Interactive versus passive virtual reality on upper limb pain, function, and range of motion in pediatric thermal burns, a randomized controlled trial

Abstract

Objectives: The objective of the current study was to assess the effect of applying interactive virtual reality (VR) versus passive VR in addition to physical therapy exercise program on pain, upper limb disability, and improvement of joint range of motion (ROM) in pediatric burn patients.

Material and methods: Sixty patients with acute upper extremity thermal burn injury, between 9 and 14 years old, were randomly allocated to either group A or Group B. Group A underwent an interactive VR program combined with a traditional physiotherapy program encompassing stretching exercises, range-of-motion exercises, and splinting, while Group B received a passive VR program combined with a traditional physiotherapy program. Each group underwent treatment 3 sessions per week for 8 weeks. The outcome measures were pain intensity as measured by a color visual analogue scale (cVAS), upper extremity disability by the Disabilities of the Arm, Shoulder and Hand (DASH), and upper extremity ROM by a digital goniometer. All outcomes were measured for all participants at baseline and 8 weeks later.

Results: Post-intervention assessment revealed significant improvements in cVAS scores, DASH, and ROM scores in both Groups A and B (p < 0.001). However, Group A showed greater improvements in all outcomes compared to Group B (p < 0.001).

Conclusion: Interactive VR added to the physical therapy exercise might effectively modulate pain, upper extremity disability, and ROM compared to passive VR added to physical therapy exercise during rehabilitation of pediatric patients with acute upper extremity thermal burn injury.

Keywords: Disabilities of the Arm; Interactive virtual reality; Pain; Passive virtual reality; Pediatric burns; Shoulder and Hand Questionnaire; Upper extremity range of motion.