Virtual Reality for Pain Management in Burn Patients

Overseen By Olivia Baryluk, BS

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: Weill Medical College of Cornell University

Disqualifiers: Cognitive disorder, Psychotic disorder, Bipolar I, Opioid abuse

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: Unknown

Duration: Approximately 15 days

50 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests if using VR headsets can help reduce pain for adult burn patients by distracting them with virtual experiences. Virtual reality (VR) has been shown to reduce pain in various medical procedures, including burn wound care.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications. However, participants will continue to receive opioids as part of the standard care.

Is virtual reality therapy safe for use in burn patients?

Virtual reality therapy is generally safe for burn patients, with most experiencing zero to mild nausea. It is a non-drug option that can help manage pain without significant side effects. ^{1 2 3 4 5}

How does virtual reality treatment differ from other treatments for pain management in burn patients?

Virtual reality (VR) is unique because it provides an immersive experience that serves as a powerful distraction, reducing pain and anxiety during painful procedures like wound care, without relying on drugs. Unlike traditional pain management methods that primarily use medications like opioids, VR offers a non-drug alternative that can be used alongside medications to enhance pain relief. ^{2 6 7 8 9}

What data supports the effectiveness of the treatment Virtual Reality for pain management in burn patients?

Research shows that using Virtual Reality (VR) during physical therapy and wound care for burn patients can significantly reduce pain levels compared to not using VR. Patients reported less pain and spent less time thinking about their pain when VR was used, making it a helpful addition to traditional pain management methods. ^{1 2 4 10 11}

Who Is on the Research Team?

JoAnn Difede, PhD

Principal Investigator

Weill Medical College of Cornell University

Are You a Good Fit for This Trial?

This trial is for burn patients aged 8 and older at New York Presbyterian who are awake, alert, can move on their own, have burns covering less than 15% of their body, and can consent to the study. It's not for those with certain cognitive or psychotic disorders or current opioid abuse.

Inclusion Criteria

I don't need strong sedation for minor procedures like staple removal.

I am awake, alert, and able to walk.

Patients with a burn injury and is in the Burn Unit at New York Presbyterian

Exclusion Criteria

You have been diagnosed with a mental disorder like bipolar disorder, psychosis, or cognitive disorders in the past.

You are currently misusing opioids.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1 week

Treatment

Participants receive either Virtual Reality intervention or standard care during painful procedures

Approximately 15 days

Daily visits during hospitalization

Follow-up

Participants are monitored for changes in pain, narcotic dose, anxiolytic dose, anxiety, and depressive symptoms

2 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Virtual Reality

Trial Overview The study tests if Virtual Reality (VR) can help manage pain during procedures like wound dressing changes in addition to standard care with opioids. Patients will be split into two groups: one receives VR plus standard care; the other only gets standard care.

How Is the Trial Designed?

Group I: Virtual Reality Experimental Treatment 1 Intervention

Virtual reality-enhanced distraction using a portable head mounted display during panful events (such as wound dressing changes or physical therapy sessions) in addition to standard of care.

Group II: Treatment as Usual Active Control 1 Intervention

Standard of care during painful event (such as wound dressing changes or physical therapy sessions).

Who Is Running the Clinical Trial?

Weill Medical College of Cornell University

Lead Sponsor

Trials

1,103

Recruited

1,157,000+

Published Research Related to This Trial

Virtual Reality (VR) significantly reduces pain in burn injury patients during wound dressing changes and physiotherapy when used alongside pharmacologic analgesics, based on a systematic review of nine studies.

The evidence for VR's effectiveness in reducing anxiety during these procedures is less clear, indicating a need for further research to explore its potential benefits in managing anxiety for burn patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effectiveness of virtual reality on reducing pain and anxiety in burn injury patients: a systematic review. Morris, LD., Louw, QA., Grimmer-Somers, K.[2022]

In a study of 39 adults with burn injuries, immersive virtual reality (VR) significantly reduced pain scores during physical therapy sessions, with reductions of 27% in worst pain, 37% in time spent thinking about pain, and 31% in pain unpleasantness compared to standard therapy without VR.

The use of VR did not negatively impact the range of motion (ROM) during therapy, and 97% of patients reported only zero to mild nausea, indicating that VR is a safe and effective nonpharmacologic option for pain management in postburn rehabilitation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effect of virtual reality on pain and range of motion in adults with burn injuries. Carrougher, GJ., Hoffman, HG., Nakamura, D., et al.[2021]

The study involving 11 adult burn patients suggested that using a low-cost VR system alongside pharmacological analgesia may help reduce pain and anxiety during physiotherapy, although the differences were not statistically significant.

Despite the lack of significant results, the VR system was deemed safe and could potentially enhance pain management strategies in burn treatment settings, indicating a promising area for further research.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Feasibility and potential effect of a low-cost virtual reality system on reducing pain and anxiety in adult burn injury patients during physiotherapy in a developing country. Morris, LD., Louw, QA., Crous, LC.[2019]

A systematic review and meta-analysis of 30 studies involving 1,293 burn patients found that virtual reality (VR) significantly reduces pain severity during wound care procedures, with a strong effect size (SMD: -0.70).

Immersive VR interventions were particularly effective in decreasing pain intensity compared to control groups, while non-immersive VR did not show significant benefits, suggesting that immersive VR should be prioritized in burn care settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of Virtual Reality-Based Interventions on Pain During Wound Care in Burn Patients; a Systematic Review and Meta-Analysis. Norouzkhani, N., Chaghian Arani, R., Mehrabi, H., et al.[2022]

Virtual reality (VR) rehabilitation significantly improves quality of life and work performance in burn patients, with a notable increase in range of motion (ROM) of joints (SMD=0.72) compared to usual rehabilitation methods.

VR interventions effectively reduce various aspects of pain (intensity, affective, and cognitive components) and lower anxiety levels during treatment, while also making rehabilitation more enjoyable, although they do not significantly enhance hand grip or pinch strength.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Use of Virtual Reality in Burn Rehabilitation: A Systematic Review and Meta-analysis. Lan, X., Tan, Z., Zhou, T., et al.[2023]

A case study of a 40-year-old male burn patient showed that using water-friendly virtual reality (VR) technology during wound care significantly reduced both sensory and emotional pain ratings.

The VR treatment helped distract the patient from his pain, suggesting that VR can be an effective non-drug pain management strategy for patients with severe burns, especially in settings like hydrotherapy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Water-friendly virtual reality pain control during wound care. Hoffman, HG., Patterson, DR., Magula, J., et al.[2019]

A randomized clinical trial involving 35 pediatric burn patients showed that using a virtual reality (VR) game during at-home dressing changes significantly reduced pain levels compared to standard distraction techniques, with a 33.3% reduction in child-reported pain.

The majority of children found the VR game engaging and enjoyable, with no reported challenges or side effects, suggesting that VR can be a safe and effective nonpharmacologic option for pain management in pediatric burn care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Mobile phone virtual reality game for pediatric home burn dressing pain management: a randomized feasibility clinical trial. Armstrong, M., Lun, J., Groner, JI., et al.[2023]

In two case reports involving a soldier and a civilian with severe burns, the combination of 40 mg intravenous ketamine and immersive virtual reality (VR) significantly reduced pain during wound care compared to ketamine alone.

Patients reported a more enjoyable experience during wound care with VR, describing it as 'pretty fun' or 'extremely fun', while experiencing minimal nausea, suggesting that this multimodal approach could enhance pain management in burn treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Combining ketamine and virtual reality pain control during severe burn wound care: one military and one civilian patient. Maani, CV., Hoffman, HG., Fowler, M., et al.[2021]

Immersive virtual reality has been shown to be a safe and effective method for reducing pain and anxiety during painful procedures in burn patients, complementing traditional pharmacologic analgesics like opioids.

Preliminary studies suggest that virtual reality is feasible for a wide range of patients, especially children, but further research with larger groups is needed to fully understand its benefits and limitations in burn care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Applications of virtual reality for pain management in burn-injured patients. Sharar, SR., Miller, W., Teeley, A., et al.[2022]

Virtual reality (VR) can effectively reduce pain during burn care, but implementing it in a clinical setting requires a significant time commitment from staff, averaging 59 minutes per session for setup, instruction, therapy, and cleaning.

The lack of on-site technical support for VR equipment poses challenges, making it difficult for smaller burn centers to allocate the necessary resources for a VR program, highlighting the need for further research to evaluate the cost-effectiveness of VR in pain management.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Virtual reality: feasibility of implementation in a regional burn center. Markus, LA., Willems, KE., Maruna, CC., et al.[2019]

In a study involving 41 adolescents aged 11-17, the use of off-the-shelf virtual reality (VR) during burn wound care significantly reduced pain scores reported by nursing staff and decreased the need for additional pain relief medication compared to standard distraction techniques.

While the overall pain reduction was minimal, the findings suggest that a more tailored VR experience designed specifically for adolescents could enhance pain management during such procedures.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Virtual reality for acute pain reduction in adolescents undergoing burn wound care: a prospective randomized controlled trial. Kipping, B., Rodger, S., Miller, K., et al.[2022]

Citations

1. United States pubmed.ncbi.nlm.nih.gov

The effectiveness of virtual reality on reducing pain and anxiety in burn injury patients: a systematic review. [2022]

2. England pubmed.ncbi.nlm.nih.gov

The effect of virtual reality on pain and range of motion in adults with burn injuries. [2021]

3. Netherlands pubmed.ncbi.nlm.nih.gov

Feasibility and potential effect of a low-cost virtual reality system on reducing pain and anxiety in adult burn injury patients during physiotherapy in a developing country. [2019]

4. Iran pubmed.ncbi.nlm.nih.gov

Effect of Virtual Reality-Based Interventions on Pain During Wound Care in Burn Patients; a Systematic Review and Meta-Analysis. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

Use of Virtual Reality in Burn Rehabilitation: A Systematic Review and Meta-analysis. [2023]

6. United States pubmed.ncbi.nlm.nih.gov

Water-friendly virtual reality pain control during wound care. [2019]

7. England pubmed.ncbi.nlm.nih.gov

Mobile phone virtual reality game for pediatric home burn dressing pain management: a randomized feasibility clinical trial. [2023]

8. England pubmed.ncbi.nlm.nih.gov

Combining ketamine and virtual reality pain control during severe burn wound care: one military and one civilian patient. [2021]

9. England pubmed.ncbi.nlm.nih.gov

Applications of virtual reality for pain management in burn-injured patients. [2022]

10. Netherlands pubmed.ncbi.nlm.nih.gov

Virtual reality: feasibility of implementation in a regional burn center. [2019]

11. Netherlands pubmed.ncbi.nlm.nih.gov

Virtual reality for acute pain reduction in adolescents undergoing burn wound care: a prospective randomized controlled trial. [2022]