Virtual reality use in pediatric patients for orthopedic clinical procedures: A randomized prospective trial of efficacy.

IF 1.3 4区 医学 Q3 ORTHOPEDICS Journal of Childrens Orthopaedics Pub Date : 2024-05-26 eCollection Date: 2024-08-01 DOI:10.1177/18632521241254707
Bhumit Desai, Nicholas Newcomb, Brielle Plost, Sean Waldron, Korak Sarkar, Lawrence Haber
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Abstract

Background: Distraction therapy use such as virtual reality is novel in the pediatric orthopedic field. In this study, we use subjective and objective metrics to evaluate virtual reality efficacy to reduce anxiety and pain in a pediatric orthopedic cohort.

Methods: A prospective randomized controlled trial included patients between age 5 and 17 years, presenting to a tertiary care pediatric orthopedic clinic. Parallel groups underwent orthopedic procedures in clinic, utilizing immersive and interactive virtual reality distraction therapies versus standard of care. Procedures included cast application, cast removal, bone pin removal, and fracture reduction. All preprocedure parameters were similar between the groups. Primary outcome was the difference between maximum procedural heart rate and baseline. Secondary outcomes included Wong Baker FACES Rating Scale (Wong & Baker, 1988, Oklahoma, USA) for pain and Visual Analog Scale scores for anxiety.

Results: Ninety-five patients (66 M, 29 F) underwent 59 cast removals, 26 cast applications, 7 percutaneous pin removals, and 3 fracture reductions. Average patient age in the virtual reality and control cohorts was 10.1 (5-17) and 10.6 (5-17), respectively. Average change in maximum heart rate in the virtual reality and control groups was 10.6 ± 10.1 versus 18.4 ± 11.0 (p = 0.00048). The virtual reality group demonstrated trends toward lower perceived anxiety (1.7 ± 2.8 versus 2.9 ± 3.6, p = 0.0666) when compared to controls.

Conclusions: This level 1 study is the first to utilize objective biometric measurements to evaluate use of interactive virtual reality during multiple types of pediatric orthopedic procedures in the clinical setting. The findings suggest that an interactive and immersive virtual reality experience can be effective in reducing pain and anxiety.

Level of evidence: Level 1, Randomized Controlled Trial.

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虚拟现实技术在儿童患者骨科临床手术中的应用:随机前瞻性疗效试验。
背景:使用虚拟现实技术等分散注意力疗法在儿科骨科领域尚属首次。在这项研究中,我们使用主观和客观指标来评估虚拟现实技术对减轻儿科骨科患者焦虑和疼痛的疗效:方法:一项前瞻性随机对照试验纳入了在一家三级医院儿科骨科诊所就诊的 5 至 17 岁患者。两组患者分别在诊所接受骨科手术,采用沉浸式互动虚拟现实分散注意力疗法和标准护理疗法。手术过程包括打石膏、拆石膏、取骨针和骨折复位。各组的所有术前参数均相似。主要结果是最大手术心率与基线之间的差异。次要结果包括针对疼痛的 Wong Baker FACES 评分量表(Wong & Baker,1988 年,美国俄克拉荷马州)和针对焦虑的视觉模拟量表评分:95 名患者(66 名男性,29 名女性)接受了 59 例石膏拆除术、26 例石膏应用术、7 例经皮针拆除术和 3 例骨折复位术。虚拟现实组和对照组患者的平均年龄分别为 10.1 岁(5-17 岁)和 10.6 岁(5-17 岁)。虚拟现实组和对照组最大心率的平均变化分别为 10.6 ± 10.1 和 18.4 ± 11.0(P = 0.00048)。与对照组相比,虚拟现实组的焦虑感呈下降趋势(1.7 ± 2.8 对 2.9 ± 3.6,p = 0.0666):这项 1 级研究首次在临床环境中利用客观生物测量来评估在多种类型的儿科矫形手术中使用交互式虚拟现实技术的情况。研究结果表明,交互式和沉浸式虚拟现实体验可以有效减轻疼痛和焦虑:1级,随机对照试验。
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来源期刊
Journal of Childrens Orthopaedics
Journal of Childrens Orthopaedics Medicine-Orthopedics and Sports Medicine
CiteScore
2.70
自引率
14.30%
发文量
61
审稿时长
23 weeks
期刊介绍: Aims & Scope The Journal of Children’s Orthopaedics is the official journal of the European Paediatric Orthopaedic Society (EPOS) and is published by The British Editorial Society of Bone & Joint Surgery. It provides a forum for the advancement of the knowledge and education in paediatric orthopaedics and traumatology across geographical borders. It advocates an increased worldwide involvement in preventing and treating musculoskeletal diseases in children and adolescents. The journal publishes high quality, peer-reviewed articles that focus on clinical practice, diagnosis and treatment of disorders unique to paediatric orthopaedics, as well as on basic and applied research. It aims to help physicians stay abreast of the latest and ever-changing developments in the field of paediatric orthopaedics and traumatology. The journal welcomes original contributions submitted exclusively for review to the journal. This continuously published online journal is fully open access and will publish one print issue each year to coincide with the EPOS Annual Congress, featuring the meeting’s abstracts.
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