PTOTNarrative ReviewJournal of hand therapy : official journal of the American Society of Hand Therapists2020

Virtual reality hand therapy: A new tool for nonopioid analgesia for acute procedural pain, hand rehabilitation, and VR embodiment therapy for phantom limb pain.

Hunter G Hoffman, David A Boe, Eric Rombokas and 6 others

PMID 32482376

WHAT IT FOUND

In burn wound care and hand therapy, immersive VR reduced pain while patients stretched as far as without VR.

Evidence is strongest for short-term procedural pain, not for chronic phantom limb pain.

Key findings

01In 48 children with very large severe burns, adding VR to standard of care pain medications during wound debridement reduced worst pain, pain unpleasantness, time spent thinking about pain, and made wound care more fun.

02A hand therapy study reported that occupational therapy with VR and optical hand tracking was associated with increased finger range of motion, reduced scar thickening, and improved hand function compared with occupational therapy without VR.

03The review says evidence for chronic pain is preliminary and unpublished, and temporary reduction may occur while the person is in VR.

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

This is a narrative review, so it does not report a systematic search, study selection, or quality appraisal. The pain studies are small and mostly compare VR with no VR during the same care session or a few sessions. Patients also received usual pain medications, so the studies show an add-on effect, not VR alone. Chronic pain and phantom limb pain conclusions are preliminary, unpublished, or future directions. Hand function findings come from limited studies and do not establish long-term benefit. The paper is relevant to PT and OT hand therapy, not to speech-language pathology.

Declared interests

The authors report no conflicts of interest. An author joined the Scientific Advisory Board of BehaVR.com. An author works for Johnson and Johnson and an author works for GlaxoSmithKline, but the paper states no products or funding from these companies were involved in the studies discussed.

The easy way to misread this

Do not conclude that VR is a proven treatment for hand rehabilitation or chronic pain. The review mainly supports short-term pain reduction during wound care and therapy when added to usual pain medications, while chronic and phantom limb pain evidence is preliminary and unpublished.

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