Examining the Feasibility of Early Mobilization With Virtual Reality Gaming Using Head-Mounted Display and Adaptive Software With Adolescents in the Pediatric Intensive Care Unit: Case Report.
Byron Lai, Maegen Powell, Anne Grace Clement and 3 others
PMID 34042602WHAT IT FOUND
Two adolescents in intensive care completed VR gaming added to usual early mobility physical therapy for an average of 27 minutes per session, with no serious adverse events related to the intervention, although technical issues and adverse events occurred.
Key findings
01Adolescents in the PICU completed 2 to 4 VR gaming sessions added to usual early mobility physical therapy, averaging 27 minutes of game time.
02Three adverse events were recorded, none were related to the intervention, and one was serious.
03Staff narratives described each adolescent as more awake or alert after VR sessions.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 2 male adolescents were studied, so this is a case report rather than evidence that VR works for PICU patients. The participants were already experienced with video games, so acceptance may not generalize to adolescents who are unfamiliar with gaming. There were no objective outcomes or treatment effect estimates, so the study cannot show improvements in mobility, strength, pain, or function. VR gaming was delivered together with usual early mobility physical therapy, and the contribution of any single component cannot be separated. Session frequency, duration, and intensity were not fixed in advance, so the feasibility metrics reflect an exploratory learn-as-you-go process. Adverse events and technical issues occurred, including vomiting and many issues when adaptive software was not used, so safety and usability need larger study. Narratives were written from the research assistant and therapists, not from formal interviews with the adolescents, so the user experience is incomplete.
The easy way to misread this
Do not conclude that VR gaming improves PICU mobility or outcomes. This report covers two adolescents receiving VR in addition to usual early mobility physical therapy, with no objective outcomes and no way to separate the contribution of VR from usual physical therapy and nurse support.