronic and non-specific form, low back pain is experienced by a large percentage of the population; its persistence impacts the quality of life and increases costs to the health care system. In recent years, the scientific literature highlights how treatment based on assessment and functional recovery is effective through IMU technology with biofeedback or exergaming as part of the tools available to assist the evaluation and treatment of these patients, who present not only with symptoms affecting the lumbar spine but often also incorrect postural attitudes. Aim: Evaluate the impact of technology, based on inertial sensors with biofeedback or exergaming, in patients with chronic non-specific low back pain. A systematic review of clinical studies obtained from PubMed, Scopus, Science Direct, and Web of Science databases from 1 January 2016 to 1 July 2024 was conducted, developing the search string based on keywords and combinations of terms with Boolean AND/OR operators; on the retrieved articles were applied inclusion and exclusion criteria. The procedure of publication selection will be represented with the PRISMA diagram, the risk of bias through the RoB scale 2, and methodological validity with the PEDro scale. Eleven articles were included, all RCTs, and most of the publications use technology with exergaming within about 1-2 months. Of the outcomes measured, improvements were reported in pain, disability, and increased function; the neuropsychological sphere related to experiencing the pathology underwent improvements. From the results obtained, the efficacy of using technology based on exergames and inertial sensors, in patients with chronic non-specific low back pain, was increased. Further clinical studies are required to achieve more uniformity in the proposed treatment to create a common guideline for health care providers.
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Affiliation(s)
- Giovanni Morone
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (G.M.); (I.C.)
- San Raffaele Institute of Sulmona, 67039 Sulmona, Italy
| | - Foivos Papaioannou
- Euleria Health srl Società Benefit, Via delle Zigherane, 4/A, 38068 Rovereto, Italy; (F.P.); (A.A.)
| | - Alberto Alberti
- Euleria Health srl Società Benefit, Via delle Zigherane, 4/A, 38068 Rovereto, Italy; (F.P.); (A.A.)
| | - Irene Ciancarelli
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (G.M.); (I.C.)
| | - Mirjam Bonanno
- IRCCS Centro Neurolesi “Bonino-Pulejo”, Cda Casazza, S.S. 113, 98124 Messina, Italy;
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Orgil Z, Karthic A, Bell NF, Heisterberg LM, Williams SE, Ding L, Kashikar-Zuck S, King CD, Olbrecht VA. Use of Biofeedback-Based Virtual Reality in Pediatric Perioperative and Postoperative Settings: Observational Study. JMIR Perioper Med 2024; 7:e48959. [PMID: 38742940 PMCID: PMC11444093 DOI: 10.2196/48959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 02/08/2024] [Accepted: 04/01/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Biofeedback-based virtual reality (VR-BF) is a novel, nonpharmacologic method for teaching patients how to control their breathing, which in turn increases heart rate variability (HRV) and may reduce pain. Unlike traditional forms of biofeedback, VR-BF is delivered through a gamified virtual reality environment, increasing the accessibility of biofeedback. This is the first study to systematically integrate VR-BF use in the pediatric perioperative setting, with the ultimate goal of evaluating the efficacy of VR-BF to reduce pain, anxiety, and opioid consumption once feasibility and acceptability have been established. OBJECTIVES The primary objective was to develop a clinical trial protocol for VR-BF use in the pediatric perioperative setting, including preoperative education and training, and postoperative application of VR-BF in children undergoing surgery. A secondary objective was to evaluate the patient and parent experience with VR-BF. METHODS A total of 23 patients (12-18 years of age) scheduled for surgery at Nationwide Children's Hospital were recruited using purposive sampling. Following training, participants independently completed a daily, 10-minute VR-BF session for 7 days before surgery and during their inpatient stay. Participants could use VR-BF up to 2 weeks after hospital discharge. Patient- and session-level data of VR-BF usage and achievement of target HRV parameters were measured to identify the optimal frequency and duration of sessions before and after surgery for this population. Standardized questionnaires and semistructured interviews were conducted to obtain qualitative information about patients' experiences with VR-BF. RESULTS Patient-level data indicated that the highest odds of achieving 1 session under target HRV parameters was after 4 sessions (odds ratio [OR] 5.1 for 4 vs 3 sessions, 95% CI 1.3-20.6; OR 16.6 for 3 vs 2 sessions, 95% CI 1.2-217.0). Session-level data showed that a session duration of 9 to 10 minutes provided the greatest odds of achieving 1 session under target HRV parameters (OR 1.3 for 9 vs 8 min, 95% CI 1.1-1.7; OR 1.4 for 8 vs 7 min, 95% CI 1.1-1.8; OR 1 for 10 vs 9 min, 95% CI 0.9-1.2). Qualitative data revealed patient satisfaction with the VR-BF technology, particularly in managing perioperative stress (17/20, 85%). Few patients reported VR-BF as beneficial for pain (8/20, 40%). CONCLUSIONS Children and adolescents undergoing surgery successfully learned behavioral strategies with VR-BF with 10-minute sessions once daily for 5 days. To integrate VR-BF as a therapeutic intervention in a subsequent clinical trial, patients will be instructed to complete three 10-minute sessions a day for 7 days after surgery. TRIAL REGISTRATION ClinicalTrials NCT04943874; https://clinicaltrials.gov/ct2/show/NCT04943874.
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Affiliation(s)
- Zandantsetseg Orgil
- Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, United States
| | - Anitra Karthic
- Department of Anesthesiology, The Ohio State University College of Medicine, Columbus, OH, United States
- Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, OH, United States
| | - Nora F Bell
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Lisa M Heisterberg
- Department of Anesthesiology, The Ohio State University College of Medicine, Columbus, OH, United States
| | - Sara E Williams
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Lili Ding
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Susmita Kashikar-Zuck
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
- Pediatric Pain Research Center, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Christopher D King
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
- Pediatric Pain Research Center, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Vanessa A Olbrecht
- Department of Anesthesiology and Perioperative Medicine, Nemours Children's Health, Delaware Valley, Wilmington, DE, United States
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11
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Tamasauskas A, Silva-Passadouro B, Fallon N, Frank B, Laurinaviciute S, Keller S, Marshall A. Management of Central Post-Stroke Pain: Systematic Review and Meta-Analysis. THE JOURNAL OF PAIN 2024:104666. [PMID: 39260808 DOI: 10.1016/j.jpain.2024.104666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 08/30/2024] [Accepted: 08/31/2024] [Indexed: 09/13/2024]
Abstract
Central post stroke pain (CPSP) is a neuropathic pain condition prevalent in 8% to 35% of stroke patients. This systematic review and meta-analysis aimed to provide insight in the effectiveness of available pharmacological, physical, psychological, and neuromodulation intervention in reducing pain in CPSP patients (PROSPERO Registration: CRD42022371835). Secondary outcomes included mood, sleep, global impression of change, and physical responses. Data extraction included participant demographics, stroke aetiology, pain characteristics, pain reduction scores, and secondary outcome metrics. Forty two original studies were included with a total of 1451 participants. No studies providing psychological therapy to CPSP patients were identified. Twelve studies met requirements for a random-effects meta-analyses that found: pharmacological therapy to have a small effect on mean pain score (SMD = -0.36, 96.0% Confidence Interval [-0.68, -0.03], physical interventions did not show a significant effect (SMD = -0.55, [-1.28, 0.18]), and neuromodulation treatments had a moderate effect (SMD -0.64, [-1.08, -0.19]). Fourteen studies were included in proportional meta-analysis with pharmacological studies having a moderate effect (58.3% mean pain reduction, [-36.51, -80.15]), and neuromodulation studies a small effect (31.1% mean pain reduction, [-43.45, -18.76]). Sixteen studies were included in the narrative review, findings from which largely supported meta-analyses results. Duloxetine, Amitriptyline and repetitive Transcranial Magnetic Stimulation (rTMS) had the most robust evidence for their effectiveness in alleviating CPSP induced pain. Further multi-centre placebo-controlled research is needed to ascertain the effectiveness of physical therapies, such as acupuncture and virtual reality, and invasive and non-invasive neuromodulation treatments. PERSPECTIVE: This article presents a top-down and bottom-up overview of evidence for the effectiveness of different pharmacological, physical, and neuromodulation treatments of CPSP. This review could provide clinicians with a comprehensive understanding of the effectiveness and tolerability of different treatment types.
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12
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Matthie N, Jenerette C. Knowledge and Experience of In-home Virtual Reality for Chronic Pain in Sickle Cell Disease. THE JOURNAL OF PAIN 2024:104668. [PMID: 39243922 DOI: 10.1016/j.jpain.2024.104668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 08/27/2024] [Accepted: 08/31/2024] [Indexed: 09/09/2024]
Abstract
Many adults with sickle cell disease experience chronic, non-vaso-occlusive pain that can benefit from non-pharmacological interventions available for use in the home setting. Virtual reality has been shown to be effective in decreasing pain in chronic pain conditions and may be useful for home-based self-management of chronic pain in sickle cell. However, the literature lacks studies examining this potential. Additionally, the knowledge and experiences of adults with sickle cell who have tried virtual reality for home-based chronic pain management have not yet been reported. This qualitative, descriptive pilot study explored the knowledge and perceptions of virtual reality among adults with sickle cell and their experience with using in-home virtual reality for chronic pain. Nine participants completed demographic questionnaires and an individual interview that was recorded, transcribed verbatim, and analyzed using thematic analysis. Participants were 21 to 38 years of age, and most were female (88.9%) with a medium or high sickle cell disease severity (88.9%) and a chronic pain grade classification of Grade III (high disability-moderately limiting) or Grade IV (high disability-severely limiting) (55.5%). Interview themes, which aligned with the Technology Acceptance Model, were: (1) pain beliefs and self-management; (2) virtual reality as another world; and (3) experience of using in-home virtual reality. Based on preliminary data, virtual reality shows promise as a strategy for non-pharmacological management of chronic pain in adults with sickle cell. However, further investigations are warranted to mitigate the challenges and limitations associated with using virtual reality in this capacity. PERSPECTIVE: Few evidence-based, non-pharmacological interventions exist for chronic pain in adults with sickle cell disease (SCD). This first qualitative, pilot study of in-home VR for chronic pain in adults with SCD suggests that VR interventions need further exploration as a non-pharmacological strategy for mitigating their pain in the home setting.
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Affiliation(s)
- Nadine Matthie
- Emory University, Nell Hodgson Woodruff School of Nursing, 1520 Clifton Road NE, Atlanta, GA 30322, USA.
| | - Coretta Jenerette
- Thelma Shobe Endowed Chair and Professor; University of California San Francisco, School of Nursing, Community Health Systems, Box 0608, 490 Illinois Street, Floor 9, San Francisco, CA 94143, USA.
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13
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Lendaro E, Van der Sluis CK, Hermansson L, Bunketorp-Käll L, Burger H, Keesom E, Widehammar C, Munoz-Novoa M, McGuire BE, O'Reilly P, Earley EJ, Iqbal S, Kristoffersen MB, Stockselius A, Gudmundson L, Hill W, Diers M, Turner KL, Weiss T, Ortiz-Catalan M. Extended reality used in the treatment of phantom limb pain: a multicenter, double-blind, randomized controlled trial. Pain 2024:00006396-990000000-00699. [PMID: 39250328 DOI: 10.1097/j.pain.0000000000003384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 07/22/2024] [Indexed: 09/11/2024]
Abstract
ABSTRACT Phantom limb pain (PLP) represents a significant challenge after amputation. This study investigated the use of phantom motor execution (PME) and phantom motor imagery (PMI) facilitated by extended reality (XR) for the treatment of PLP. Both treatments used XR, but PME involved overt execution of phantom movements, relying on the decoding of motor intent using machine learning to enable real-time control in XR. In contrast, PMI involved mental rehearsal of phantom movements guided by XR. The study hypothesized that PME would be superior to PMI. A multicenter, double-blind, randomized controlled trial was conducted in 9 outpatient clinics across 7 countries. Eighty-one participants with PLP were randomly assigned to PME or PMI training. The primary outcome was the change in PLP, measured by the Pain Rating Index, from baseline to treatment cessation. Secondary outcomes included various aspects related to PLP, such as the rate of clinically meaningful reduction in pain (CMRP; >50% pain decrease). No evidence was found for superiority of overt execution (PME) over imagery (PMI) using XR. PLP decreased by 64.5% and 68.2% in PME and PMI groups, respectively. Thirty-seven PME participants (71%) and 19 PMI participants (68%) experienced CMRP. Positive changes were recorded in all other outcomes, without group differences. Pain reduction for PME was larger than previously reported. Despite our initial hypothesis not being confirmed, PME and PMI, aided by XR, are likely to offer meaningful PLP relief to most patients. These findings merit consideration of these therapies as viable treatment options and alternatives to pharmacological treatments.
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Affiliation(s)
- Eva Lendaro
- Department of Electrical Engineering, Chalmers University of Technology, Goteborg, Sweden
- Department of Brain and Cognitive Sciences, McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Corry K Van der Sluis
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands
| | - Liselotte Hermansson
- Department of Prosthetics and Orthotics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Faculty of Medicine and Health, University Health Care Research Centre, Örebro University, Örebro, Sweden
| | - Lina Bunketorp-Käll
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Centre for Advanced Reconstruction of Extremities, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Helena Burger
- University Rehabilitation Institute, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Els Keesom
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands
- Department of Pediatric Rehabilitation, Treant Hospitals, Netherlands
| | - Cathrine Widehammar
- Faculty of Medicine and Health, University Health Care Research Centre, Örebro University, Örebro, Sweden
| | - Maria Munoz-Novoa
- Integrum AB, Mölndal, Sweden
- Center for Bionics and Pain Research, Mölndal, Sweden
| | - Brian E McGuire
- School of Psychology & Centre for Pain Research, University of Galway, Galway, Ireland
| | - Paul O'Reilly
- School of Psychology & Centre for Pain Research, University of Galway, Galway, Ireland
| | - Eric J Earley
- Department of Electrical Engineering, Chalmers University of Technology, Goteborg, Sweden
- Center for Bionics and Pain Research, Mölndal, Sweden
- Department of Orthopedics, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
- Bone-Anchored Limb Research Group, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Sonam Iqbal
- Integrum AB, Mölndal, Sweden
- Center for Bionics and Pain Research, Mölndal, Sweden
| | - Morten B Kristoffersen
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands
- Center for Bionics and Pain Research, Mölndal, Sweden
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
| | | | | | - Wendy Hill
- Institute of Biomedical Engineering, University of New Brunswick, Fredericton, NB, Canada
| | - Martin Diers
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Hospital, Ruhr Universität Bochum, Germany
| | - Kristi L Turner
- Center for Bionic Medicine, Shirley Ryan Ability Lab, Chicago, IL, USA
| | - Thomas Weiss
- Department of Clinical Psychology, Friedrich Schiller University Jena, Jena, Germany
| | - Max Ortiz-Catalan
- Department of Electrical Engineering, Chalmers University of Technology, Goteborg, Sweden
- Center for Bionics and Pain Research, Mölndal, Sweden
- Bionics Institute, Melbourne, Australia
- University of Melbourne, Melbourne, Australia
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14
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Gerçeker GÖ, Bektaş M, Önal A, Kudubeş AA, Çeçen RE. The Effect of Virtual Reality Distraction and Fatigue Training on Anxiety and Fatigue Levels in Children with Cancer: A Randomized Controlled Study. Semin Oncol Nurs 2024:151725. [PMID: 39227259 DOI: 10.1016/j.soncn.2024.151725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 07/29/2024] [Accepted: 07/31/2024] [Indexed: 09/05/2024]
Abstract
OBJECTIVES This randomized controlled trial evaluated the effect of virtual reality (VR) distraction and fatigue training on anxiety and fatigue in children with cancer. METHODS The sample of this parallel design randomized controlled trial consisted of 41 children aged 7 to 16 who were receiving chemotherapy treatment in the pediatric hematology and oncology wards of a university hospital. Data was collected with the Child Anxiety Scale-State, Child Fatigue Scale-24-Hours, and Visual Fatigue Scale in both groups before and during the first three days of chemotherapy treatment. All children admitted to the clinic during chemotherapy received fatigue education. On the first, second, and third days of chemotherapy treatment, children in the study group underwent a 15-minute VR distraction intervention following stratified randomization. Repeated measures analysis of variance was used to compare scale scores by group, time, and group-time interaction. RESULTS Of the patients, 63.4% were male, and 39% had neuroblastoma. There was no difference between the groups in terms of diagnosis, age, duration of diagnosis, chemotherapy, or hemoglobin levels. A statistically significant difference was found between the mean scores of the anxiety and fatigue scores in the intervention and control groups in terms of group, time, and group-time interaction. CONCLUSION Applying VR distraction on the first, second, and third days of chemotherapy treatment was found to be useful in lowering anxiety and fatigue levels in addition to fatigue training. IMPLICATIONS FOR NURSING PRACTICE Virtual reality distraction is an effective method for reducing anxiety and fatigue in this population.
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Affiliation(s)
- Gülçin Özalp Gerçeker
- Pediatric Nursing Department, Dokuz Eylul University Faculty of Nursing, Izmir, Türkiye.
| | - Murat Bektaş
- Pediatric Nursing Department, Dokuz Eylul University Faculty of Nursing, Izmir, Türkiye
| | - Ayşe Önal
- Dokuz Eylul University Child Hospital, Izmir, Türkiye; Department of Nursing, Institute of Health Sciences, Dokuz Eylul University, Izmir, Türkiye
| | - Aslı Akdeniz Kudubeş
- Pediatric Nursing Department, Bilecik Şeyh Edebali University Faculty of Health, Bilecik, Türkiye
| | - Refik Emre Çeçen
- Department of Paediatric Oncology, Dokuz Eylül University Hospital, Izmir, Türkiye
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15
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Moreau S, Thérond A, Cerda IH, Studer K, Pan A, Tharpe J, Crowther JE, Abd-Elsayed A, Gilligan C, Tolba R, Ashina S, Schatman ME, Kaye AD, Yong RJ, Robinson CL. Virtual Reality in Acute and Chronic Pain Medicine: An Updated Review. Curr Pain Headache Rep 2024; 28:893-928. [PMID: 38587725 DOI: 10.1007/s11916-024-01246-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2024] [Indexed: 04/09/2024]
Abstract
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.
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Affiliation(s)
- Sacha Moreau
- Massachusetts Institute of Technology, Boston, MA, USA
| | - Alexandra Thérond
- Department of Psychology, Université du Québec a Montréal, 100 Sherbrooke St W, Montréal, QC, H2X 3P2, Canada.
| | - Ivo H Cerda
- Harvard Medical School, Boston, MA, USA
- Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Kachina Studer
- Department of Earth and Planetary Science, Harvard University, Cambridge, MA, USA
- Department Mechanical Engineering, Massachusetts Institute of Technology (MIT), Cambridge, MA, USA
| | - Alicia Pan
- Northeastern University, Boston, MA, USA
| | - Jacob Tharpe
- Department of Anesthesiology and Perioperative Medicine, University of Massachusetts, Worcester, MA, USA
| | - Jason E Crowther
- Department of Anesthesiology and Perioperative Medicine, University of Massachusetts, Worcester, MA, USA
| | - Alaa Abd-Elsayed
- Department of Anesthesiology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | | | - Reda Tolba
- Pain Management Department in the Anesthesiology Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE
| | - Sait Ashina
- Department of Neurology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Anesthesiology, Critical Care, and Pain Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Michael E Schatman
- Department of Anesthesiology, Perioperative Care, and Pain Medicine, NYU Grossman School of Medicine, New York, NY, USA
- Department of Population Health-Division of Medical Ethics, NYU Grossman School of Medicine, New York, NY, USA
| | - Alan D Kaye
- Department of Anesthesiology, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, USA
| | | | - Christopher L Robinson
- Department of Anesthesiology, Critical Care, and Pain Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA
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16
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Falci SGM, Lima LJS, de Sá Oliveira I, Becheleni MT, Silva HC, Galvão EL, de Souza GM. Does virtual reality reduce anxiety and pain in patients undergoing third molar surgery? A systematic review and meta-analysis. Oral Maxillofac Surg 2024; 28:1095-1104. [PMID: 38834821 DOI: 10.1007/s10006-024-01265-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 05/29/2024] [Indexed: 06/06/2024]
Abstract
This study aimed to systematically review the literature to evaluate the effectiveness of virtual reality in reducing anxiety and pain in patients undergoing third molar surgeries. Clinical trials evaluating patients who used virtual reality (VR) compared with no VR in the management of pain or anxiety after third molar extractions were included. A literature search was conducted in five electronic databases to identify relevant articles: Medline (PubMed interface), Web of Science, Virtual Health Library, Embase, and Scopus. There were no restrictions on the time or language of publication. The risk of bias was assessed using the Cochrane Risk of Bias Tool for Randomised Trials (RoB 2.0). A total of six studies were included in the qualitative analysis and three in the quantitative analysis. The results of the meta-analyses on anxiety revealed that patients in the intervention group before VR already showed less anxiety compared to those in the control group (-0.28 [-0.44 to -0.13, 95%CI] I²=24.51%. In the post-intervention evaluation, the group that received VR remained with a lower level of anxiety and a slight reduction compared to the pre-intervention. (-0.34 [-0.49 to -0.19, 95%CI] I²=36.61%. Virtual reality can be a clinical resource in dental care because it seems to cause a small reduction in anxiety, and with still uncertain results in the reduction of postoperative pain in extractions of third molars.
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Affiliation(s)
- Saulo Gabriel Moreira Falci
- Department of Dentistry, School of Biological and Health Sciences, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Gloria street, 187, Diamantina, MG, 39100-000, Brazil
| | - Laura Jordana Santos Lima
- Department of Dentistry, School of Biological and Health Sciences, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Gloria street, 187, Diamantina, MG, 39100-000, Brazil
| | - Isabela de Sá Oliveira
- Department of Dentistry, School of Biological and Health Sciences, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Gloria street, 187, Diamantina, MG, 39100-000, Brazil
| | - Marco Túllio Becheleni
- Department of Dentistry, School of Biological and Health Sciences, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Gloria street, 187, Diamantina, MG, 39100-000, Brazil
| | - Herberth Campos Silva
- Department of Dentistry, School of Biological and Health Sciences, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Gloria street, 187, Diamantina, MG, 39100-000, Brazil
| | - Endi Lanza Galvão
- Department of Physical Therapy, School of Biological and Health Sciences, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Gloria street, 187, Diamantina, MG, 39100-000, Brazil
| | - Glaciele Maria de Souza
- Department of Dentistry, School of Biological and Health Sciences, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Gloria street, 187, Diamantina, MG, 39100-000, Brazil.
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17
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Mace RA, Brewer JR, Cohen JE, Ly TV, Weaver MJ, Borsook D. Virtual Reality for Subacute Pain After Orthopedic Traumatic Musculoskeletal Injuries: A Mixed Methods Pilot Study. Clin J Pain 2024; 40:526-541. [PMID: 39016312 DOI: 10.1097/ajp.0000000000001231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 06/17/2024] [Indexed: 07/18/2024]
Abstract
OBJECTIVES Acute orthopedic traumatic musculoskeletal injuries are prevalent, costly, and often lead to persistent pain and functional limitations. Psychological risk factors (eg, pain catastrophizing and anxiety) exacerbate these outcomes but are often overlooked in acute orthopedic care. Addressing gaps in current treatment approaches, this mixed-methods pilot study explored the use of a therapeutic virtual reality (VR; RelieVRx ), integrating principles of mindfulness and cognitive-behavioral therapy, for pain self-management at home following orthopedic injury. METHODS We enrolled 10 adults with acute orthopedic injuries and elevated pain catastrophizing or pain anxiety from Level 1 Trauma Clinics within the Mass General Brigham health care system. Participants completed daily RelieVRx sessions at home for 8 weeks, which included pain education, relaxation, mindfulness, games, and dynamic breathing biofeedback. Primary outcomes were a priori feasibility, appropriateness, acceptability, satisfaction, and safety. Secondary outcomes were pre-post measures of pain, physical function, sleep, depression, and hypothesized mechanisms (pain self-efficacy, mindfulness, and coping). RESULTS The VR and study procedures met or exceeded all benchmarks. We observed preliminary improvements in pain, physical functioning, sleep, depression, and mechanisms. Qualitative exit interviews confirmed high satisfaction with RelieVRx and yielded recommendations for promoting VR-based trials with orthopedic patients. DISCUSSION The results support a larger randomized clinical trial of RelieVRx versus a sham placebo control to replicate the findings and explore mechanisms. There is potential for self-guided VR to promote evidence-based pain management strategies and address the critical mental health care gap for patients following acute orthopedic injuries.
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Affiliation(s)
- Ryan A Mace
- Center for Health Outcomes and Interdisciplinary Research, Massachusetts General Hospital
- Harvard Medical School
- Department of Psychiatry, Massachusetts General Hospital
| | - Julie R Brewer
- Center for Health Outcomes and Interdisciplinary Research, Massachusetts General Hospital
| | - Joshua E Cohen
- Center for Health Outcomes and Interdisciplinary Research, Massachusetts General Hospital
| | - Thuan V Ly
- Harvard Medical School
- Department of Orthopaedic Surgery, Massachusetts General Hospital
| | - Michael J Weaver
- Harvard Medical School
- Department of Orthopaedic Surgery, Brigham and Women's Hospital
| | - David Borsook
- Harvard Medical School
- Department of Psychiatry, Massachusetts General Hospital
- Department of Radiology, Massachusetts General Hospital, Boston, MA
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18
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Galst IM, Høxbro Knudsen M, Hjuler T. Distracting children with virtual reality during otomicroscopy: A randomised control trial. Int J Pediatr Otorhinolaryngol 2024; 184:112045. [PMID: 39121683 DOI: 10.1016/j.ijporl.2024.112045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 06/25/2024] [Accepted: 07/14/2024] [Indexed: 08/12/2024]
Abstract
OBJECTIVES Virtual Reality (VR) is a successful distraction method for reducing procedure-related pain in children, though it has never been studied during otomicroscopy. Therefore, we investigated the efficacy of VR as a distraction method during otomicroscopy. METHODS This Randomised Control Trial (RCT) included 60 children aged 4-15 years. The patients were randomised to receive distraction by VR, tablet, or no distraction. Procedure-related pain was scored by patients and compared with previous examinations. RESULTS Patients' experience with otomicroscopy was significantly improved with VR compared to tablet (p < 0.05) and no distraction (p < 0.01). Pain scores did not differ significantly between groups. CONCLUSION VR did not reduce pain scores, but it improved the children's experience with otomicroscopy without causing significant adverse outcomes.
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Affiliation(s)
- Ida Marie Galst
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen, Denmark.
| | - Marie Høxbro Knudsen
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen, Denmark.
| | - Thomas Hjuler
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen, Denmark.
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Singhal A, Taksande K. Continuous Catheter Techniques Versus Single-Injection Nerve Blocks: A Comprehensive Review of Postoperative Pain Management Strategies. Cureus 2024; 16:e70040. [PMID: 39449957 PMCID: PMC11501424 DOI: 10.7759/cureus.70040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2024] [Accepted: 09/23/2024] [Indexed: 10/26/2024] Open
Abstract
Effective postoperative pain management is crucial for optimizing patient recovery and enhancing surgical outcomes. This review compares two prominent regional anesthesia techniques, continuous catheter techniques and single-injection nerve blocks, focusing on their efficacy, safety, and impact on patient outcomes. Single-injection nerve blocks involve administering a one-time anesthetic dose to a specific nerve or plexus, offering immediate but transient pain relief. In contrast, continuous catheter techniques utilize a catheter to deliver a continuous infusion of anesthetic, providing extended analgesia. The review synthesizes current evidence on the effectiveness of each method, highlighting that single-injection blocks are advantageous for their simplicity and rapid onset but may require supplementary pain management for longer procedures. Continuous catheter techniques, while offering prolonged pain relief, carry risks such as infection and catheter displacement. The comparative analysis of these techniques reveals that both have distinct roles in postoperative care, with choice depending on the surgical procedure and patient needs. Patient satisfaction, recovery times, and overall outcomes are critical factors in determining the optimal pain management strategy. Future research should focus on refining these techniques and exploring innovations to improve patient care and pain management outcomes. This review provides insights for clinicians to make informed decisions about postoperative pain management to enhance patient comfort and recovery.
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Affiliation(s)
- Akansha Singhal
- Anaesthesiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Karuna Taksande
- Anaesthesiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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20
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Shanbhag NM, Bin Sumaida A, Al Shamisi K, Balaraj K. Apple Vision Pro: A Paradigm Shift in Medical Technology. Cureus 2024; 16:e69608. [PMID: 39308843 PMCID: PMC11413724 DOI: 10.7759/cureus.69608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2024] [Accepted: 09/17/2024] [Indexed: 09/25/2024] Open
Abstract
The introduction of Apple Vision Pro (AVP) marks a significant milestone in the intersection of technology and healthcare, offering unique capabilities in mixed reality, which Apple terms "spatial computing." This narrative review aims to explore the various applications of AVP in medical technology, emphasizing its impact on patient care, clinical practices, medical education, and future directions. The review synthesizes findings from multiple studies and articles published between January 2023 and May 2024, highlighting AVP's potential to enhance visualization in diagnostic imaging and surgical planning, assist visually impaired patients, and revolutionize medical education through immersive learning environments. Despite its promise, challenges remain in integrating AVP into existing healthcare systems and understanding its long-term impact on patient outcomes. As research continues, AVP is poised to play a pivotal role in the future of medicine, offering a transformative tool for healthcare professionals.
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Affiliation(s)
- Nandan M Shanbhag
- Oncology/Radiation Oncology/Palliative Care, Tawam Hospital, Al Ain, ARE
- College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, ARE
| | | | | | - Khalid Balaraj
- Oncology/Radiation Oncology, Tawam Hospital, Al Ain, ARE
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21
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Saleh SES, Abozed HW. Technology and Children's health: Effect of virtual reality on pain and clinical outcomes during hydrotherapy for children with burns. J Pediatr Nurs 2024; 78:e155-e166. [PMID: 38971634 DOI: 10.1016/j.pedn.2024.06.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 06/30/2024] [Accepted: 06/30/2024] [Indexed: 07/08/2024]
Abstract
BACKGROUND Virtual Reality (VR) has been frequently used as an engaging, interactive, and effective non-pharmacological distraction technique for children during painful procedures, including burnt wound care. AIM This study aimed to evaluate the effect of virtual reality on pain and clinical outcomes during hydrotherapy for children with burns. DESIGN A randomized controlled pretest, during, and post-test research design was utilized. METHODS Sixty children with burns underwent hydrotherapy, divided randomly and assigned equally into two groups. Children of the control group received the standard pharmacological treatment of the unit to manage pain and stabilize their physiological parameters throughout the three days of study. Children of the virtual reality intervention group received all basic standard care as the control group plus VR intervention across different software content, and interaction immersion designs which took place using a cell phone coupled with the three-dimensional (3D) image glasses. Outcome measures were physiological parameters, wound healing, and Face, Leg, Activity, Cry and Consolability (FLACC) Behavioral Pain Assessment Scale. SETTING This study was carried out in the burns unit at the Plastic, Reconstructive, and Burns Surgery Center affiliated to Mansoura University, from September to November 2023. RESULTS Children in the study group had lower pain scores, more stable physiological parameters, and higher rates of wound healing compared to the control group with a statistically significant difference between both groups. CONCLUSION Using VR intervention significantly reduced pain intensity, enhanced physiological parameters and promoted the rate of wound healing in children with burns during hydrotherapy.
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Affiliation(s)
| | - Hend Wageh Abozed
- Pediatric Nursing Department, Faculty of Nursing, Mansoura University, Egypt.
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22
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Nagpal AK, Gadkari C, Singh A, Pundkar A. Optimizing Pain Management in Emergency Departments: A Comprehensive Review of Current Analgesic Practices. Cureus 2024; 16:e69789. [PMID: 39429329 PMCID: PMC11491142 DOI: 10.7759/cureus.69789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2024] [Accepted: 09/20/2024] [Indexed: 10/22/2024] Open
Abstract
Effective pain management in Emergency Departments (EDs) is vital for improving patient comfort and clinical outcomes. This review provides a comprehensive analysis of current pain management practices in ED settings, focusing on the challenges and opportunities for optimization. The review examines pharmacologic and non-pharmacologic pain management strategies, evaluating their effectiveness and identifying inconsistencies and gaps in current practices. Key challenges in the ED environment include time constraints, variability in clinical protocols, and the need to address diverse patient needs, including those of paediatric, geriatric, and chronic pain patients. The review highlights the importance of standardized pain assessment tools and protocols to improve consistency in pain management. Innovations, such as technological advances and multimodal approaches, are explored for their potential to enhance pain management practices. Recommendations address identified challenges, including improved training for ED staff, the development of evidence-based protocols, and the integration of multimodal pain management strategies. By addressing these areas, the review aims to contribute to the development of more effective and uniform pain management practices in emergency care, ultimately leading to better patient outcomes and experiences. This review emphasizes the need for ongoing research and adaptation of best practices to meet the evolving needs of patients in emergency settings.
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Affiliation(s)
- Anmol K Nagpal
- Emergency Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Charuta Gadkari
- Emergency Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Akhilesh Singh
- Emergency Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Aditya Pundkar
- Orthopedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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23
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Aldhaleei WA, Bakheet N, Odah T, Jett H, Wallace MB, Lacy BE, Bhagavathula AS, Bi Y. The effect of virtual reality on perioperative pain management in patients undergoing gastrointestinal procedures and surgeries: a systematic review of clinical trials. J Gastrointest Surg 2024:S1091-255X(24)00575-4. [PMID: 39121908 DOI: 10.1016/j.gassur.2024.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 07/30/2024] [Accepted: 08/03/2024] [Indexed: 08/12/2024]
Abstract
BACKGROUND Virtual reality (VR) is an advanced technology that transports users into a virtual world. It has been proven to be effective in pain management via distraction and alteration of pain perception. However, the impact of VR on treating perioperative pain is inconclusive. This systematic review aimed to evaluate the effect of VR on perioperative pain after a gastrointestinal (GI) procedure or surgery. METHODS A systematic review of randomized controlled trials was conducted from inception to January 31, 2024, following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The updated Cochrane risk of bias (RoB 2) assessment tool was used to evaluate the risk of bias. RESULTS Of 724 articles screened, 8 studies with 678 participants were included in the systematic review. Four studies evaluated the effect of VR on perioperative pain during GI procedure (eg, colonoscopy) focused on its use after GI surgeries (eg, abdominal surgeries). Some studies reported a reduction in pain scores after the procedure; however, the findings of pain difference in before or during vs after the procedure in the VR vs control groups were mixed. CONCLUSION VR is a promising tool to control perioperative pain after a GI procedure or surgery. Differences in study protocols, pain assessment scales, and pain therapy used were limitations in performing a comprehensive meta-analysis. Further studies are needed to better evaluate the effects of VR on perioperative pain compared with standard of care.
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Affiliation(s)
- Wafa A Aldhaleei
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, United States.
| | - Nader Bakheet
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, United States
| | - Tarek Odah
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, United States
| | - Heather Jett
- Mayo Clinic Libraries, Mayo Clinic Health System, La Crosse, WI, United States
| | - Michael B Wallace
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, United States
| | - Brian E Lacy
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, United States
| | - Akshaya Srikanth Bhagavathula
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, United States; Department of Public Health, College of Health and Human Services, North Dakota State University, Fargo, ND, United States
| | - Yan Bi
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, United States
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24
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Levit T, Grzela P, Lavoie DCT, Wang L, Agarwal A, Couban RJ, Shanthanna H. The Effectiveness of Virtual and Augmented Reality in Surgical Pain Management: A Systematic Review of Randomized Controlled Trials. Anesth Analg 2024:00000539-990000000-00888. [PMID: 39088374 DOI: 10.1213/ane.0000000000007051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2024]
Abstract
BACKGROUND Satisfactory management of postoperative pain remains challenging. Nonpharmacological modalities such as virtual and augmented reality (VR/AR) offer potential benefits and are becoming increasingly popular. This systematic review evaluates the effectiveness and safety of VR/AR interventions on postoperative pain and recovery. METHODS MEDLINE, Embase, CINAHL, Web of Science, and CENTRAL databases were searched from inception to July 27, 2023, for randomized controlled trials (RCTs), published in English, evaluating the use of VR/AR interventions for surgical pain relief. Study selection and data extraction were performed by pairs of reviewers independently and in duplicate, and potential risk of bias was determined using the Risk of Bias-version 2 (RoB 2) tool. Our outcomes included pain relief, reduction of anxiety, satisfaction, and adverse effects. Due to substantial heterogeneity, a narrative synthesis without meta-analysis was performed. RESULTS We included 35 trials among 2257 citations, categorized as surgery (n = 12), minor procedures (n = 15), and postoperative physiotherapy (n = 8). Surgical group included various surgeries, with 11 using immersive VR predominantly in the postoperative period, and most reporting no differences in pain, but potential for reduced anxiety and sedation requirements. In the minor procedures group, most studies reported decreased pain and anxiety during the procedural performance. Two studies reported increased heart rate, while 2 others reported better hemodynamic stability. Home-based AR physiotherapy achieved (n = 6) similar pain and functional outcomes after knee replacement, with 1 large study (n = 306) reporting reduction of mean costs by $2745 for provision of 12 weeks physiotherapy. There were some concerns around potential bias for most studies, as the nature of interventions make it challenging to blind assessors and participants. No important adverse effects were noted using VR/AR technology. CONCLUSIONS Evidence from RCTs indicates that the use of immersive VR during minor procedures may reduce procedural pain, decrease anxiety, and improve satisfaction. However, small studies, inconsistent effect, and variation in the application of interventions are important limitations. Evidence to support the application of AR/VR for major surgeries is limited and needs to be further investigated. Use of home-based physiotherapy with AR likely has economic advantages, and facilitates virtual care for appropriate patients who can access and use the technology safely.
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Affiliation(s)
- Tal Levit
- From the Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Patrick Grzela
- From the Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Declan C T Lavoie
- From the Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Li Wang
- Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, Canada
| | - Aashna Agarwal
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Rachel J Couban
- Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, Canada
| | - Harsha Shanthanna
- Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, Canada
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25
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Matthie N, Higgins M, Doorenbos A, Maddox T, Jenerette C. Feasibility of In-Home Virtual Reality for Chronic Pain in Sickle Cell Disease. Pain Manag Nurs 2024; 25:425-431. [PMID: 38697889 PMCID: PMC11324415 DOI: 10.1016/j.pmn.2024.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 04/02/2024] [Accepted: 04/06/2024] [Indexed: 05/05/2024]
Abstract
PURPOSE This study assessed the feasibility of an in-home virtual reality intervention for chronic pain in adults with sickle cell disease. DESIGN Two-group, parallel, randomized, multiple methods design with surveys, and interviews. METHODS Participants were randomized to virtual reality or audio control, with 2-16-minute daily modules for 8 weeks, a daily pain diary survey, and a post study interview. Chronic pain and pain correlates were evaluated at baseline and every 4 weeks for 3 months. Feasibility outcomes were participant enrollment (set at > 50%), questionnaire response (> 50%), intervention use, and cybersickness (< 20%). RESULTS Of the individuals approached, 67.8% (n = 19) were enrolled. Questionnaire response rates were 100% at baseline, 57.8% at week 4, and < 50% at weeks 8 and 12. The intervention was used for a median of 781 minutes and 210 minutes in the virtual reality and audio groups, respectively. Participants reported slight symptoms of cybersickness with no reports of severe symptoms, and the intervention was acceptable. CONCLUSIONS Home-based virtual reality can be used in future sickle cell disease research. To further strengthen evaluations of virtual reality in adults with sickle cell who experience chronic pain, future trials should address sample size limitations and incorporate recommended strategies to address cybersickness and questionnaire response. CLINICAL IMPLICATIONS The first known application of in-home virtual reality for chronic pain in adults with sickle cell disease was successful. Findings can inform future in-home investigations of virtual reality in this underserved population.
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Affiliation(s)
- Nadine Matthie
- Emory University, Nell Hodgson Woodruff School of Nursing, Atlanta, GA.
| | - Melinda Higgins
- Office of Nursing Research; Emory University, Nell Hodgson Woodruff School of Nursing, Atlanta, GA
| | - Ardith Doorenbos
- Biobehavioral Nursing Science; University of Illinois Chicago, College of Nursing, Chicago, IL
| | - Todd Maddox
- Clinical Research and Development, AppliedVR, Inc., Van Nuys, CA
| | - Coretta Jenerette
- University of California San Francisco, School of Nursing, San Francisco, CA
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26
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Baradwan S, Hafedh B, Alyafi M, Algreisi F, Baradwan A, Alghamdi DS, Atalla EMI, El-Mazzally YM, Ismail HS, Shrief KE, Abdelhakim AM, Khodry MM. The Effect of Virtual Reality Application on Pain and Anxiety During Episiotomy Repair: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Int Urogynecol J 2024:10.1007/s00192-024-05867-4. [PMID: 39042152 DOI: 10.1007/s00192-024-05867-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 06/20/2024] [Indexed: 07/24/2024]
Abstract
INTRODUCTION AND HYPOTHESIS There is a rising trend among women towards nonpharmacological approaches owing to their minimally invasive nature and limited adverse effects. Virtual reality (VR) has recently gained popularity as a new technology for reducing pain and anxiety in medical settings. Our research sought to investigate the impact of VR on pain and anxiety levels while undergoing episiotomy repair. METHODS A comprehensive search was carried out across PubMed, Scopus, Cochrane Library, and ISI Web of Science to find relevant randomized clinical trials (RCTs) up to January 2024. These trials investigated the use of VR as a treatment during episiotomy repair compared with a control group that did not receive VR intervention. Meta-analysis was performed using Review Manager software to analyze the data collected. Our primary outcomes were pain scores reported during and after episiotomy repair measured by a visual analog scale. Secondary outcomes analyzed included anxiety scores during and after the procedure, as well as the duration of episiotomy repair. RESULTS Seven RCTs, involving 578 patients, met the inclusion criteria. VR resulted in a significant reduction in pain scores both during and after episiotomy repair (p < 0.001). Additionally, anxiety levels during and after the procedure were significantly reduced in the VR group compared with the control group. Moreover, the duration of episiotomy repair was significantly shorter in the VR group. CONCLUSION Using VR has proven to be an effective technique in reducing pain and anxiety during and after episiotomy repair, as well as potentially speeding up the procedure.
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Affiliation(s)
- Saeed Baradwan
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Bandr Hafedh
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Mohammad Alyafi
- Department of Obstetrics and Gynecology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Fahad Algreisi
- Department of Obstetrics and Gynecology, Jeddah University, Jeddah, Saudi Arabia
| | - Afnan Baradwan
- Department of Obstetrics and Gynecology, Al Salama Hospital, Jeddah, Saudi Arabia
| | - Deama Saeed Alghamdi
- Department of Obstetrics and Gynecology, Faculty of Medicine, King Khalid University, Abha, Saudi Arabia
| | | | - Yousef Mohamed El-Mazzally
- Department of Community Medicine and Industrial Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Hany Said Ismail
- Department of Anesthesia and Intensive Care and Pain Management, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Khaled Elsheshtawy Shrief
- Department of Anesthesia and Intensive Care and Pain Management, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Ahmed Mohamed Abdelhakim
- Kasr Al-Ainy, Faculty of Medicine, Cairo University, 395 Portsaid Street, Bab El-Kalq, Cairo, 11638, Egypt.
| | - Mostafa Mohamed Khodry
- Department of Obstetrics and Gynecology, Faculty of Medicine, South Valley University, Qena, Egypt
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27
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Su S, Wang R, Chen Z, Zhou F, Zhang Y. The effectiveness of extended reality on relieving pain after total knee arthroplasty: a systematic review and meta-analysis of randomized controlled trials. Arch Orthop Trauma Surg 2024; 144:3217-3226. [PMID: 38960934 DOI: 10.1007/s00402-024-05440-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 06/27/2024] [Indexed: 07/05/2024]
Abstract
PURPOSE Patients with total knee arthroplasty (TKA) often suffer from severe postoperative pain, which seriously hinders postoperative rehabilitation. Extended reality (XR), including virtual reality, augmented reality, and mixed reality, has been increasingly used to relieve pain after TKA. The purpose of this study was to evaluate the effectiveness of XR on relieving pain after TKA. METHODS The electronic databases including PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), and clinicaltrials.gov were searched for studies from inception to July 20, 2023. The outcomes were pain score, anxiety score, and physiological parameters related to pain. Meta-analysis was performed using the Review Manager 5.4 software. RESULTS Overall, 11 randomized control trials (RCTs) with 887 patients were included. The pooled results showed XR had lower pain scores (SMD = - 0.31, 95% CI [- 0.46 to - 0.16], P < 0.0001) and anxiety scores (MD = - 3.95, 95% CI [- 7.76 to - 0.13], P = 0.04) than conventional methods. The subgroup analysis revealed XR had lower pain scores within 2 weeks postoperatively (SMD = - 0.49, 95% CI [- 0.76 to - 0.22], P = 0.0004) and XR had lower pain scores when applying XR combined with conventional methods (SMD = - 0.43, 95% CI [- 0.65 to - 0.20], P = 0.0002). CONCLUSION This systematic review and meta-analysis found applying XR could significantly reduce postoperative pain and anxiety after TKA. When XR was combined with conventional methods, postoperative pain can be effectively relieved, especially within 2 weeks after the operation. XR is an effective non-pharmacological analgesia scheme.
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Affiliation(s)
- Shilong Su
- Department of Orthopedics, Peking University Third Hospital, No.49 North Garden Road. Haidian, Beijing, 100191, China
- Engineering Research Center of Bone and Joint Precision Medicine, Peking University Third Hospital, No.49 North Garden Road. Haidian, Beijing, 100191, China
| | - Ruideng Wang
- Department of Orthopedics, Peking University Third Hospital, No.49 North Garden Road. Haidian, Beijing, 100191, China
- Engineering Research Center of Bone and Joint Precision Medicine, Peking University Third Hospital, No.49 North Garden Road. Haidian, Beijing, 100191, China
| | - Zhengyang Chen
- Department of Orthopedics, Peking University Third Hospital, No.49 North Garden Road. Haidian, Beijing, 100191, China
- Engineering Research Center of Bone and Joint Precision Medicine, Peking University Third Hospital, No.49 North Garden Road. Haidian, Beijing, 100191, China
| | - Fang Zhou
- Department of Orthopedics, Peking University Third Hospital, No.49 North Garden Road. Haidian, Beijing, 100191, China.
- Engineering Research Center of Bone and Joint Precision Medicine, Peking University Third Hospital, No.49 North Garden Road. Haidian, Beijing, 100191, China.
| | - Yunqing Zhang
- Department of Orthopedics, The First Hospital of Changsha, No.311 Yingpan Road, Changsha, Hunan Province, 410005, China.
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28
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Jones K, Armstrong M, Luna J, Thakkar RK, Fabia R, Groner JI, Noffsinger D, Ni A, Griffin B, Xiang H. Age and Sex Differences of Virtual Reality Pain Alleviation Therapeutic During Pediatric Burn Care: A Randomized Clinical Trial. JOURNAL OF MEDICAL EXTENDED REALITY 2024; 1:163-173. [PMID: 39091668 PMCID: PMC11290595 DOI: 10.1089/jmxr.2024.0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/02/2024] [Indexed: 08/04/2024]
Abstract
Virtual reality (VR) effectively alleviates pain for pediatric patients during many medical procedures, such as venipuncture and burn care. In our previously published randomized clinical trial among 90 pediatric burn patients, participants in the active VR group had significantly lower scores for overall pain compared with participants in the standard care control and for worst pain compared with participants in the passive VR and control group. However, whether VR differs by a patient's age or sex remains unresolved. Thus, we reanalyzed our data by comparing the active and passive VR participants to evaluate how age and sex affect VR pain alleviation during dressing care for pediatric burns. In total, 90 patients aged 6-17 years (inclusive) with burn injuries were recruited from an outpatient burn clinic of an American Burn Association-verified pediatric burn center. Before randomization, VR helpfulness and need expectations were assessed on a visual analog scale (0-100). Participants were randomly assigned to active VR, passive VR, or control for one dressing change. Immediately following the dressing change, active and passive VR participants self-reported pain and the time spent thinking about pain and rated the VR features on the degree of realism, pleasure/fun, and perceived engagement level. Path analyses assessed how these VR features were interrelated and how they affected self-reported pain by age and sex. Patients aged 6-9 years reported higher mean expectations of VR helpfulness and need (mean = 73.6 and 94.5, respectively) than 10-12-year-olds (mean = 55.7 and 84.2, respectively) and 13-17-year-olds (mean = 68.6 and 77.4, respectively). The path analysis indicated VR engagement and fun were significantly correlated (p-value < 0.05). VR engagement significantly negatively impacted overall pain scores (coefficient = -0.45, -0.41; p-value < 0.05) and significantly positively impacted time thinking of pain (coefficient = 0.38, 0.32; p-value < 0.05). Younger patients had the highest expectations of VR helpfulness and need. VR game realism, fun, and engagement features were not statistically different between age groups and sexes. VR engagement and thinking of pain during burn dressing significantly positively affected self-reported pain (p-value < 0.05), suggesting an analgesic mechanism beyond distraction alone. Younger patients benefited more from VR than older patients.
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Affiliation(s)
- Katerina Jones
- College of Medicine, Northeast Ohio Medical University, Rootstown, Ohio, USA
- Center for Pediatric Trauma Research, The Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, Ohio, USA
| | - Megan Armstrong
- Center for Pediatric Trauma Research, The Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, Ohio, USA
- Center for Injury Research & Policy, The Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, Ohio, USA
| | - John Luna
- IT Research and Innovation, The Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, Ohio, USA
| | - Rajan K. Thakkar
- Center for Pediatric Trauma Research, The Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, Ohio, USA
- Trauma and Burn Program, Nationwide Children’s Hospital, Columbus, Ohio, USA
- College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Renata Fabia
- Center for Pediatric Trauma Research, The Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, Ohio, USA
- Trauma and Burn Program, Nationwide Children’s Hospital, Columbus, Ohio, USA
- College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Jonathan I. Groner
- Center for Pediatric Trauma Research, The Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, Ohio, USA
- Trauma and Burn Program, Nationwide Children’s Hospital, Columbus, Ohio, USA
- College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Dana Noffsinger
- Center for Pediatric Trauma Research, The Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, Ohio, USA
- Trauma and Burn Program, Nationwide Children’s Hospital, Columbus, Ohio, USA
| | - Ai Ni
- Division of Biostatistics, The Ohio State University College of Public Health, Columbus, Ohio, USA
| | - Bronwyn Griffin
- NHMRC Centre of Research Excellence-Wiser Wound Care, Menzies Health Institute of Queensland, Griffith University Brisbane, Gold Coast, Australia
| | - Henry Xiang
- Center for Pediatric Trauma Research, The Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, Ohio, USA
- Center for Injury Research & Policy, The Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, Ohio, USA
- College of Medicine, The Ohio State University, Columbus, Ohio, USA
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29
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Patil RU, Onkari PS, Gurunathan D. Effectiveness of Audiovisual Distraction in Reducing Children's Anxiety for Pain During Medical and Dental Treatments: A Systematic Review and Meta-analysis. SAUDI JOURNAL OF MEDICINE & MEDICAL SCIENCES 2024; 12:252-258. [PMID: 39055078 PMCID: PMC11268543 DOI: 10.4103/sjmms.sjmms_275_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 09/15/2023] [Accepted: 12/03/2023] [Indexed: 07/27/2024]
Abstract
Background Audiovisual distraction is a potentially good technique to reduce medical treatment procedure-related fear and anxiety among children. However, few studies have assessed its effectiveness. Objective To conduct a systematic review and meta-analysis for evaluating the effectiveness of audiovisual distraction in reducing pain anxiety in pediatrics. Methods Randomized control trials and experimental studies that reported the use of audiovisual distraction during medical/dental treatments among children aged 3-8 years, used the Face, Legs, Activity, Cry, Consolability (FLACC) scale to assess pain, and were published between 2005-2021 and in English were retrieved from PubMed, Scopus, and Web of Science. A random-effects model was used for evidence analysis. Results A total of four studies were included in the systematic review and meta-analysis: two were from South Asia and one each were from Africa and North America. Three of these studies were randomized control trials. The variability among the studies was high. Three of the four studies found that AV techniques were significantly effective in reducing pain during procedures compared with the control group (P < 0.00001), while one study found no difference; the cumulative evidence in the forest plot was similar. Conclusion Cumulative evidence suggests that the use of audiovisual distraction is an effective strategy in reducing medical/dental procedures-related pain anxiety among children aged 3-8 years. However, evidence on this is currently limited, and thus further studies are required using various AD techniques and on different populations to substantiate these findings. Funding None. Registration PROSPERO (Ref no.: CRD42021245874).
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Affiliation(s)
- Raju Umaji Patil
- Department of Pediatric and Preventive Dentistry, Sinhgad Dental College and Hospital, Pune, Maharashtra, India
| | - Prajakta Somappa Onkari
- Department of Pediatric and Preventive Dentistry, Sinhgad Dental College and Hospital, Pune, Maharashtra, India
| | - Deepa Gurunathan
- Department of Pedodontics, Saveetha Dental College, Chennai, Tamil Nadu, India
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Kurt G, Ozcan NK. The Effect of Virtual Reality On Pain and Anxiety Management During Pelvic Examination: A Randomized Controlled Trial. J Midwifery Womens Health 2024; 69:543-549. [PMID: 38178322 DOI: 10.1111/jmwh.13587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 09/15/2023] [Indexed: 01/06/2024]
Abstract
INTRODUCTION It is important for health care professionals to address women's pain and anxiety during pelvic examinations. This study aimed to evaluate the impact of virtual reality (VR) on pain and anxiety management during pelvic examinations. METHODS The study was a randomized controlled clinical trial reported in according to the Consolidated Standards of Reporting Trials 2010 Guidelines. The research was conducted with 128 women (64 intervention, 64 control) who received care at a tertiary hospital outpatient clinic between November 2021 and February 2022. The intervention group received VR application via virtual glasses during pelvic examination, while the control group received routine care. Anxiety was measured using the State-Trait Anxiety Inventory before and after the pelvic examination, and the Visual Analog Scale was used to assess pain after the pelvic examination. The study was registered at ClinicalTrials.gov (NCT05545488). RESULTS The mean anxiety scores of the women in the intervention and control groups were similar pretest (59.00 and 57.77). The mean anxiety score decreased after the pelvic examination to 36.53 in the intervention group and 47.55 in the control group. Results indicated a significant main effect for group assignment (F9.56; η2 = .071; P = .002), a significant main effect for time (F384.14; η2 = .753; P < .001), and a significant interaction between group and time (F53.95; η2 = .300; P < .001). Pain scores after the pelvic examination were lower in the intervention group (4.25) than in the control group (6.41; P < .001). CONCLUSION VR was effective in the management of pain and anxiety during pelvic examination. Future studies should compare the effectiveness of VR with other methods in reducing pain and anxiety during a pelvic examination.
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Affiliation(s)
- Gülay Kurt
- Department of Midwifery, Institute of Graduate Studies, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Neslihan Keser Ozcan
- Department of Midwifery, Faculty of Health Science, Istanbul University-Cerrahpaşa, Istanbul, Turkey
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Massov L, Robinson B, Rodriguez-Ramirez E, Maude R. 'Giving birth on a beach': Women's experiences of using virtual reality in labour. PLoS One 2024; 19:e0304349. [PMID: 38865321 PMCID: PMC11168694 DOI: 10.1371/journal.pone.0304349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 05/10/2024] [Indexed: 06/14/2024] Open
Abstract
INTRODUCTION Birth is a normal physiological process, and many women want a natural birth. Women use a range of non-pharmacological pain relief methods to reduce labour pain intensity, to help manage labour pain and to induce relaxation. The purpose of this study was to explore the experiences of women using Virtual Reality as a non-pharmacological method of pain relief in labour. Virtual Reality has been shown to be an effective distraction technique in other acute pain settings which also reduces anxiety. METHODS This study conducted qualitative in-depth interviews postnatally with women who used Virtual Reality in labour. Thematic analysis was used to analyse the qualitative data. RESULTS Nineteen women used Virtual Reality in labour. Results from interviews with nineteen women in the postnatal period identified three main themes: impact of virtual reality on experience of labour, managing the pain of labour and challenges of using virtual reality in labour. CONCLUSION This study identified that Virtual Reality was effective as a relaxation technique and helped in pain management by the use of self-efficacy techniques. Women in this study also identified preferred virtual environments specifically to use during labour and birth. This study provides a unique and original contribution to the field of Virtual Reality in labour and birth. It also identifies Virtual Reality as an acceptable and positive experience in the management of anxiety and labour pain.
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Affiliation(s)
- Lorna Massov
- School of Nursing, Midwifery and Health Practice, Victoria University Wellington, Wellington, New Zealand
| | - Brian Robinson
- School of Nursing, Midwifery and Health Practice, Victoria University Wellington, Wellington, New Zealand
| | | | - Robyn Maude
- School of Nursing, Midwifery and Health Practice, Victoria University Wellington, Wellington, New Zealand
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Alaniz L, Shams A, Sayadi L, Pakvasa M, Stulginski A, Cordero J, Prabhakar N, Wang E. Modernizing ED Care: Virtual Reality Enhances the Patient Experience during Minor Wide-awake Hand Procedures. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2024; 12:e5790. [PMID: 38706467 PMCID: PMC11068151 DOI: 10.1097/gox.0000000000005790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 03/12/2024] [Indexed: 05/07/2024]
Abstract
Background Minor procedures in the emergency department (ED) can be distressing for patients. The emergence of virtual reality (VR) offers a promising new tool by immersing patients in an engaging three-dimensional world. Prior studies have shown VR's effectiveness during procedures in reducing pain, anxiety, and procedure duration but have not assessed its efficacy in the ED. This study aims to evaluate the efficacy of VR in managing pain and anxiety during ED minor hand procedures. Methods This was a prospective, interventional study at a level I trauma center examining adult patients requiring minor hand procedures. Patients were provided the Oculus Quest 2 VR headset, offering various immersive three-dimensional experiences. Pre- and postprocedure surveys assessed previous VR use, anxiety and pain levels, VR efficacy, and possible adverse effects. Responses were rated on a 10-point Likert scale with paired t tests used to compare scores. Results The study included sixteen patients, seven of whom were first-time VR users. Patients experienced a significant decrease in both anxiety and pain levels. Survey results indicated overall benefits from VR in several aspects, with no adverse effects reported, and unanimous patient recommendation of the VR experience to others. Conclusions VR is an effective tool to optimize the patient experience during ED hand procedures. The study observed a significant decrease in anxiety and a declining trend in pain levels. Patients believed VR helped manage their pain and would recommend it to others. Given the benefits and high safety profile, VR should become a standard offering in ED minor hand procedures.
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Affiliation(s)
- Leonardo Alaniz
- From the School of Medicine, University of California Irvine, Irvine, Calif
- Department of Plastic Surgery, University of California Irvine Medical Center, Orange, Calif
| | - Abtin Shams
- Department of Plastic Surgery, University of California Irvine Medical Center, Orange, Calif
| | - Lohrasb Sayadi
- Department of Plastic Surgery, University of California Irvine Medical Center, Orange, Calif
| | - Mikhail Pakvasa
- Department of Plastic Surgery, University of California Irvine Medical Center, Orange, Calif
| | - Avril Stulginski
- From the School of Medicine, University of California Irvine, Irvine, Calif
| | - Justin Cordero
- University of California Riverside, School of Medicine, Riverside, Calif
| | - Nikhil Prabhakar
- Department of Plastic Surgery, University of California Irvine Medical Center, Orange, Calif
| | - Eric Wang
- Department of Plastic Surgery, University of California Irvine Medical Center, Orange, Calif
- Plastic Surgery, Long Beach Veterans Affairs, Long Beach, Calif
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Canut DM, Tatar R, Enescu DM, Marinescu AE, Talaban AI, Parvanescu V, Ciurea ME, Nacea I. Case Presentation of a Minor Patient, Survivor of a Burn with ABSI Score - 12 Points (Probability of Survival Below 20%). CURRENT HEALTH SCIENCES JOURNAL 2024; 50:337-341. [PMID: 39391371 PMCID: PMC11465948 DOI: 10.12865/chsj.50.02.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 06/15/2024] [Indexed: 10/12/2024]
Abstract
According to the World Health Organization, burns represent a major global public health issue, causing approximately 180,000 deaths annually. The article presents the case of a 17-year-old patient with burns after electric shock (27,000 volts), with a burned area of approximately 72%, 3rd degree, segment IIB, with ABSI score=12, who was treated in a centre dedicated to paediatric burn patients. The use of treatment of paediatric burns not only enhances the quality of healthcare but also has the potential to reduce suffering and improve the chances of recovery for children who go through such traumatic experiences.
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Affiliation(s)
- Denisa Maria Canut
- Student, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania
| | - Raluca Tatar
- Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Dan Mircea Enescu
- Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | | | | | - Vlad Parvanescu
- Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania
| | - Marius Eugen Ciurea
- Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania
| | - Iulia Nacea
- Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
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Peng K, Moussavi Z, Karunakaran KD, Borsook D, Lesage F, Nguyen DK. iVR-fNIRS: studying brain functions in a fully immersive virtual environment. NEUROPHOTONICS 2024; 11:020601. [PMID: 38577629 PMCID: PMC10993907 DOI: 10.1117/1.nph.11.2.020601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 03/05/2024] [Accepted: 03/06/2024] [Indexed: 04/06/2024]
Abstract
Immersive virtual reality (iVR) employs head-mounted displays or cave-like environments to create a sensory-rich virtual experience that simulates the physical presence of a user in a digital space. The technology holds immense promise in neuroscience research and therapy. In particular, virtual reality (VR) technologies facilitate the development of diverse tasks and scenarios closely mirroring real-life situations to stimulate the brain within a controlled and secure setting. It also offers a cost-effective solution in providing a similar sense of interaction to users when conventional stimulation methods are limited or unfeasible. Although combining iVR with traditional brain imaging techniques may be difficult due to signal interference or instrumental issues, recent work has proposed the use of functional near infrared spectroscopy (fNIRS) in conjunction with iVR for versatile brain stimulation paradigms and flexible examination of brain responses. We present a comprehensive review of current research studies employing an iVR-fNIRS setup, covering device types, stimulation approaches, data analysis methods, and major scientific findings. The literature demonstrates a high potential for iVR-fNIRS to explore various types of cognitive, behavioral, and motor functions in a fully immersive VR (iVR) environment. Such studies should set a foundation for adaptive iVR programs for both training (e.g., in novel environments) and clinical therapeutics (e.g., pain, motor and sensory disorders and other psychiatric conditions).
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Affiliation(s)
- Ke Peng
- University of Manitoba, Department of Electrical and Computer Engineering, Price Faculty of Engineering, Winnipeg, Manitoba, Canada
| | - Zahra Moussavi
- University of Manitoba, Department of Electrical and Computer Engineering, Price Faculty of Engineering, Winnipeg, Manitoba, Canada
| | - Keerthana Deepti Karunakaran
- Massachusetts General Hospital, Harvard Medical School, Department of Psychiatry, Boston, Massachusetts, United States
| | - David Borsook
- Massachusetts General Hospital, Harvard Medical School, Department of Psychiatry, Boston, Massachusetts, United States
- Massachusetts General Hospital, Harvard Medical School, Department of Radiology, Boston, Massachusetts, United States
| | - Frédéric Lesage
- University of Montreal, Institute of Biomedical Engineering, Department of Electrical Engineering, Ecole Polytechnique, Montreal, Quebec, Canada
- Montreal Heart Institute, Montreal, Quebec, Canada
| | - Dang Khoa Nguyen
- University of Montreal, Department of Neurosciences, Montreal, Quebec, Canada
- Research Center of the Hospital Center of the University of Montreal, Department of Neurology, Montreal, Quebec, Canada
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Boyce L, Jordan C, Egan T, Sivaprakasam R. Can virtual reality enhance the patient experience during awake invasive procedures? A systematic review of randomized controlled trials. Pain 2024; 165:741-752. [PMID: 37870233 DOI: 10.1097/j.pain.0000000000003086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 08/16/2023] [Indexed: 10/24/2023]
Abstract
ABSTRACT Procedural anxiety and pain negatively affect surgical outcomes and the patient experience during awake, invasive procedures (AIPs). This systematic review aims to evaluate the effect of using virtual reality (VR) to enhance the intraprocedural patient experience during AIPs. PRISMA, Cochrane, and SWiM Reporting Items guidelines were followed. PubMed, EMBASE, CENTRAL, and medRxiv databases were systematically searched for randomised controlled trials (RCTs) investigating the use of immersive VR headsets to enhance the patient experience in adults undergoing AIPs. Sixteen studies were included. The VR and control groups comprised 685 and 677 patients, respectively. Patients underwent endoscopic procedures in 9 studies ("endoscopic") and interventions that involved a skin incision in 7 studies ("incision"). Eleven (of 13) studies demonstrated a favourable effect on procedural anxiety with VR use compared with standard intraprocedural care (85% [95% CI: 46%-100%], P = 0.011). Ten (of 13) studies demonstrated a favourable effect on pain with VR use (77% [95% CI: 38%-100%], P = 0.046). Seven (of 9) studies demonstrated a favourable VR effect on patient satisfaction (78% (95% CI: 44%-100%), P = 0.070). The effect of VR on physiological markers of anxiety and pain and requirements for additional pro re nata (PRN) analgesia and sedation were not clear. No significant differences in patient experience were identified between the "incision" and "endoscopic" subgroups. This review demonstrates that VR can feasibly be used to enhance the patient experience during AIPs by attenuating subjective perceptions of procedural anxiety and pain. However, further RCTs are required to elucidate the effect of VR on more objective measures of the patient experience.
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Affiliation(s)
| | | | | | - Rajesh Sivaprakasam
- Nephrology and Renal Transplant, the Royal London Hospital, Barts Health NHS Trust, London, United Kingdom
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Squara F, Bateau J, Scarlatti D, Bun SS, Moceri P, Ferrari E. Virtual Reality for the Management of Pain and Anxiety in Patients Undergoing Implantation of Pacemaker or Implantable Cardioverter Defibrillator: A Randomized Study. J Med Syst 2024; 48:28. [PMID: 38441786 DOI: 10.1007/s10916-024-02039-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 02/05/2024] [Indexed: 03/07/2024]
Abstract
BACKGROUND The Virtual Reality Headset (VRH) is a device aiming at improving patient's comfort by reducing pain and anxiety during medical interventions. Its interest during cardiac implantable electronic devices (CIED) implant procedures has not been studied. METHODS We randomized consecutive patients admitted for pacemaker or Implantable Cardioverter Defibrillator (ICD) at our center to either standard analgesia care (STD-Group), or to VRH (VRH-Group). Patients in the STD-Group received intra-venous paracetamol (1 g) 60 min before the procedure, and local anesthesia was performed with lidocaine. For patients of the VRH-Group, VRH was used on top of standard care. We monitored patients' pain and anxiety using numeric rating scales (from 0 to 10) at the time of sub-cutaneous pocket creation, and during deep axillary vein puncture. Patient comfort during the procedure was assessed using a detailed questionnaire. Morphine consumption was also assessed. RESULTS We randomized 61 patients to STD-Group (n = 31) or VRH-Group (n = 30). Pain and anxiety were lower in the VRH-Group during deep venous puncture (3.0 ± 2.0 vs. 4.8 ± 2.2, p = 0.002 and 2.4 ± 2.2 vs. 4.1 ± 2.4, p = 0.006) but not during pocket creation (p = 0.58 and p = 0.5). Morphine consumption was lower in the VRH-Group (1.6 ± 0.7 vs. 2.1 ± 1.1 mg; p = 0.041). Patients' overall comfort during procedure was similar in both groups. CONCLUSION VRH use improved pain and anxiety control during deep venous puncture compared to standard analgesia care, and allowed morphine consumption reduction. However, pain and anxiety were similar at the time of sub-cutaneous pocket creation.
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Affiliation(s)
- Fabien Squara
- Cardiology department, Pasteur University Hospital, 30 voie Romaine, Nice, France.
| | - Jules Bateau
- Cardiology department, Pasteur University Hospital, 30 voie Romaine, Nice, France
| | - Didier Scarlatti
- Cardiology department, Pasteur University Hospital, 30 voie Romaine, Nice, France
| | - Sok-Sithikun Bun
- Cardiology department, Pasteur University Hospital, 30 voie Romaine, Nice, France
| | - Pamela Moceri
- Cardiology department, Pasteur University Hospital, 30 voie Romaine, Nice, France
| | - Emile Ferrari
- Cardiology department, Pasteur University Hospital, 30 voie Romaine, Nice, France
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Martinez-Bernal D, Cross WF, Hasselberg M, Tapparello C, Stenz CFH, Kolokythas A. A brief virtual reality intervention for pre-operative anxiety in adults. Oral Surg Oral Med Oral Pathol Oral Radiol 2024; 137:209-214. [PMID: 38171998 DOI: 10.1016/j.oooo.2023.08.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/08/2023] [Accepted: 08/11/2023] [Indexed: 01/05/2024]
Abstract
OBJECTIVE Virtual reality (VR) is a promising non-pharmacologic tool for managing health care anxiety. We assessed the feasibility and acceptability of a pre-operative VR intervention by adult patients and medical staff and measured anxiety in adult patients pre- and post-VR intervention. STUDY DESIGN We recruited 30 patients scheduled to undergo oral surgery and 8 medical staff as participants. The patients completed a verbal demographic survey and rated their anxiety before the VR intervention and at 1 minute and 2 minutes post-intervention. We administered the Acceptability of Intervention Measure to the patients to measure their perceptions of the VR intervention and the Feasibility of Intervention Measure to the medical staff to assess their perception of VR implementation. We performed an analysis of variance to compare pre-operative anxiety over time and assess demographic differences. RESULTS The patients showed high and consistent acceptability of the pre-operative use of VR among patients, but acceptability varied among medical staff. The patients experienced a statistically significant reduction of pre-operative anxiety (P = .003). CONCLUSION A brief VR pre-intervention is highly accepted by and very beneficial for patients undergoing oral surgery, positively affecting anxiety reduction. The perception of VR by health care providers needs to be explored to increase acceptability.
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Affiliation(s)
| | - Wendi F Cross
- Department of Psychiatry and Pediatrics, University of Rochester Medical Center, Rochester, NY, USA.
| | - Michael Hasselberg
- Chief Digital Health Officer, University of Rochester Medical Center, Rochester, NY, USA
| | - Cristiano Tapparello
- Department of Electrical and Computer Engineering, University of Rochester, Rochester, NY, USA
| | - Colette F H Stenz
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Antonia Kolokythas
- Department of Oral and Maxillofacial Surgery, University of Augusta, Augusta, GA, USA
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Li LW, Beng MH, Singh PA, Koo SH, Sng BL. Evaluating simulator sickness and acceptability of virtual reality prototype in pain management in hospitalized patients. Pain Manag 2024; 14:53-63. [PMID: 38357747 DOI: 10.2217/pmt-2023-0072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024] Open
Abstract
Aim: Acute and chronic noncancer pain is a common healthcare problem locally and globally, and remains under treated and poorly controlled. We created a virtual reality (VR)-based prototype with customization of content to our local population. Materials & methods: This was an open-label, single center, single-arm study to examine the safety, acceptability and tolerability of the use of VR as an adjunctive tool for pain relief in hospitalized patients. The participants rated their baseline and post-VR pain and anxiety scores. Results & conclusion: All 50 patients completed the VR sessions with good tolerability and safety. Preliminary exploration of pain reduction indicated a positive effect (for pain and anxiety visual analog scale scores; p < 0.001). We believe VR is a potentially beneficial tool for use in pain management.
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Affiliation(s)
- Lydia Weiling Li
- Department of Anaesthesia & Surgical Intensive Care, Changi General Hospital, Singapore
- Duke-NUS Graduate Medical School, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Michael Hock Beng
- Department of Anaesthesia & Surgical Intensive Care, Changi General Hospital, Singapore
| | - Prit Anand Singh
- Department of Anaesthesia & Surgical Intensive Care, Changi General Hospital, Singapore
- Duke-NUS Graduate Medical School, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Seok Hwee Koo
- Research Laboratory, Changi General Hospital, Singapore
| | - Ban Leong Sng
- Duke-NUS Graduate Medical School, Singapore
- KK Women's & Children's Hospital, Singapore
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Iqbal AI, Aamir A, Hammad A, Hafsa H, Basit A, Oduoye MO, Anis MW, Ahmed S, Younus MI, Jabeen S. Immersive Technologies in Healthcare: An In-Depth Exploration of Virtual Reality and Augmented Reality in Enhancing Patient Care, Medical Education, and Training Paradigms. J Prim Care Community Health 2024; 15:21501319241293311. [PMID: 39439304 DOI: 10.1177/21501319241293311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2024] Open
Abstract
BACKGROUND Virtual reality (VR) and augmented reality (AR) are rapidly gaining traction in healthcare, offering transformative opportunities for patient care, medical education, and therapeutic interventions. Despite their potential, challenges remain regarding the implementation and integration of these technologies into existing healthcare practices. OBJECTIVE This review aims to explore the current applications of VR and AR in healthcare, particularly focusing on their roles in enhancing patient care and medical training, as well as identifying research gaps that hinder their widespread adoption. METHODS A comprehensive literature search was conducted across 2 primary databases, PubMed, and Google Scholar. The search was restricted to peer-reviewed articles, systematic reviews, meta-analyses, and randomized controlled trials (RCTs) published from 2000 to 2024. Reference lists of included articles were also examined for additional relevant studies. Inclusion criteria focused on empirical studies addressing the use of VR and/or AR in patient care or medical training, while editorial pieces, non-peer-reviewed sources, and unrelated studies were excluded. A total of 17 900 search results were identified on Google Scholar and 300 on PubMed, leading to the inclusion of 89 articles in this review. RESULTS The findings indicate that VR and AR technologies significantly enhance patient experiences and medical training, providing immersive and interactive environments for learning and practice. However, notable challenges include integration issues with existing electronic health record systems, the need for appropriate implementation models, and a lack of substantial evidence supporting the clinical efficacy of AR-assisted procedures. CONCLUSION While VR and AR hold considerable promise in revolutionizing healthcare practices, further research is essential to address existing gaps, particularly regarding implementation strategies, user acceptance, and empirical evaluation of patient outcomes and training effectiveness. Understanding the needs of healthcare professionals and patients will be critical to maximizing the impact of these technologies in clinical settings.
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Affiliation(s)
- Arham I Iqbal
- Dow International Medical College, Karachi, Pakistan
| | - Ali Aamir
- Dow Medical College, Karachi, Pakistan
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Isbel S, Holloway H, Greber C, Nguyen K, Frost J, Pearce C, D’Cunha NM. Virtual reality after stroke: Identifying important characteristics when designing experiences to improve engagement in upper limb rehabilitation. Digit Health 2024; 10:20552076241251634. [PMID: 38817838 PMCID: PMC11138195 DOI: 10.1177/20552076241251634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 04/12/2024] [Indexed: 06/01/2024] Open
Abstract
Objective Virtual reality (VR) has been used to improve upper limb function after stroke but there is little to guide product developers in building experiences that engage users in the sustained, repetitive training required. This research sought to understand the characteristics of VR scenarios best suited to engaging someone with a stroke during recovery to achieve therapeutic outcomes. Methods Five creative immersive VR scenarios were designed by an experienced VR content creator containing unique combinations of VR characteristics. The usefulness of the scenarios was reviewed by expert clinicians experienced in stroke rehabilitation. Following this review, seven stroke survivors participated in each experience and reported on their engagement and motivation. Outcome measures were the User Satisfaction Evaluation Questionnaire and the modified Intrinsic Motivation Inventory. Semi-structured interviews were conducted with five participants following their immersive VR experience and analysed thematically. Results Expert clinicians reported potential therapeutic value in the immersive VR scenarios by providing opportunities for repeated and graded practice of upper limb movements. Stroke survivors reported varied levels of enjoyment and engagement for each scenario. They recommended changes to the experiences, primarily relating to the tailoring of the scenarios to match varied upper limb capacities. Conclusion This study highlights the characteristics of immersive VR scenarios that are important in sustaining motivation and providing high-repetition task-specific movement experiences. Differences in the experience and preferences of stroke participants regarding the characteristics of immersive VR experiences indicate that a variety of experiences are necessary to engage and sustain participation in an immersive VR-related therapy programme.
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Affiliation(s)
- Stephen Isbel
- Faculty of Health, School of Exercise and Rehabilitation Sciences, University of Canberra, Canberra, ACT, Australia
- Faculty of Health, Centre for Ageing Research and Translation, University of Canberra, Bruce, ACT, Australia
| | - Helen Holloway
- Faculty of Health, School of Exercise and Rehabilitation Sciences, University of Canberra, Canberra, ACT, Australia
- Faculty of Health, Centre for Ageing Research and Translation, University of Canberra, Bruce, ACT, Australia
| | - Craig Greber
- Faculty of Health, School of Exercise and Rehabilitation Sciences, University of Canberra, Canberra, ACT, Australia
| | - Kelly Nguyen
- Faculty of Health, School of Exercise and Rehabilitation Sciences, University of Canberra, Canberra, ACT, Australia
| | - Jane Frost
- School of Nursing and Midwifery, Western Sydney University, Penrith South, New South Wales, Australia
| | - Claire Pearce
- Faculty of Health, School of Exercise and Rehabilitation Sciences, University of Canberra, Canberra, ACT, Australia
| | - Nathan M D’Cunha
- Faculty of Health, School of Exercise and Rehabilitation Sciences, University of Canberra, Canberra, ACT, Australia
- Faculty of Health, Centre for Ageing Research and Translation, University of Canberra, Bruce, ACT, Australia
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Jain S, Armstrong M, Luna J, Thakkar RK, Fabia R, Groner JI, Noffsinger D, Ni A, Nelson E, Xiang H. Features of virtual reality impact effectiveness of VR pain alleviation therapeutics in pediatric burn patients: A randomized clinical trial. PLOS DIGITAL HEALTH 2024; 3:e0000440. [PMID: 38271320 PMCID: PMC10810440 DOI: 10.1371/journal.pdig.0000440] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 12/27/2023] [Indexed: 01/27/2024]
Abstract
Key features of virtual reality (VR) that impact the effectiveness of pain reduction remain unknown. We hypothesized that specific features of the VR experience significantly impact VR's effectiveness in reducing pain during pediatric burn dressing care. Our randomized controlled trial included children 6 to 17 years (inclusive) who were treated in the outpatient clinic of an American Burn Association-verified pediatric burn center. Participants were randomly assigned (1:1:1) to active VR (playing the VR), passive VR (immersed in the same VR environment without interactions), or standard-of-care. On a scale from 0 to 100, participants rated overall pain (primary outcome) and features of the VR experience (game realism, fun, and engagement). Path analysis assessed the interrelationships among these VR key features and their impact on self-reported pain scores. From December 2016 to January 2019, a total of 412 patients were screened for eligibility, and 90 were randomly assigned (31 in the active VR group, 30 in the passive VR group, and 29 in the standard-of-care group). The current study only included those in the VR groups. The difference in median scores of VR features was not statistically significant between the active (realism, 77.5 [IQR: 50-100]; fun, 100 [IQR: 81-100]; engagement, 90 [IQR: 70-100]) and passive (realism, 72 [IQR: 29-99]; fun, 93.5 [IQR: 68-100]; engagement, 95 [IQR: 50-100]) VR distraction types. VR engagement had a significant direct (-0.39) and total (-0.44) effect on self-reported pain score (p<0.05). Key VR features significantly impact its effectiveness in pain reduction. The path model suggested an analgesic mechanism beyond distraction. Differences in VR feature scores partly explain active VR's more significant analgesic effect than passive VR. Trial Registration: ClinicalTrials.gov Identifier: NCT04544631.
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Affiliation(s)
- Soumil Jain
- College of Medicine, The Ohio State University, Columbus, Ohio, United States of America
- Center for Pediatric Trauma Research, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, United States of America
| | - Megan Armstrong
- Center for Pediatric Trauma Research, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, United States of America
- Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, United States of America
| | - John Luna
- IT Research and Innovation, The Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, Ohio, United States of America
| | - Rajan K. Thakkar
- College of Medicine, The Ohio State University, Columbus, Ohio, United States of America
- Center for Pediatric Trauma Research, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, United States of America
- Trauma and Burn Program, Nationwide Children’s Hospital, Columbus, Ohio, United States of America
| | - Renata Fabia
- College of Medicine, The Ohio State University, Columbus, Ohio, United States of America
- Center for Pediatric Trauma Research, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, United States of America
- Trauma and Burn Program, Nationwide Children’s Hospital, Columbus, Ohio, United States of America
| | - Jonathan I. Groner
- College of Medicine, The Ohio State University, Columbus, Ohio, United States of America
- Center for Pediatric Trauma Research, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, United States of America
- Trauma and Burn Program, Nationwide Children’s Hospital, Columbus, Ohio, United States of America
| | - Dana Noffsinger
- Center for Pediatric Trauma Research, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, United States of America
- Trauma and Burn Program, Nationwide Children’s Hospital, Columbus, Ohio, United States of America
| | - Ai Ni
- Division of Biostatistics, The Ohio State University College of Public Health, Columbus, Ohio, United States of America
| | - Eric Nelson
- Center for Biobehavioral Health, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, United States of America
| | - Henry Xiang
- College of Medicine, The Ohio State University, Columbus, Ohio, United States of America
- Center for Pediatric Trauma Research, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, United States of America
- Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, United States of America
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Zattoni F, Carletti F, Randazzo G, Tuminello A, Betto G, Novara G, Dal Moro F. Potential Applications of New Headsets for Virtual and Augmented Reality in Urology. Eur Urol Focus 2023:S2405-4569(23)00295-X. [PMID: 38160172 DOI: 10.1016/j.euf.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 12/02/2023] [Accepted: 12/18/2023] [Indexed: 01/03/2024]
Abstract
Virtual and augmented reality (VR/AR) technologies hold great promise in various medical fields. The release of a new generation of headsets for medical enhanced VR/AR (MER) opens new possibilities for applications in medicine, particularly in urology, to improve accessibility to everyone. These innovative headsets offer deep immersion without requiring a controller, which represents a novel approach to VR/AR engagement. The potential of these headsets applies to all aspects of urology, including surgical training, virtual meetings, communication between health care providers, patient counseling, telemedicine, delivering patient advice, and pain control. MER has the potential to improve operative planning and enhance intraoperative navigation and spatial awareness. The surgeon's visualization and overall experience can be significantly enhanced via improved guidance and visualization, ultimately leading to greater precision and safety. This cutting-edge technology has the potential to reshape urology practice, communication methods, and medical procedures, and ultimately to improve patients' experience of their urological condition. PATIENT SUMMARY: This mini review explores how a new generation of headsets for medical enhanced virtual reality could revolutionize urology by improving surgical planning, assistance during procedures, and medical education. Patients can benefit from better pain management and a deeper understanding of their conditions. However, challenges such as costs, accuracy, and ethical concerns must be addressed. This technology holds promise for transforming urological practice and patient care.
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Affiliation(s)
- Fabio Zattoni
- Department of Surgery, Oncology, and Gastroenterology, Urological Unit, University of Padova, Padova, Italy.
| | - Filippo Carletti
- Department of Surgery, Oncology, and Gastroenterology, Urological Unit, University of Padova, Padova, Italy
| | - Gianmarco Randazzo
- Department of Surgery, Oncology, and Gastroenterology, Urological Unit, University of Padova, Padova, Italy
| | - Arianna Tuminello
- Department of Surgery, Oncology, and Gastroenterology, Urological Unit, University of Padova, Padova, Italy
| | - Giovanni Betto
- Department of Surgery, Oncology, and Gastroenterology, Urological Unit, University of Padova, Padova, Italy
| | - Giacomo Novara
- Department of Surgery, Oncology, and Gastroenterology, Urological Unit, University of Padova, Padova, Italy
| | - Fabrizio Dal Moro
- Department of Surgery, Oncology, and Gastroenterology, Urological Unit, University of Padova, Padova, Italy
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Fan L, Zeng J, Ran L, Zhang C, Wang J, Yu C, Zhao N. Virtual reality in managing dental pain and anxiety: a comprehensive review. Front Med (Lausanne) 2023; 10:1285142. [PMID: 38131048 PMCID: PMC10736194 DOI: 10.3389/fmed.2023.1285142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 11/09/2023] [Indexed: 12/23/2023] Open
Abstract
Objectives This study aimed to identify, analyze, and summarize the clinical efficacy of virtual reality (VR) distraction therapy for oral treatment in different hospital settings in contrast to medical interventions that induce anxiety and pain. Furthermore, this review aimed to determine the implications for research and clinical practice of VR distraction therapy. Data This review investigated the clinical efficacy of VR in the oral treatment of procedural pain or anxiety. Quality assessment of the included studies was conducted. A narrative synthesis of the collected data was performed. Sources Literature studies from six electronic databases were searched for a comprehensive review, namely, the Cochrane Oral Health's Trials Register, Cochrane Central Register of Controlled Trials (Central), MEDLINE (PubMed), EMBASE, Scopus, and Web of Science. Study selection One thousand five hundred twenty-two patients aged between 0 and 60 years who used VR during dental treatment were included in this review. Among these studies, 8 and 14 studies comprised adult and pediatric patients. Conclusion Overall, the reviewed studies underscore the efficacy of VR to mitigate pain and anxiety in the context of dental treatment. VR is an innovative pain and anxiety management approach that facilitates dental treatment patients to immerse themselves in a virtual world while using distractions to reduce pain and anxiety. Clinical significance VR is an effective and novel non-pharmacological method of behavioral management that contributes to improving medication safety for dental patients. VR as a distractive approach can reduce the fear associated with medical interventions and prevent severe pain sensitivity, anxiety, and medical avoidance among adults and children.
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Affiliation(s)
- Lin Fan
- Department of Anesthesiology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Jie Zeng
- Department of Anesthesiology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Longkuan Ran
- Department of Anesthesiology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Chao Zhang
- Department of Anesthesiology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Jing Wang
- Department of Anesthesiology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Cong Yu
- Department of Anesthesiology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Nan Zhao
- Department of Anesthesiology, Stomatological Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
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Zhou S, Gromala D, Wang L. Ethical Challenges of Virtual Reality Technology Interventions for the Vulnerabilities of Patients With Chronic Pain: Exploration of Technician Responsibility. J Med Internet Res 2023; 25:e49237. [PMID: 38048153 PMCID: PMC10728792 DOI: 10.2196/49237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 10/20/2023] [Accepted: 10/26/2023] [Indexed: 12/05/2023] Open
Abstract
Chronic pain, a common disease, is a crucial global public health concern. Approximately 20% of the worldwide population is affected by chronic pain, which accounts for 15% to 20% of hospital visits. In Canada, approximately 7.6 million people-or 1 in 5 people-experience chronic pain. Among this population, 60% has either lost their employment or experienced a reduction in income as a result of their pain. The proportion of older people (aged ≥65 years) with chronic pain is high, comprising one-third of the total older population. In addition, the causes of chronic pain and its cures are unknown, and treatment is limited by these unknowns and the dangers of opioids. These essential factors make patients with chronic pain one of the most vulnerable populations. The use of emerging virtual reality (VR) technology as an intervention for chronic pain has consistently demonstrated early effectiveness and has been termed as a "nonpharmacological analgesic." Nevertheless, we must remain vigilant about the potential ethical risks of VR interventions, as inappropriate VR interventions may exacerbate the vulnerabilities of patients. Currently, a central challenge for VR developers is the ambiguity of patient vulnerability and the unpredictability of ethical dilemmas. Therefore, our paper focused on the vulnerability and ethical dilemmas faced by patients with chronic pain in VR interventions. Through an experience-based, prospective ethical examination, we have identified both existing and potential new vulnerabilities and specific manifestations that patients with chronic pain may encounter in VR interventions. Our aim was to highlight the ethical risks that may be present in VR interventions. On one hand, this can help raise awareness among technology developers regarding the vulnerabilities of patients with chronic pain and mitigate technological ethical risks. In addition, it can assist technology developers in determining the priorities for VR technology interventions. These efforts collectively lay a solid foundation for the comprehensive realization of responsible VR technology interventions.
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Affiliation(s)
- Siyu Zhou
- Department of Philosophy, Central South University, Changsha, China
- School of Interactive Arts and Technology, Simon Fraser University, Surrey, BC, Canada
| | - Diane Gromala
- School of Interactive Arts and Technology, Simon Fraser University, Surrey, BC, Canada
| | - Leyu Wang
- Department of Philosophy, Central South University, Changsha, China
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Almajed OS, Alhujhuj R, Alshaheen E, Almujhim A, Albutayh M, Raghunath RG, Lele G. The Effectiveness of Virtual Reality in Controlling Pain and Anxiety Levels in Four-to-Six-Year-Old Children During Dental Treatment. Cureus 2023; 15:e51099. [PMID: 38274902 PMCID: PMC10809031 DOI: 10.7759/cureus.51099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2023] [Indexed: 01/27/2024] Open
Abstract
Background and objective Oral health is critical for children's overall well-being; however, dental anxiety often leads to the avoidance of necessary dental care among children. Virtual reality (VR) has emerged as a successful adjunctive tool in various clinical settings, including pain management. This cohort study explores the use of VR technology in reducing anxiety and pain perception during dental procedures for children. The primary objective of this study was to assess the efficacy of VR distraction in managing pain and anxiety levels in children aged four to six years during dental procedures. Additionally, the study aimed to compare children's anxiety levels with and without VR eyeglasses. Methodology This single-blind, crossover clinical trial was conducted at the Dental Complex of King Faisal University, Al Ahsa, Kingdom of Saudi Arabia. Of the 200 children screened initially, 20 aged four to six years who met the inclusion criteria were selected, and ethical approval for the study was obtained. The study comprised two groups: a control group and an experimental group. Dental procedures were conducted both with and without the use of VR, employing a split-mouth design. Results Our findings provide important insights into the clinical impact of using VR technology to alleviate children's anxiety during dental clinic visits. In our study, we used ANOVA and Tukey's post hoc test to evaluate the effect of VR glasses on vital metrics in children during dental procedures. Our results showed no significant differences before and after using the VR glasses, indicating limited effectiveness in reducing anxiety in this context. Conclusion Based on our findings, we reject the assumption that VR devices are highly effective in diverting children's attention and reducing their anxiety and pain during dental procedures; we recommend further investigations to identify potential confounding factors that could modulate the utility of VR in medical settings.
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Affiliation(s)
- Omar S Almajed
- Pediatric Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, SAU
- Dental Public Health, King's College London, London, GBR
| | - Rakan Alhujhuj
- Dental Department, King Abdulaziz National Guard Hospital, Al Hofuf, SAU
| | | | | | | | - Ravi G Raghunath
- Department of Preventive Dental Sciences, King Faisal University, Al Ahsa, SAU
| | - Gauri Lele
- Pediatric and Preventive Dentistry, Navrachana University, Gujarat, IND
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McGirt MJ, Holland CM, Farber SH, Zuckerman SL, Spertus MS, Theodore N, Pfortmiller D, Stanley G. Remote cognitive behavioral therapy utilizing an in-home virtual reality toolkit (Vx Therapy) reduces pain, anxiety, and depression in patients with chronic cervical and lumbar spondylytic pain: A potential alternative to opioids in multimodal pain management. NORTH AMERICAN SPINE SOCIETY JOURNAL 2023; 16:100287. [PMID: 38033880 PMCID: PMC10684389 DOI: 10.1016/j.xnsj.2023.100287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/15/2023] [Accepted: 10/16/2023] [Indexed: 12/02/2023]
Abstract
Background Context Virtual reality (VR) reduces pain through visual and auditory distraction without narcotic-related side effects or dependency. Cognitive behavioral therapy (CBT) improves pain-related disability and quality of life, but patient access remains a challenge. We hypothesized that in-home weekly CBT coordinated with daily use of a proprietary VR toolkit will reduce pain, anxiety, and depression for patients with non-operative chronic cervical and lumbar spondylitic pain with and without radiculopathy. Methods A total of 145 patients with chronic spondylitic pain (63 cervical, 46 noradicular lumbar, 36 radicular lumbar) were enrolled into a guided 14-week VR+CBT program (Vx Therapy) consisting of weekly encounters with a trained therapist and 50 modules. Pain/anxiety severity scores and time to pain recurrence were recorded prospectively by patients. PROMIS measures of overall daily pain intensity, behavior, interference, anxiety, and depression were recorded at baseline and conclusion of the program. Results A total of 52% of the 145 patients were male. The average (SD) age of the cohort was 51 (10.7) years (range: 24-76 years). Mean score for all PROMIS domains were significantly improved after 14 weeks of Vx Therapy (pain intensity 36±24 vs. 28±21, interference 39±25 vs. 24±21, behavior 35±21 vs. 25±16, anxiety 51±28 vs. 41±26, depression 58±32 vs. 48±32) for the entire cohort and each diagnosis group. Virtual reality acutely reduced pain on average by 33% (4.5±2.5 vs. 6.7±2.2, p<.05) across all 14 weeks, lasting a mean 2.8 hours after use. Duration of pain relief increased by the final vs. first month (4.5 hours vs. 2.5 hours, p<.05). Virtual reality acutely reduced anxiety on average by 46% (3.5±3 vs. 6.4±2, p<.05) across all 14 weeks lasting a mean 2.7 hours after use. The effect was similar for all 3 groups. Conclusions Fourteen weeks of a remote CBT guided in-home VR toolkit provided effective and sustained pain, anxiety, and depression relief in patients with chronic degenerative neck/back pain with and without radiculopathy. The non-invasive, non-pharmacological nature of Vx Therapy makes it an ideal option for pain management in the post-opioid epidemic era.
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Affiliation(s)
- Matthew J. McGirt
- Carolina Neurosurgery & Spine Associates, Atrium-Wake Forest University, 225 Baldwin Ave, Charlotte, NC 28205, USA
| | - Christopher M. Holland
- Carolina Neurosurgery & Spine Associates, Atrium-Wake Forest University, 225 Baldwin Ave, Charlotte, NC 28205, USA
| | - S. Harrison Farber
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, 350 W. Thomas Rd. Phoenix, AZ 85013, USA
| | - Scott L. Zuckerman
- Department of Neurosurgery, Vanderbilt University, 1211 Medical Center, Nashville, TN 37232, USA
| | - Michael S. Spertus
- Whole Health in Pain Medicine, Miami Veterans Affairs Healthcare System, 1201 NW 16th St., Miami, FL 33125, USA
| | - Nicholas Theodore
- Department of Neurosurgery, Johns Hopkins University, 1800 Orleans St., Baltimore, MD 21287, USA
| | - Deborah Pfortmiller
- Carolina Neurosurgery & Spine Associates, Atrium-Wake Forest University, 225 Baldwin Ave, Charlotte, NC 28205, USA
| | - Gerry Stanley
- Harvard Med Tech, 6280 S. Valley View Blvd., Las Vegas, NV 89118, USA
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Yang X, Zhong S, Yang S, He M, Xu X, He S, Fan G, Liu L. Global Scientific Trends in Virtual Reality for Pain Treatment From 2000 to 2022: Bibliometric Analysis. JMIR Serious Games 2023; 11:e48354. [PMID: 37991981 PMCID: PMC10686536 DOI: 10.2196/48354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 09/04/2023] [Accepted: 09/20/2023] [Indexed: 11/24/2023] Open
Abstract
Background Virtual reality (VR) is a computer simulation technique that has been increasingly applied in pain management over the past 2 decades. Objective In this study, we used bibliometrics to explore the literature on VR and pain control, with the aim of identifying research progress and predicting future research hot spots. Methods We extracted literature on VR and pain control published between 2000 and 2022 from the Web of Science Core Collections and conducted bibliometric analyses. We analyzed the publication and citation trends in the past 2 decades, as well as publication and citation analyses of different countries, institutions, journals, and authors. For references, we conducted cocitation and burst analyses. For keywords, we conducted co-occurrence, clustering, timeline view, and citation burst analyses. Results Based on 1176 publications, we found that there was a continuous increase in publication and citation volumes, especially in the last 5 years. The United States was the most representative country, and the University of Washington was the most representative institution, with both having the most publications and citations. The most popular journal in this field was Burns, and Hoffman HG was the most productive author, leading many studies on patients with burn pain. The reference with the most citation burst was a study on the verification of new hardware in pain control. The keywords with the highest citation bursts related to various situations of pain such as "burn pain," "wound care," "low back pain," and "phantom limb." Conclusions VR has been applied in various clinical situations for pain management, among which burns and pediatric surgery have achieved satisfactory results. We infer that VR will be extended to more clinical pain situations in the future, such as pain control in wound care, low back pain, and phantom limb pain. New research hot spots will include the development of software and hardware to improve the immersive experience of VR for pain control. However, our work was based solely on English literature from the Web of Science database. For future studies, we recommend that researchers explore literature from multiple databases to enhance the scope of their research.
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Affiliation(s)
- Xun Yang
- Department of Traumatic Orthopedics, Shenzhen Second People’s Hospital (The First Affiliated Hospital, Shenzhen University; Shenzhen Translational Medicine Institute), Shenzhen, China
| | - Sen Zhong
- Department of Orthopedic, School of Medicine, Spinal Pain Research Institute, Shanghai Tenth People’s Hospital, Tongji University, Shanghai, China
| | - Sheng Yang
- Department of Orthopedic, School of Medicine, Spinal Pain Research Institute, Shanghai Tenth People’s Hospital, Tongji University, Shanghai, China
| | - Meng He
- Department of Traumatic Orthopedics, Shenzhen Second People’s Hospital (The First Affiliated Hospital, Shenzhen University; Shenzhen Translational Medicine Institute), Shenzhen, China
| | - Xu Xu
- Department of Traumatic Orthopedics, Shenzhen Second People’s Hospital (The First Affiliated Hospital, Shenzhen University; Shenzhen Translational Medicine Institute), Shenzhen, China
| | - Shisheng He
- Department of Orthopedic, School of Medicine, Spinal Pain Research Institute, Shanghai Tenth People’s Hospital, Tongji University, Shanghai, China
| | - Guoxin Fan
- Department of Pain Medicine, National Key Clinical Pain Medicine of China, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
| | - Lijun Liu
- Department of Traumatic Orthopedics, Shenzhen Second People’s Hospital (The First Affiliated Hospital, Shenzhen University; Shenzhen Translational Medicine Institute), Shenzhen, China
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Park J, Wiese LAK, Holt J. Online Chair Yoga and Digital Learning for Rural Underserved Older Adults at Risk for Alzheimer's Disease and Related Dementias. Clin Gerontol 2023:1-17. [PMID: 37941382 DOI: 10.1080/07317115.2023.2277333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
OBJECTIVES We evaluated the feasibility and preliminary efficacy of a home-based online chair yoga (OCY) program for racially and ethnically diverse rural community-dwelling older adults. METHODS We randomly assigned participants to OCY or a computer brain game (CBG). After a computer literacy training led by high school students, participants engaged in remotely supervised OCY or CBG in twice-weekly 45-minute sessions for 12 weeks. Outcome data (pain interference, cognitive function, mobility, computer skills) were collected at baseline, post-intervention, and 3-month follow-up. RESULTS A total of 32 eligible residents with mean age of 71 years participated in this intervention study. The interventions were feasible (100% recruitment rate, 96.8% retention rate, 100% safety rate). There were significant improvements in pain interference, cognitive function, mobility, and computer skills from baseline to follow-up among participants in both OCY and CBG but no significant differences in outcomes between groups. CONCLUSIONS Preliminary results indicated that the CBG was as effective as online OCY in clinical outcomes in these participants. However, this should be confirmed in future studies. CLINICAL IMPLICATIONS This telehealth-based intervention is feasible for older adults in rural and digitally underserved communities and could provide a strategy for delivering health-promoting interventions for home-bound older adults at risk for Alzheimer's disease and related dementias (ADRD) and connect caregivers to online resources.
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Affiliation(s)
- Juyoung Park
- Phyllis and Harvey Sandler School of Social Work, Florida Atlantic University, Boca Raton, Florida, USA
| | - Lisa Ann Kirk Wiese
- Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, Florida, USA
| | - Janet Holt
- Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, Florida, USA
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Perenic E, Grember E, Bassard S, Koutlidis N. Impact of virtual reality on pain management in transrectal MRI-guided prostate biopsy. FRONTIERS IN PAIN RESEARCH 2023; 4:1156463. [PMID: 37854306 PMCID: PMC10580802 DOI: 10.3389/fpain.2023.1156463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 07/25/2023] [Indexed: 10/20/2023] Open
Abstract
Background The beneficial effect of virtual reality (VR) on pain management in the context of transrectal MRI-guided prostate biopsy is not well established. However, it remains unclear whether an adjunctive of VR also improves pain management. This study aimed to evaluate the impact of VR as adjunctive in pain management in transrectal MRI-guided prostate biopsy (PB). Methods We retrospectively evaluated the pain intensity incidence in the 153 patients with PB indication (of which 102 were naïve of PB) who were admitted to our hospital since the acquisition of the Healthy Mind virtual reality headset on 19 January 2021. Results Baseline characteristics of patients who received local anesthesia with 1% lidocaine periprostatic nerve block (PPNB) (Group SOC, N = 78) and patients who received VR associated with PPNB (Group VR, N = 75) were largely similar. One PB with general anesthesia was excluded. The mean pain score at day zero was respectively 3.4 (±2.5) and 2.9 (±2.3) for SOC and VR (p = 0.203). However, the mean pain score at day zero was significantly lower in naïve PB patients with VR [2.7 (±2.0)] than in naïve PB patients with SOC [3.8 (±2.5), p = 0.012] when patients were stratified in PB status. Similar results were found on day 3 for the analysis including naïve-PB patients with SOC vs. with VR [0.4 (±2.5) vs. 0.2 (±2.0); p = 0.023)]. Conclusions The pain intensity was significantly lower in naïve PB patients with VR than in naïve PB patients with SOC. There were no side effects from VR and tolerability was excellent.
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Affiliation(s)
- Emma Perenic
- Department of Urology, Chalon-sur-Saone Hospital, Chalon-sur-Saone, France
| | - Emilie Grember
- Department of Urology, Dijon University Hospital, Dijon, France
| | - Sébastien Bassard
- Department of Urology, Chalon-sur-Saone Hospital, Chalon-sur-Saone, France
| | - Nicolas Koutlidis
- Department of Urology, Chalon-sur-Saone Hospital, Chalon-sur-Saone, France
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Şolt Kırca A, Güdücü N, İkiz B. The Effect of Virtual Glasses Application on Pain and Anxiety During Episiotomy Repair: Randomized Controlled Trial. Pain Manag Nurs 2023; 24:e123-e130. [PMID: 37455184 DOI: 10.1016/j.pmn.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 06/16/2023] [Accepted: 06/21/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND In the literature, the efficacy of virtual glasses on acute pain and anxiety has been investigated, and no study has been found on its effect on pain and anxiety during episiotomy repair. AIMS To determine the efficacy of virtual glasses application in pain and anxiety during episiotomy repair. DESIGN Randomized controlled trial design was used. PARTICIPANTS The study included 120 women who were primiparous and pregnant: 40 in the control group and 80 in the experimental groups (virtual glasses and skin to skin contact). METHODS Data were collected using Descriptive Information Form, the Visual Analog Scale (VAS), and the State Anxiety Inventory. In experimental groups, virtual glasses and skin to skin contact were applied during episio tomy repair by the researcher, and they were not applied to the control group. The VAS and State Anxiety Inventory were used to assess pain and anxiety in all groups before and after application. In the statistical analysis of the data, the SPSS 23.0 packa ge program was used. In all tests, p < .005 wa s considered statistically significant. RESULTS Immediately post intervention, the women in the experimental groups had significantly decreased anxiety and pain during episiotomy repair. Comparing three methods, the virtual glasses significantly reduced anxiety and pain after application (p < .05). CONCLUSIONS Virtual glasses are more effective than skin to skin contact and control methods in decreasing pain and reducing anxiety during episiotomy repair. Additionally, virtual glasses may reduce the need for pharmacological medication due to this reduction in pain and anxiety during episiotomy repair.
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Affiliation(s)
- Ayça Şolt Kırca
- Kirklareli University School of Health Science, Midwifery Department, Kirklareli, Turkey.
| | - Neriman Güdücü
- Kirklareli University School of Health Science, Midwifery Department, Kirklareli, Turkey
| | - Bahar İkiz
- Kapaklı State Hospital, Çerkezköy, Turkey.
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