A Systematic Review of the Effectiveness of Virtual Reality-Based Interventions on Pain and Range of Joint Movement Associated with Burn Injuries
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Search Strategy
2.3. Eligibility Criteria
- Type of participants: subjects with burns in any part of their body showing decreased range of joint movement and pain on rehabilitation. No age range or gender was limited.
- Type of intervention: virtual-reality interventions with or without additional or complementary treatment.
- Study type: randomized controlled trials, quasi-experimental studies, studies with experimental and control groups and clinical studies. The language of the studies was established as English or Spanish. Due to the specificity of the topic and the lack of related scientific production, the date of publication was not limited in the searches.
- Outcome measures: pain and range of joint movement.
- Meta-analyses, studies with less than two treatment sessions, study protocols, and qualitative descriptions.
- Studies with only one participant.
2.4. Selection of Studies
2.5. Methodological Quality Analysis
2.6. Risk of Bias Analysis
3. Results
3.1. Sociodemographic Characteristics
3.2. Methodology of the Studies
3.2.1. Interventions
3.2.2. Professionals
3.2.3. Outcome Measures and Assessment Tools
3.3. Results of the Studies
3.4. Methodological Quality of the Included Studies
3.5. Risk of Bias
4. Discussion
4.1. Virtual Reality and Pain
4.2. Virtual Reality and Range of Movement
4.3. Limitations of the Study
4.4. Implications for Clinical Practice
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Conflicts of Interest
References
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Database | Syntax Adopted |
---|---|
PubMed | “Virtual Reality AND therapy AND pain AND burn patients AND range of motion” |
Cochrane | “Virtual Reality AND therapy AND pain AND burn patients AND range of motion” |
Dialnet | “Realidad Virtual AND terapia AND dolor AND quemados AND rango de movimiento” |
Scopus | “Virtual Reality AND therapy AND pain AND burn patients AND range of motion” |
Science Direct | “Virtual Reality AND therapy AND pain AND burn patients AND range of motion” |
Author | Country and Location | Age, Mean (SD), Median | Type of Study | Sample Size | Type of Intervention | Dose of Treatment | Outcome Measures/ Assessment Tools | Results |
---|---|---|---|---|---|---|---|---|
Yohannan et al. (2012) [20] | America Inc., Redmond, WA, USA | 20–78 GE = mean 42.1 GC = mean 32.1 | Comparative study | n = 28 (5 were eliminated) EG = 11 CG = 12 | EG = active ROM therapy and Wii exercises. CG = therapy for active range of motion adapted by the therapist. | 3 consecutive 15 min sessions of standardized therapy followed by an additional 15 min of Wii play. | Subjective assessment questionnaires developed. VAS goniometer. | The Wii group experienced less pain (× 0.97, p 0.07) than the control group (× 0.97, p 0.07) over time. Overall, trends with anxiety (× 0.1 l, p 0.77), AROM (× 0.55, p 0.81), function (× 0.38, p 0.43) and enjoyment (× 0.09, p 0.73) favoured the Wii group. |
Lozano et al. (2018) [26] | Soweto (Gauteng) South Africa | 5–9, mean 7 | Control group and experimental group study | n = 66 CG = 35 XboxG = 31 | XboxG = standard physiotherapy treatment and an Xbox Kinect. 1 or 2 times a day. CG = standard standard physiotherapy. | 30 to 45 min treatment sessions performed at least 1 or 2 times a day. | Goniometer. activity scale for kids (ASK) Wong–Baker modified enjoyment rating scale (FACES) | The addition of Xbox Kinect in the treatment was effective in achieving higher AROM between discharge and follow-up (p < 0.01). |
Radwan et al. (2020) [27] | Al-Kharj City, Riyadh, KSA. Saudi Arabia | 7–12 GE = 9.52 ± 1.72 GC = 10.23 ± 1.75 | Control group and experimental group study | n = 50 EG = 25 (3 excluded and 1 did not participate) EG = 21 CG = 25 (1 excluded and 1 did not attend) CG = 23 | EG = 30 min of traditional physical therapy treatment followed by 30 min of Wii training. Approved games were bowling, baseball and tennis. CG = a conventional physical therapy program to maintain normal ROM. | 30 min sessions of traditional therapy followed by 30 min of Wii therapy. | JTHFT | The study group significantly improved hand-to-head (p = 0.001, p < 0.001), hand-to-mouth (p = 0.001) and hand-to-shoulder (p < 0.001, p = 0.0018) movements compared to the control group. |
Kamel et al. (2021) [17] | Cairo, Egypt | 7–14, mean 10,70 | RCT | n = 50 XboxG = 17 GTOT = 16 CG = 17 | XboxG = conventional rehabilitation plus therapeutic games on Xbox. TOTG = conventional rehabilitation by increasing the time of the activity and modifying the time spent in the materials used. CG = conventional rehabilitation. | 50 min sessions, 3 days a week for 8 weeks with motion detection games and interactive video games with the Xbox. | JTHFT DHI COPM Goniometer. | There were no significant changes in JTHFT performance and COMP performance, ROM, grip strength, and lateral and toe pinch strength between the Xbox group and the TOTG [p > 0.05]. |
Soltani et al. (2018) [25] | Seattle, WA, USA | 15–66, mean 36 | RCT | n = 39 | Active ROM exercises while playing in virtual reality with the SnowWorld game. | Average treatment duration was approximately 3 min. | GRS Goniometer. Subjective evaluations. | No significant effect of VR on peak ROM was found when compared to order (No VR M = 59.0 ± 44.8 degrees; VR M ± 58.9 ± 43.6 degrees), t(37) p = 0.94 NS. Pain discomfort was also significantly lower during RV than during no RV (no RV M = 52.7 [SD = 28.8]; RV M = 29.3 [SD = 24.7], t (36) = 5.18, p < 0.001; SD = 27.44. |
Carrougher et al. (2009) [26] | Seattle, WA, USA | 21–57, mean 35 | RCT and prospective study. | n = 41 (2 were withdrawn) n = 39 | Virtual-reality therapy with the SnowWorld game plus physiotherapy and pharmacological therapy. | Ten-minute sessions of exercises with and without virtual reality. Total duration not specified. | GRS Goniometer. | VR reduced all GRS pain scores (worst pain, time spent thinking about pain, and pain discomfort) by 27, 37, and 37%. (worst pain, time spent thinking about pain, and pain discomfort by 27%, 37%, and 31%, respectively). The mean improvement in ROM was slightly slightly greater with the VR condition; however, this difference did not reach clinical or statistical significance (p = 0.243). |
Faber et al. (2013) [27] | Netherlands. | 8–57, mean 27.7. | Comparative study | n = 289 (253 excluded) n = 36 | Virtual-reality therapy with the SnowWorld game. | Seven virtual-reality sessions performed during wound care of the participants. | VAT Subjective valuations. | VR reduced the amount of reported pain by more than one dressing change/wound debridement session per patient. |
Hoffman et al. (2019) [28] | Galveston, TX, USA | 6–17, mean 12. | Pilot study | n = 62 (14 excluded) n = 48 | Virtual-reality therapy with SnowWorld game and nursing care. | Five min virtual-reality sessions alternated with another 5 min of treatment without virtual reality. | GRS Surveys to assess the user’s presence in the virtual world. PSC-C | VR significantly reduced the “worst pain” indices. during No VR = 8.52 (SD = 1.75) vs. during VR yes = 5.10 (SD = 3.27), t (47) = 7.11, p < 0.001 |
Schmitt et al. (2011) [29] | Seattle, WA, USA | 6–19, mean 12.0 ± 3.9, | RCT | n = 54 | Virtual-reality therapy with the SnowWorld game more physiotherapy to increase range of motion. | Sessions of 6 to 20 min divided into two consecutive parts of identical duration (3–10 min each) over 5 days | GRS Subjective assessments. Goniometer. | The GRS assessments of cognitive pain (44% reduction), affective pain (32% reduction), and sensory pain (27% reduction) were significantly lower (p < 0.05) with the adjunctive virtual-reality treatment than with the control. Immersive VR did not result in a significant increase in maximal range of joint motion compared to the control condition (p = 0.21). However, there was a significant increase in maximal range of motion (mean increase of 6.8 degrees, p = 0.03) in the second treatment condition. |
Lee et al. (2022) [30] | Korea. (Asia Oriental) | Mean 57.55 ± 7.55 | Interventional (clinical trial) | n = 33 | Robot-assisted gait training (RAGT) in burn patients by analysing the cerebral blood flow (CBF) in the prefrontal cortex. | RAGT: 30 min sessions, 10 times for 2 weeks, from Monday to Friday. 15 min sessions of VR application, with a 2 min break, and 15 min session without VR. | Functional near-infrared spectroscopy (fNIRS). Visual analogue scale (VAS). | The mean VAS pain scores were significantly lower (p < 0.05) in the experimental condition than in the control condition. Oxyhaemoglobin in the prefrontal lobe significantly increased when RAGT was performed with VR. The results of the analyses conducted on HbO2 in the PFC indicated a significant VR-related PFC activation during RAGT, as compared with the results in the control condition. |
Criteria | |||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Studies | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | Total | Score Interpretation |
Yohannan et al. [20] | Y | Y | N | Y | N | N | Y | Y | Y | Y | Y | 7 | Good |
Lozano et al. [24] | Y | N | N | Y | N | N | N | Y | N | Y | Y | 5 | Average |
Radwan et al. [31] | Y | Y | N | Y | N | N | N | Y | Y | Y | Y | 6 | Good |
Kamel et al. [17] | Y | Y | Y | Y | N | N | Y | Y | Y | Y | Y | 8 | Good |
Yoltani et al. [25] | Y | Y | N | Y | N | N | N | Y | Y | Y | Y | 6 | Good |
Carrougher et al. [26] | Y | Y | N | Y | N | N | N | Y | Y | Y | Y | 6 | Good |
Faber et al. [27] | Y | N | N | N | N | N | N | Y | Y | Y | Y | 4 | Average |
Hoffman et al. [28] | Y | N | N | Y | N | N | N | Y | Y | Y | Y | 5 | Average |
Schmitt et al. [29] | Y | N | N | Y | N | N | N | Y | Y | Y | Y | 5 | Average |
Lee et al. [30] | Y | N | N | Y | N | N | N | Y | Y | Y | Y | 5 | Average |
Criteria | |||||||
---|---|---|---|---|---|---|---|
Studies | 1 | 2 | 3 | 4 | 5 | 6 | 7 |
Yohannan et al. [20] | ? | ? | - | - | + | + | + |
Lozano et al. [24] | - | - | - | - | + | + | + |
Radwan et al. [31] | + | - | ? | ? | + | + | + |
Kamel et al. [17] | + | + | - | +? | + | + | + |
Soltani et al. [25] | ? | ? | - | ? | - | + | + |
Carrougher et al. [26] | ? | ? | - | - | + | + | + |
Faber et al. [27] | - | ? | - | - | + | + | + |
Hoffman et al. [28] | ? | ? | - | ? | + | + | + |
Schmitt et al. [29] | ? | ? | - | - | + | + | + |
Lee et al. [30] | - | - | - | - | + | + | + |
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Garrido-Ardila, E.M.; Santos-Domínguez, M.; Rodríguez-Mansilla, J.; Torres-Piles, S.T.; Rodríguez-Domínguez, M.T.; González-Sánchez, B.; Jiménez-Palomares, M. A Systematic Review of the Effectiveness of Virtual Reality-Based Interventions on Pain and Range of Joint Movement Associated with Burn Injuries. J. Pers. Med. 2022, 12, 1269. https://doi.org/10.3390/jpm12081269
Garrido-Ardila EM, Santos-Domínguez M, Rodríguez-Mansilla J, Torres-Piles ST, Rodríguez-Domínguez MT, González-Sánchez B, Jiménez-Palomares M. A Systematic Review of the Effectiveness of Virtual Reality-Based Interventions on Pain and Range of Joint Movement Associated with Burn Injuries. Journal of Personalized Medicine. 2022; 12(8):1269. https://doi.org/10.3390/jpm12081269
Chicago/Turabian StyleGarrido-Ardila, Elisa María, María Santos-Domínguez, Juan Rodríguez-Mansilla, Silvia Teresa Torres-Piles, María Trinidad Rodríguez-Domínguez, Blanca González-Sánchez, and María Jiménez-Palomares. 2022. "A Systematic Review of the Effectiveness of Virtual Reality-Based Interventions on Pain and Range of Joint Movement Associated with Burn Injuries" Journal of Personalized Medicine 12, no. 8: 1269. https://doi.org/10.3390/jpm12081269
APA StyleGarrido-Ardila, E. M., Santos-Domínguez, M., Rodríguez-Mansilla, J., Torres-Piles, S. T., Rodríguez-Domínguez, M. T., González-Sánchez, B., & Jiménez-Palomares, M. (2022). A Systematic Review of the Effectiveness of Virtual Reality-Based Interventions on Pain and Range of Joint Movement Associated with Burn Injuries. Journal of Personalized Medicine, 12(8), 1269. https://doi.org/10.3390/jpm12081269