Effectiveness of virtual reality-based pain control with multiple treatments

Objective: The current study explored whether immersive virtual reality continues to reduce pain (via distraction) with repeated use. Setting: The study was conducted in a burn care unit at a regional trauma center. Patients: Seven patients aged 9-32 years (mean age of 21.9 years; average of 23.7% total body surface area burned [range, 3-60%]) performed range-of-motion exercises of their injured extremity under an occupational therapist's direction on at least 3 separate days each. Intervention: For each physical therapy session. each patient spent equal amounts of time in virtual reality and in the control condition (no distraction). The mean duration of physical therapy in virtual reality was 3.5, 4.9, and 6.4 minutes for the first, second, and third session, respectively. Condition order was randomized and counterbalanced, Outcome Measures: For each of the three physical therapy sessions, five visual analog pain scores for each treatment condition served as the dependent variables. Results: Pain ratings were statistically lower when patients were in virtual reality, and the magnitude of pain reduction did not diminish with repeated use of virtual reality. The results of this study may be examined in more detail at www.vrpain.com. Conclusions: Although the small sample size limits generalizability, results provide converging preliminary evidence that virtual reality can function as a strong nonpharmacological pain reduction technique for burn patients during physical therapy. Results suggest that virtual reality does not diminish in analgesic effectiveness with three (and possibly more) uses. Virtual reality may also have analgesic potential for other painful procedures or pain populations. Practical implications are discussed.