Virtual reality analgesia for burn joint flexibility: A randomized controlled trial.
Maryam Soltani, Sydney A Drever, Hunter G Hoffman and 4 others
PMID 30284865WHAT IT FOUND
Virtual reality did not increase range of motion during self-directed burn joint exercises.
It did lower pain intensity, unpleasantness, and time thinking about pain, and made exercises more fun.
Key findings
01Adding VR did not increase maximum joint range of motion compared with no VR when treatment order was combined (No VR mean 59.0 degrees; VR mean 58.9 degrees).
02Participants reported lower worst pain intensity during VR than no VR (mean 52.9 vs 64.4 on a 0 to 100 scale).
03VR also lowered pain unpleasantness (mean 29.3 vs 52.7) and time spent thinking about pain (mean 24.9 vs 59.0), and increased fun ratings (mean 63.98 vs 28.2).
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study looked at one therapy session only, so it does not show whether repeated VR use improves range of motion. Pain outcomes were patient-reported, and participants knew whether they were using VR because each patient received both conditions in the same session. No baseline warm-up was provided before the range-of-motion sessions, which can affect stiffness and movement. A strong practice effect occurred: the second condition in each session produced more range of motion, so the within-session crossover design may have hidden a VR effect on range. The VR software was not designed to reflect the patient's body or the joint being moved; it was an independent distraction. The goggles used cost $36,500, so this exact system was too expensive for home use, although the paper notes newer lower-cost VR systems.
The easy way to misread this
Do not conclude that VR increases joint range of motion. The primary range-of-motion result did not differ when treatment order was combined, and the second condition in each session produced more movement regardless of VR.