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 whether Virtual Reality (VR) can help manage pain for burn patients during treatments like wound care or physical therapy. Participants will be divided into two groups: one will use VR with standard pain relief, such as opioids, while the other will receive only standard pain relief. It targets patients with burn injuries in the New York Presbyterian Burn Unit who are awake, alert, and not heavily sedated. The goal is to determine if VR can make painful procedures more bearable. As an unphased trial, this study offers patients the chance to explore innovative pain management techniques that could enhance their treatment experience.

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.

What prior data suggests that this virtual reality therapy is safe for pain management in burn patients?

Research shows that virtual reality (VR) offers a promising way to manage pain for burn patients. Studies have found that VR significantly distracts patients and reduces their pain during wound care. Some research suggests that VR use can lower pain levels by 30% to 50% for those receiving treatment for severe burns.

Additionally, VR is generally well-tolerated. It has been used successfully with both adults and children who have burns, without major side effects. VR works by immersing patients in a virtual world, distracting them from pain without needing extra medication. Based on current evidence, VR appears to be a safe option for managing pain in burn patients. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about using virtual reality (VR) for pain management in burn patients because it offers a unique way to distract patients during painful procedures. Unlike traditional pain relief methods that rely on medications like opioids, VR provides a drug-free alternative that immerses patients in an engaging virtual environment. This innovative approach not only helps reduce pain perception but also minimizes the risk of medication side effects, making it a promising complementary option to standard care.

What evidence suggests that Virtual Reality is effective for pain management in burn patients?

Research has shown that virtual reality (VR) can reduce pain by distracting patients during uncomfortable procedures. Studies have found that VR lowers pain levels in medical situations, such as for burn patients. In this trial, some participants will receive VR therapy, which has also improved quality of life and increased joint movement during burn recovery. By immersing patients in a virtual world, VR shifts their focus away from pain and toward the experience. These findings suggest that VR could be a helpful tool in managing pain for burn patients, alongside standard treatments like pain medications. ^{1 2 6 7 8}

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 are currently misusing opioids.

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

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

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]

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]

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]

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 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]

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]

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]

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]

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]

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]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11924071/

Virtual reality as an intervention for adult burn patients Virtual reality (VR) allows burn patients to engage in a virtual world and can provide patients with a distraction from pain.

2. sciencedirect.com sciencedirect.com/science/article/pii/S0003999322005937

Use of Virtual Reality in Burn Rehabilitation: A Systematic ... VR-based burn rehabilitation significantly improves the QOL and work performance of burn patients, significantly increases the ROM gain of the tested joints.

3. frontiersin.org frontiersin.org/journals/virtual-reality/articles/10.3389/frvir.2025.1651695/full

Efficacy of virtual reality in pediatric burn patients Outcomes: Studies must report data on primary outcome: pain intensity. Studies reporting data on any secondary outcome were also included ...

4. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9410425/

A Systematic Review of the Effectiveness of Virtual Reality ... The objective of this study was to analyse the effectiveness of virtual-reality therapy for pain relief and the improvement of the range of joint movement

5. bmcmedicine.biomedcentral.com bmcmedicine.biomedcentral.com/articles/10.1186/s12916-024-03266-6

Efficacy of virtual reality for pain relief in medical procedures Immersive VR technology offers effective pain control across various medical procedures, albeit statistical heterogeneity.

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9676699/

Effect of Virtual Reality-Based Interventions on Pain During ... This systematic review and meta-analysis aimed to examine the effect of virtual reality (VR)-based interventions on pain during wound care in burn patients.

7. clinicaltrials.gov clinicaltrials.gov/study/NCT00591448

Study in the Use of Virtual Reality as an Adjunct to Pain ... Researchers have found that immersive virtual reality distraction can reduce patient's pain rating during severe burn wound care by 30% to 50% ( ...

8. jamanetwork.com jamanetwork.com/journals/jamanetworkopen/fullarticle/2781117

Efficacy of Smartphone Active and Passive Virtual Reality ... These findings suggest that smartphone-based VR games could be an effective pain management tool for pediatric patients with burns.