Features of virtual reality impact effectiveness of VR pain alleviation therapeutics in pediatric burn patients: A randomized clinical trial.

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...

Full description

Bibliographic Details
Main Authors: Soumil Jain, Megan Armstrong, John Luna, Rajan K Thakkar, Renata Fabia, Jonathan I Groner, Dana Noffsinger, Ai Ni, Eric Nelson, Henry Xiang
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2024-01-01
Series:PLOS Digital Health
Online Access:https://journals.plos.org/digitalhealth/article/file?id=10.1371/journal.pdig.0000440&type=printable
_version_ 1797326162671697920
author Soumil Jain
Megan Armstrong
John Luna
Rajan K Thakkar
Renata Fabia
Jonathan I Groner
Dana Noffsinger
Ai Ni
Eric Nelson
Henry Xiang
author_facet Soumil Jain
Megan Armstrong
John Luna
Rajan K Thakkar
Renata Fabia
Jonathan I Groner
Dana Noffsinger
Ai Ni
Eric Nelson
Henry Xiang
author_sort Soumil Jain
collection DOAJ
description 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.
first_indexed 2024-03-08T06:20:31Z
format Article
id doaj.art-85e3cc8190fe4cf9bfa6f004b9f120ad
institution Directory Open Access Journal
issn 2767-3170
language English
last_indexed 2024-03-08T06:20:31Z
publishDate 2024-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLOS Digital Health
spelling doaj.art-85e3cc8190fe4cf9bfa6f004b9f120ad2024-02-04T05:32:07ZengPublic Library of Science (PLoS)PLOS Digital Health2767-31702024-01-0131e000044010.1371/journal.pdig.0000440Features of virtual reality impact effectiveness of VR pain alleviation therapeutics in pediatric burn patients: A randomized clinical trial.Soumil JainMegan ArmstrongJohn LunaRajan K ThakkarRenata FabiaJonathan I GronerDana NoffsingerAi NiEric NelsonHenry XiangKey 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.https://journals.plos.org/digitalhealth/article/file?id=10.1371/journal.pdig.0000440&type=printable
spellingShingle Soumil Jain
Megan Armstrong
John Luna
Rajan K Thakkar
Renata Fabia
Jonathan I Groner
Dana Noffsinger
Ai Ni
Eric Nelson
Henry Xiang
Features of virtual reality impact effectiveness of VR pain alleviation therapeutics in pediatric burn patients: A randomized clinical trial.
PLOS Digital Health
title Features of virtual reality impact effectiveness of VR pain alleviation therapeutics in pediatric burn patients: A randomized clinical trial.
title_full Features of virtual reality impact effectiveness of VR pain alleviation therapeutics in pediatric burn patients: A randomized clinical trial.
title_fullStr Features of virtual reality impact effectiveness of VR pain alleviation therapeutics in pediatric burn patients: A randomized clinical trial.
title_full_unstemmed Features of virtual reality impact effectiveness of VR pain alleviation therapeutics in pediatric burn patients: A randomized clinical trial.
title_short Features of virtual reality impact effectiveness of VR pain alleviation therapeutics in pediatric burn patients: A randomized clinical trial.
title_sort features of virtual reality impact effectiveness of vr pain alleviation therapeutics in pediatric burn patients a randomized clinical trial
url https://journals.plos.org/digitalhealth/article/file?id=10.1371/journal.pdig.0000440&type=printable
work_keys_str_mv AT soumiljain featuresofvirtualrealityimpacteffectivenessofvrpainalleviationtherapeuticsinpediatricburnpatientsarandomizedclinicaltrial
AT meganarmstrong featuresofvirtualrealityimpacteffectivenessofvrpainalleviationtherapeuticsinpediatricburnpatientsarandomizedclinicaltrial
AT johnluna featuresofvirtualrealityimpacteffectivenessofvrpainalleviationtherapeuticsinpediatricburnpatientsarandomizedclinicaltrial
AT rajankthakkar featuresofvirtualrealityimpacteffectivenessofvrpainalleviationtherapeuticsinpediatricburnpatientsarandomizedclinicaltrial
AT renatafabia featuresofvirtualrealityimpacteffectivenessofvrpainalleviationtherapeuticsinpediatricburnpatientsarandomizedclinicaltrial
AT jonathanigroner featuresofvirtualrealityimpacteffectivenessofvrpainalleviationtherapeuticsinpediatricburnpatientsarandomizedclinicaltrial
AT dananoffsinger featuresofvirtualrealityimpacteffectivenessofvrpainalleviationtherapeuticsinpediatricburnpatientsarandomizedclinicaltrial
AT aini featuresofvirtualrealityimpacteffectivenessofvrpainalleviationtherapeuticsinpediatricburnpatientsarandomizedclinicaltrial
AT ericnelson featuresofvirtualrealityimpacteffectivenessofvrpainalleviationtherapeuticsinpediatricburnpatientsarandomizedclinicaltrial
AT henryxiang featuresofvirtualrealityimpacteffectivenessofvrpainalleviationtherapeuticsinpediatricburnpatientsarandomizedclinicaltrial