Virtual Reality Research for Anxiety and Pain Relief
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A comparison between audio and audiovisual distraction techniques in managing anxious pediatric dental patients."The results from this study showed that audiovisual distraction was the most effective means of managing the anxiety in children. Although not many studies have shown the effectiveness of audiovisual distraction in managing anxious pediatric dental patients, some studies have shown its effectiveness in managing anxious adult dental patients."Dental Pain, Dental Anxiety, Dental Fear, Digital Analgesic, Distraction, Nonpharmacological, Pediatric602007J Indian Soc Pedod Prev Dent. 2007 Oct-Dec;25(4):177-82.
A pilot study demonstrating effective virtual reality analgesia in the elderly"Results showed a significant reduction (p<0.05) in sensory, emotional, and cognitive pain components with VR treatment of either kind compared to baseline. However, subjective analgesia was significantly greater in the High-Immersion VR group compared to the Low-Immersion VR group for all three domains of the pain experience. Subjects also reported a greater sense of ‘presence’ in the virtual world with High-Immersion VR compared to Low-Immersion VR."Digital Analgesic, Distraction, Nonpharmacological, Elderly252011The Journal of Pain , Volume 12 , Issue 4 , P79
A Randomized, Controlled Trial of Immersive Virtual Reality Analgesia during Physical Therapy for Pediatric Burn Injuries"Results showed that on study day one, subjects reported significant decreases (27–44%) in pain ratings during virtual reality. They also reported improved affect (“fun”) during virtual reality. The analgesia and affect improvements were maintained with repeated virtual reality use over multiple therapy sessions."Anxiety, Burn, Physical Therapy, Digital Analgesic, Distraction, Nonpharmacological542011Burns. 2011 Feb; 37(1): 61–68.
Affective interactions using virtual reality: the link between presence and emotions."The results confirmed the efficacy of VR as affective medium: the interaction with "anxious" and "relaxing" virtual environments produced anxiety and relaxation. The data also showed a circular interaction between presence and emotions: on one side, the feeling of presence was greater in the "emotional" environments; on the other side, the emotional state was influenced by the level of presence. "Anxiety, Digital Analgesic, Distraction, Nonpharmacologicaln/a2007Cyberpsychol Behav. 2007 Feb;10(1):45-56.
Audiovisual video eyeglass distraction during dental treatment in children."General behavior during the AVD sessions, as rated by the Houpt scales, was excellent (rating 6) for 70% of the children, very good (rating 5) for 19%, good (rating 4) for 6%, and fair, poor, or aborted for only 5%. VAS scores showed 85% of the children, including those with poor Frankl ratings, to be satisfied with the AVD eyeglasses. Satisfaction of parents and clinicians was also high."Dental Pain, Dental Anxiety, Dental Fear, Digital Analgesic, Distraction, Nonpharmacological, Pediatric612010Quintessence Int. 2010 Sep;41(8):673-9.
Circumplex Model of Affect: A Measure of Pleasure and Arousal During Virtual Reality Distraction Analgesia"Compared with pain stimulation in the control (baseline, no VR) condition, immersive VR distraction significantly reduced subjective pain intensity (P < 0.001). During VR distraction, compared with those reporting negative affect, subjects reporting positive affect did so more frequently (41 percent versus 9 percent), as well as reporting both greater pain reduction (22 percent versus 1 percent) and fun scores (7.0 ± 1.9 versus 2.4 ± 1.4). Several factors—lower anxiety, greater fun, greater presence in the VR environment, and positive emotional valence—were associated with subjective analgesia during VR distraction."Anxiety, Digital Analgesic, Distraction, Nonpharmacological742016Games Health J. 2016 Jun 1; 5(3): 197–202.
Clinical Use of Virtual Reality Distraction System to Reduce Anxiety and Pain in Dental ProceduresThe physiological results of this research suggest that the use of the VR distraction system may be a beneficial option for patients with mild to moderate fear and anxiety associated with dental treatments. This system may be a useful adjunct in dental offices to help reduce anxiety, discomfort, boredom, and the time required to perform routine dental procedures. It allows them to relax by allowing them to navigate to another location while still physically remaining in the dental office.Dental Pain, Dental Anxiety, Dental Fear, Digital Analgesic, Distraction, Nonpharmacological52014Cyberpsychol Behav Soc Netw. 2014 Jun 1; 17(6): 359–365.
Comparative evaluation of the effectiveness of audio and audiovisual distraction aids in the management of anxious pediatric dental patients."Audiovisual distraction was found to be a more effective mode of distraction in the management of anxious children in both the age groups when compared to audio distraction. In both the age groups, a significant effect of the visit type was also observed."Dental Pain, Dental Anxiety, Dental Fear, Digital Analgesic, Distraction, Nonpharmacological, Pediatric602015J Indian Soc Pedod Prev Dent. 2015 Jul-Sep;33(3):192-203. doi: 10.4103/0970-4388.160357.
Cybertherapy--new applications for discomfort reductions. Surgical care unit of heart, neonatology care unit, transplant kidney care unit, delivery room-cesarean surgery and ambulatory surgery, 27 case reports."The majority of patients demonstrated comfort with virtual scenarios during surgical procedures or hospitalization. In ambulatory surgeries the reduction of medication dosage was real."Anxiety, Digital Analgesic, Distraction, Nonpharmacological272007Stud Health Technol Inform. 2007;125:334-6.
Cybertherapy--new applications for discomfort reductions. Surgical care unit of heart, neonatology care unit, transplant kidney care unit, delivery room-cesarean surgery and ambulatory surgery, 27 case reports. "The majority of patients demonstrated comfort with virtual scenarios during surgical procedures or hospitalization. In ambulatory surgeries the reduction of medication dosage was real."Digital Analgesic, Distraction, Nonpharmacological27
Differential effects of two virtual reality interventions: distraction versus pain control."Results showed that in comparison with the control condition, the VRC (environment designed towards pain control) intervention significantly increased pain tolerance, the pain sensitivity range, and the degree of time underestimation. It also increased self-efficacy in tolerating pain and led to a reduction in reported helplessness. The VRD intervention significantly increased the pain threshold and pain tolerance in comparison with the control condition, but it did not affect any of the cognitive variables."Digital Analgesic, Distraction, Nonpharmacological772014Cyberpsychol Behav Soc Netw. 2014 Jun;17(6):353-8. doi: 10.1089/cyber.2014.0057.
Effect of audiovisual distraction with 3D video glasses on dental anxiety of children experiencing administration of local analgesia: a randomised clinical trial."LA (local analgesia) administration with music or 3D video glasses distraction had an added advantage in a majority of children with 3D video glasses being superior to music. High levels of satisfaction from children who experienced treatment with 3D video glasses were also observed."Anxiety, Digital Analgesic, Distraction, Nonpharmacological, Pediatric,992015Eur Arch Paediatr Dent. 2015 Feb;16(1):43-50. doi: 10.1007/s40368-014-0145-9. Epub 2014 Sep 26.
Effect of virtual reality distraction on pain among patients with hand injury undergoing dressing change."Virtual reality distraction can effectively relieve pain without side effects and is not reliant on a doctor's prescription. This tool is convenient for nurses to use, especially when analgesics are unavailable."Digital Analgesic, Distraction, Nonpharmacological982015J Clin Nurs. 2015 Jan;24(1-2):115-20. doi: 10.1111/jocn.12626. Epub 2014 Jun 4.
Effect of virtual reality on time perception in patients receiving chemotherapy"VR is a noninvasive intervention that can make chemotherapy treatments more tolerable. Women with breast cancer are more likely and lung cancer patients less likely to experience altered time perception during VR (a possible indicator of effectiveness for this distraction intervention)."Anxiety, Digital Analgesic, Distraction, Nonpharmacological, Cancer, Chemotherapy1372011Support Care Cancer. 2011 Apr; 19(4): 555–564.
Effectiveness of audiovisual distraction eyewear and computerized delivery of anesthesia during pulp therapy of primary molars in phobic child patients."The use of audiovisual distraction with video eyewear and the use of CDS-IS system for anesthetic delivery was demonstrated to be effective in improving children's cooperation, than routine psychological interventions and is, therefore, highly recommended as an effective behavior management technique for long invasive procedures of pulp therapy in young children."Dental Pain, Dental Anxiety, Dental Fear, Digital Analgesic, Distraction, Nonpharmacological, Pediatric602015Eur J Dent. 2015 Oct-Dec;9(4):470-5. doi: 10.4103/1305-7456.172637.
Effectiveness of virtual reality distraction during a painful medical procedure in pediatric oncology patients"VR was effective in reducing children's distress on all measures."Anxiety, Digital Analgesic, Distraction, Nonpharmacological, Pediatric, Cancer, Chemotherapy202005Psychology & Health, Volume 20, 2005 - Issue 6
Effectiveness of virtual reality for pediatric pain distraction during i.v. placement."VR pain distraction was positively endorsed by all reporters and is a promising tool for decreasing pain, and anxiety in children undergoing acute medical interventions."Anxiety, Digital Analgesic, Distraction, Nonpharmacological202006Cyberpsychol Behav. 2006 Apr;9(2):207-12.
Effects of audiovisual distraction during dental prophylaxis."A virtual image A/V system is beneficial in the reduction of fear, pain and procedure time for most dental prophylaxis patients."Dental Pain, Dental Anxiety, Dental Fear, Digital Analgesic, Distraction, Nonpharmacological272001J Am Dent Assoc. 2001 Jul;132(7):1031-8.
Effects of distraction using virtual reality glasses during lumbar punctures in adolescents with cancer."Although VAS pain scores were not statistically different between the two groups (p = 0.77), VAS scores tended to be lower in the VR group (median VAS of 7.0, range 0-48) than in the control group (median VAS of 9.0, range 0-59). 77% of subjects in the experimental group said the VR glasses helped to distract them from the LP."Anxiety, Digital Analgesic, Distraction, Nonpharmacological, Cancer, Chemotherapy302002Oncol Nurs Forum. 2002 Jan-Feb;29(1):E8-E15.
Effects of Videogame Distraction using a Virtual Reality Type Head-Mounted Display Helmet on Cold Pressor Pain in Children"When compared to their performance during baseline, the children in this study demonstrated significantly higher pain thresholds and greater pain tolerance when engaged in interactive distraction. This finding cannot be explained by mere habituation to the cold pressor pain stimulus; the children who were exposed to repeated cold pressor trials without distraction did not improve."Digital Analgesic, Distraction, Nonpharmacological, Pediatric412009J Pediatr Psychol. 2009 Jun; 34(5): 574–584.
Embodying self-compassion within virtual reality and its effects on patients with depression"In an open trial, three repetitions of this scenario led to significant reductions in depression severity and self-criticism, as well as to a significant increase in self-compassion, from baseline to 4-week follow-up. Four patients showed clinically significant improvement."Depression, Anxiety, Digital Analgesic, Distraction, Nonpharmacological152016BJPsych Open. 2016 Jan; 2(1): 74–80.
Experiential virtual scenarios with real-time monitoring (interreality) for the management of psychological stress: a block randomized controlled trial."Our findings provide initial evidence that the Interreality protocol yields better outcomes than the traditionally accepted gold standard for psychological stress treatment: CBT."Anxiety, Psychology, Digital Analgesic, Distraction, Nonpharmacological1212014J Med Internet Res. 2014 Jul 8;16(7):e167. doi: 10.2196/jmir.3235.
Factors influencing the efficacy of virtual reality distraction analgesia during postburn physical therapy: preliminary results from 3 ongoing studies."Compared with standard analgesic treatment alone, the addition of VR distraction resulted in significant reductions in subjective pain ratings for worst pain intensity (20% reduction), pain unpleasantness (26% reduction), and time spent thinking about pain (37% reduction). Subjects' age, sex, ethnicity, size of initial burn injury, or duration of therapy session did not affect the analgesic effects of VR distraction."Anxiety, Burn, Physical Therapy, Digital Analgesic, Distraction, Nonpharmacological882007Arch Phys Med Rehabil. 2007 Dec;88(12 Suppl 2):S43-9.
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."There seems to be a trend that the low-cost VR system, when added to routine pharmacological analgesics, is a safe technique and could be of considerable benefit if implemented into the pain management regime of burn units at a South African hospital."Anxiety, Burn, Digital Analgesic, Distraction, Nonpharmacological112010Burns. 2010 Aug;36(5):659-64. doi: 10.1016/j.burns.2009.09.005. Epub 2009 Dec 21.
Feasibility of an Immersive Virtual Reality Intervention for Hospitalized Patients: An Observational Cohort Study"[...] most patients found VR to be a positive and pleasant experience. Patients described how VR could ease anxiety, reduce pain through distraction, and provide an “escape” from the confines and boredom of the hospital room. These qualitative results were further supported by endorsement of most participants that they would use VR again if given the opportunity."Anxiety, Psychology, Digital Analgesic, Distraction, Nonpharmacological,302016JMIR Ment Health. 2016 Apr-Jun; 3(2): e28.
Improving Dental Experiences by Using Virtual Reality Distraction: A Simulation Study"Dental anxiety is associated with the tendency to experience negative or threatening thoughts concerning treatment and this may prevent patients arranging and attending dental appointments. Our findings suggest that VR distraction has the potential to influence people’s memories of a potentially anxiety-inducing medical event. Our results are promising for real dental procedures in suggesting that VR distraction during dental treatment has the potential to interrupt the cycle of dental anxiety, by blocking the development of vivid memories."Dental Pain, Dental Anxiety, Dental Fear, Digital Analgesic, Distraction, Nonpharmacological692014PLoS One. 2014; 9(3): e91276.
Interactivity Influences The Magnitude Of Virtual Reality Analgesia"Results showed more pain reduction during interactive VR than during non-interactive VR. Compared to the non-interactive group, the interactive VR group reported 32% more reduction in time spent thinking about pain, 75% more reduction in pain unpleasantness, 74% more reduction in worst pain, and 47% more increase in fun during VR."Burn, Digital Analgesic, Distraction, Nonpharmacological212009J Cyber Ther Rehabil. 2009 Spring; 2(1): 27–33.
Manipulating presence influences the magnitude of virtual reality analgesia."Subjects in the High Tech VR group reported a stronger illusion of going into the virtual world (VR presence) than subjects in the Low Tech VR group, (4.2 vs. 2.5, respectively, P = 0.009) and more pain reduction (reduction of worst pain is 3.1 for High Tech VR vs. 0.7 for Low Tech VR, P < 0.001). Across groups, the amount of pain reduction was positively and significantly correlated with VR presence levels reported by subjects ( r = 0.48 for 'worst pain', P < 0.005)."Digital Analgesic, Distraction, Nonpharmacological2004Pain. 2004 Sep;111(1-2):162-8.
Modulation of thermal pain-related brain activity with virtual reality: evidence from fMRI."As predicted, virtual reality significantly reduced pain-related brain activity in all five regions of interest; the anterior cingulate cortex, primary and secondary somatosensory cortex, insula, and thalamus (p<0.002, corrected). Results showed direct modulation of human brain pain responses by virtual reality distraction."Digital Analgesic, Distraction, Nonpharmacological2004Neuroreport. 2004 Jun 7;15(8):1245-8.
Pain modulation during drives through cold and hot virtual environments."We found that both warm and cold virtual environments reduced pain intensity and unpleasantness for heat and cold pain stimuli when compared to the control condition. Since participants wore a head-mounted display (HMD) in both the control condition and VR, we concluded that the distracting value of virtual environments is not explained solely by excluding perception of the real world."Anxiety, Digital Analgesic, Distraction, Nonpharmacological482007Cyberpsychol Behav. 2007 Aug;10(4):516-22.
Repeated Use of Immersive Virtual Reality Therapy to Control Pain during Wound Dressing Changes in Pediatric and Adult Burn Patients"Results of the current study show that VR reduced the amount of pain reported on more than one dressing change/wound debridement session per patient. To our knowledge, this is the first large multi-patient study to test whether VR analgesia remains effective for reducing pain during burn wound care, when VR is used more than once per burn patient."Burn, Digital Analgesic, Distraction, Nonpharmacological362013J Burn Care Res. 2013 Sep-Oct; 34(5): 563–568.
Sound can enhance the analgesic effect of virtual reality"The results of the study are consistent with the suggestion that the analgesic effect of VR is due to competition for attentional resources [11,15]. The inclusion of sound alongside the VR game is likely to have been more attentionally demanding than both aspects in isolation, thereby leading to less attentional resources that could be allocated to the pain stimulus."Anxiety, Digital Analgesic, Distraction, Nonpharmacological322016R Soc Open Sci. 2016 Mar; 3(3): 150567.
Sustained Efficacy of Virtual Reality Distraction"Participants demonstrated increases in pain tolerance and pain threshold during the VR condition relative to their baseline, showing the largest and most stable effects for pain tolerance. Moreover, VR distraction led to significant decreases in participant ratings of pain intensity, anxiety, and time spent thinking about pain. [...] Furthermore, none of the above effects diminished significantly over the course of the 8 weekly exposures to VR, as indicated by the absence of condition by week effects in all of the variables and the absence of meaningful degradation in effect sizes over time. This suggests that participants did not habituate to the distracting properties of VR."Digital Analgesic, Distraction, Nonpharmacological282008The Journal of Pain , Volume 10 , Issue 4 , 391 - 397
The analgesic effects of opioids and immersive virtual reality distraction: evidence from subjective and functional brain imaging assessments."VR alone significantly reduced both worst pain (P < 0.01) and pain unpleasantness (P < 0.01) and significantly reduced pain-related brain activity in the insula (P < 0.05), thalamus (P < 0.05), and SS2 (P < 0.05). Combined opioid + VR reduced pain reports more effectively than did opioid alone on all subjective pain measures (P < 0.01)."Digital Analgesic, Distraction, Nonpharmacological92007Anesth Analg. 2007 Dec;105(6):1776-83, table of contents.
The Effect of Virtual Reality Distraction on Pain Relief During Dressing Changes in Children with Chronic Wounds on Lower Limbs."Virtual reality distraction significantly relieved pain and anxiety scores during dressing changes and reduced the time length for dressing changes as compared to standard distraction methods. The use of virtual reality as a distraction tool in a pediatric ward offered superior pain reduction to children as compared to standard distractions. This device can potentially improve clinical efficiency by reducing length time for dressing changes."Digital Analgesic, Distraction, Nonpharmacological, Pediatric652015Pain Manag Nurs. 2015 Oct;16(5):685-91. doi: 10.1016/j.pmn.2015.03.001. Epub 2015 May 9.
The Effect of Virtual Reality on Pain and Range of Motion in Adults With Burn Injuries"VR reduced all Graphic Rating Scale pain scores (worst pain, time spent thinking about the pain, and pain unpleasantness by 27, 37, and 31% respectively), relative to the no VR condition"Burn, Digital Analgesic, Distraction, Nonpharmacological392009J Burn Care Res. 2009 Sep–Oct; 30(5): 785–791.
The effectiveness of virtual reality for dental pain control: a case study."We contend that virtual reality is a uniquely attention-grabbing medium capable of maximizing the amount of attention drawn away from the "real world," allowing patients to tolerate painful dental procedures. These preliminary results suggest that immersive VR merits more attention as a potentially viable adjunctive nonpharmacologic analgesia for procedural dental/periodontal pain."Dental Pain, Dental Anxiety, Dental Fear, Digital Analgesic, Distraction, Nonpharmacological22001Cyberpsychol Behav. 2001 Aug;4(4):527-35.
The Effectiveness of Virtual Reality Pain Control With Multiple Treatments of Longer Durations: A Case Study"Recent studies have shown that single, 3-min visits to a virtual world can dramatically reduce the amount of pain experienced during wound care, and the illusion of going inside the computer-generated world helps make VR analgesia unusually effective."Digital Analgesic, Distraction, Nonpharmacological2001International Journal of Human–Computer Interaction, Volume 13, 2001 - Issue 1
The efficacy of playing a virtual reality game in modulating pain for children with acute burn injuries: A randomized controlled trial"The average pain scores (from the Faces Scale) for pharmacological analgesia only was, 4.1 (SD 2.9), while VR coupled with pharmacological analgesia, the average pain score was 1.3 (SD 1.8)."Digital Analgesic, Distraction, Nonpharmacological, Pediatric Pain,112005BMC Pediatr. 2005; 5: 1.
The Impact of Virtual Reality Distraction on Pain and Anxiety during Dental Treatment in 4-6 Year-Old Children: a Randomized Controlled Clinical Trial"There was a significant decrease in pain perception (P < 0.001) and state anxiety scores (P < 0.001) with the use of virtual reality eyeglasses during dental treatment. Results of this study showed that virtual reality eyeglasses can successfully decrease pain perception and state anxiety during dental treatment."Dental Pain, Dental Anxiety, Dental Fear, Digital Analgesic, Distraction, Nonpharmacological1202012J Dent Res Dent Clin Dent Prospects. 2012 Autumn; 6(4): 117–124.
The Impact of Virtual Reality on Chronic Pain"Pain was reduced from pre-session to post-session by 33%. Pain was reduced from pre-session during the VR session by 60%. These changes were both statistically significant at the p < .001 level. Three participants (10%) reported no change between pre and post pain ratings. Ten participants (33%) reported complete pain relief while doing the virtual reality session. All participants (100%) reported a decrease in pain to some degree between pre-session pain and during-session pain. The virtual reality experience was found here to provide a significant amount of pain relief."Anxiety, Digital Analgesic, Distraction, Nonpharmacological, Chronic Pain302016PLoS One. 2016; 11(12): e0167523.
The Use of Immersive Visualization for the Control of Dental Anxiety During Oral Debridement."Results from this study support the use of IV (immersive visualization) eyewear as an effective technique to reduce anxiety in adults during oral debridement. The use of the IV eyewear was well received by all subjects. The portable, affordable and easy-to-operate IV system makes this technique an appealing approach of reducing dental anxiety."Dental Pain, Dental Anxiety, Dental Fear, Digital Analgesic, Distraction, Nonpharmacological302015J Dent Hyg. 2015 Dec;89(6):372-7.
Use of virtual reality for adjunctive treatment of adult burn pain during physical therapy: a controlled study."All patients reported less pain when distracted with VR, and the magnitude of pain reduction by VR was statistically significant (e.g., time spent thinking about pain during physical therapy dropped from 60 to 14 mm on a 100-mm scale)."Anxiety, Burn, Physical Therapy, Digital Analgesic, Distraction, Nonpharmacological122000Clin J Pain. 2000 Sep;16(3):244-50.
Videogame Distraction using Virtual Reality Technology for Children Experiencing Cold Pressor Pain: The Role of Cognitive Processing"As predicted, children demonstrated significant improvements in pain tolerance when they were provided either passive or interactive distraction. However, increasing attentional load by engaging the child in ongoing interaction with the distractor resulted in superior improvements in pain tolerance."Digital Analgesic, Distraction, Nonpharmacological, Pediatric Pain,792011J Pediatr Psychol. 2011 Jan-Feb; 36(1): 84–94.
Virtual reality and anxiety in primiparous women during episiotomy repair"VR are safe, appropriate, and nonpharmacologic to decrease and manage the anxiety-associated episiotomy."Anxiety, Digital Analgesic, Distraction, Nonpharmacological, Episiotomy302016Iran J Nurs Midwifery Res. 2016 Sep-Oct; 21(5): 521–526.
Virtual reality as a distraction intervention for older children receiving chemotherapy."Eighty-two percent of the children (n = 11) indicated the chemotherapy treatment with the VR was better than previous chemotherapy treatments. All subjects responded positively when asked if they would like to use the VR again."Chemotherapy, Digital Analgesic, Distraction, Nonpharmacological112000Pediatr Nurs. 2000 Nov-Dec;26(6):593-7.
Virtual Reality as a Distraction Technique in Chronic Pain Patients"Within the subjective outcomes, patients reported significantly lower pain ratings while exploring the VE than during the pain focus session. Several patients reported encouraging feedback as well, such as “this is the first pain relief I have had in 3 years,” “I was so busy playing the game, I forgot about my pain,” and “even though the procedure was finished, I wanted to keep playing.” This shows that this technology is significant not only in reducing pain but also in eliminating the interruptive nature of chronic pain."Anxiety, Psychology, Digital Analgesic, Distraction, Nonpharmacological, Chronic Pain402014Cyberpsychol Behav Soc Netw. 2014 Jun 1; 17(6): 346–352.
Virtual Reality as an Adjunct Home Therapy in Chronic Pain Management: An Exploratory Study"Home-based VR therapy is a feasible option for chronic pain sufferers. There remains a pressing need for non-opioid alternatives in the treatment of chronic pain, [...]"Anxiety, Digital Analgesic, Distraction, Nonpharmacological, Chronic Pain82017JMIR Med Inform. 2017 Apr-Jun; 5(2): e11.
Virtual reality as an adjunctive non-pharmacologic analgesic for acute burn pain during medical procedures."Burn patients report 35-50% reductions in procedural pain while in a distracting immersive virtual reality, and fMRI brain scans show associated reductions in pain-related brain activity during VR."Burn, Digital Analgesic, Distraction, Nonpharmacological112011Ann Behav Med. 2011 Apr; 41(2): 183–191.
Virtual reality as an adjunctive pain control during burn wound care in adolescent patients."For the first session of wound care, these scores decreased 80 mm, 80 mm, 58 mm, and 93 mm, respectively, during VR treatment compared with the video game control condition. For the second session involving staple removal, scores also decreased. The second patient was a 17-year-old male with 33.5% total body surface area deep flash burns on his face, neck, back, arms, hands and legs. He had difficulty tolerating wound care pain with traditional opioids alone and showed dramatic drops in pain ratings during VR compared to the video game (e.g. a 47 mm drop in pain intensity during wound care)."Anxiety, Burn, Physical Therapy, Digital Analgesic, Distraction, Nonpharmacological22000Pain. 2000 Mar;85(1-2):305-9.
Virtual reality distraction decreases routine intravenous sedation and procedure-related pain during preoperative adductor canal catheter insertion: a retrospective study"The use of VR distraction during preoperative ACC insertion decreased the use of intravenous opioids and sedatives and reduced procedure-related pain without increasing the procedural duration."Anxiety, Digital Analgesic, Distraction, Nonpharmacological142017Korean J Anesthesiol. 2017 Aug; 70(4): 439–445.
Virtual reality distraction for pain control during periodontal scaling and root planing procedures."VAS (visual analog scale) scores were significantly lower during VR compared with the movie (P <.001) and control (P <.001) conditions. Blood pressure and pulse rate were lowest during VR, followed by the movie and control conditions. Patients reported that they preferred the VR condition."Dental Pain, Dental Anxiety, Dental Fear, Digital Analgesic, Distraction, Nonpharmacological382009J Am Dent Assoc. 2009 Dec;140(12):1508-16.
Virtual Reality for Management of Pain in Hospitalized Patients: Results of a Controlled Trial"Use of VR in hospitalized patients significantly reduces pain versus a control distraction condition. These results indicate that VR is an effective and safe adjunctive therapy for pain management in the acute inpatient setting; [...]"Anxiety, Psychology, Digital Analgesic, Distraction, Nonpharmacological,1002017JMIR Ment Health. 2017 Jan-Mar; 4(1): e9.
Virtual Reality for Pain Management in Cardiac Surgery"Overall, the results of the therapy were positive. Of the 67 patients, 59 patients (88%) reported a decreased level of pain experienced post-therapy. The mean change in the Likert scale was 3.75, which corresponds to a decrease from “severe” to “moderate” or “moderate” to “light.” Physiologically, 25 patients (37.3%) experienced reduced heart rates, 35 (52.2%) experienced reduced mean arterial pressure, and 14 (64%) of 22 patients tested for respiratory rate experienced a reduction."Anxiety, Psychology, Digital Analgesic, Distraction, Nonpharmacological762014Cyberpsychol Behav Soc Netw. 2014 Jun 1; 17(6): 371–378.
Virtual reality for the induction of positive emotions in the treatment of fibromyalgia: a pilot study over acceptability, satisfaction, and the effect of virtual reality on mood."Results showed significant increases in general mood state, positive emotions, motivation, and self-efficacy. These preliminary findings show the potential of VR as an adjunct to the psychological treatment of such an important health problem as chronic pain."Fibromyalgia, Digital Analgesic, Distraction, Nonpharmacologicaln/a2014Cyberpsychol Behav Soc Netw. 2014 Jun;17(6):379-84. doi: 10.1089/cyber.2014.0052.
Virtual reality helmet display quality influences the magnitude of virtual reality analgesia."Compared to the Low-Tech-VR helmet group, subjects in the High-Tech-VR helmet group reported 34% more reduction in worst pain (P < .05), 46% more reduction in pain unpleasantness (P = .001), 29% more reduction in "time spent thinking about pain" (P < .05), and 32% more fun during the pain stimulus in VR (P < .05)."Digital Analgesic, Distraction, Nonpharmacological772006J Pain. 2006 Nov;7(11):843-50.
Virtual Reality Hypnosis In The Treatment Of Chronic Neuropathic Pain: A Case Report"This patient reported an average of 25% pain intensity reduction and 20% pain unpleasantness reduction over the course of the first 10 sessions of VRH, compared to an average of 7% pain intensity reduction and 15% pain unpleasantness reduction over the course of the 10-session hypnosis (non-VR) treatment."Anxiety, Digital Analgesic, Distraction, Nonpharmacological, Chronic Pain12008Int J Clin Exp Hypn. 2008 Oct; 56(4): 451–462.
Virtual reality immersion method of distraction to control experimental ischemic pain."Tolerance time to ischemia was significantly longer for VR conditions than for those without (P < 0.001). Visual Analogue Scale (0–10) ratings were recorded for pain intensity, pain unpleasantness, and the time thought about pain. Affective distress ratings of unpleasantness and of time thought about pain were significantly lower during VR as compared with the control condition (P < 0.003 and 0.001 respectively)."Digital Analgesic, Distraction, Nonpharmacological202006Isr Med Assoc J. 2006 Apr;8(4):261-5.
Virtual reality in outpatient phlebotomy: Evaluating pediatric pain distraction during blood draw"Preliminary results of 57 participants found that children assigned to VR distraction reported significantly less pain intensity from the needle than children in the other three groups (F(3,53)=2.74, p < .05). Similarly, children in the VR group reported less affective needle pain than children in the cartoon and flat-screen VE distraction groups."Digital Analgesic, Distraction, Nonpharmacological, Phlebotomy572005The Journal of Pain , Volume 6 , Issue 3 , S57
Virtual reality intervention for older women with breast cancer."There was a consistent trend toward improved symptoms on all measures 48 h following completion of chemotherapy. Evaluation of the intervention indicated that women thought the head mounted device was easy to use, they experienced no cybersickness, and 100% would use VR again."Anxiety, Digital Analgesic, Distraction, Nonpharmacological, Pediatric, Cancer, Chemotherapy162003Cyberpsychol Behav. 2003 Jun;6(3):301-7.
Virtual reality on mobile phones to reduce anxiety in outpatient surgery."A significant reduction of anxiety was obtained after 45 minutes of operation in the VR group, but not in the control group and, after 90 minutes, the reduction was larger in the experimental group than in other one. In conclusion, this study presents an innovative promising technique to reduce anxiety during surgical interventions [...]"Anxiety, Digital Analgesic, Distraction, Nonpharmacologicaln/a2009Stud Health Technol Inform. 2009;142:195-200.
Virtual reality pain control during burn wound debridement in the hydrotank."Patients reported significantly less pain when distracted with VR [eg, "worst pain" ratings during wound care dropped from "severe" (7.6) to "moderate" (5.1)]. The 6 patients who reported the strongest illusion of "going inside" the virtual world reported the greatest analgesic effect of VR on worst pain ratings, dropping from severe pain (7.2) in the no VR condition to mild pain (3.7) during VR."Burn, Digital Analgesic, Distraction, Nonpharmacological112008Clin J Pain. 2008 May;24(4):299-304. doi: 10.1097/AJP.0b013e318164d2cc.
Virtual Reality Pain Control During Burn Wound Debridement of Combat-Related Burn Injuries Using Robot-Like Arm Mounted VR Goggles"Patients reported significantly less pain when distracted with VR. “Worst pain” (pain intensity) dropped from 6.25 of 10 to 4.50 of 10. “Pain unpleasantness” ratings dropped from “moderate” (6.25 of 10) to “mild” (2.83 of 10). “Time spent thinking about pain” dropped from 76% during no VR to 22% during VR. Patients rated “no VR” as “no fun at all” (<1 of 10) and rated VR as “pretty fun” (7.5 of 10). Follow-up analyses showed VR was especially effective for the six patients who scored 7 of 10 or higher (severe to excruciating) on the “worst pain” (pain intensity) ratings."Burn, Digital Analgesic, Distraction, Nonpharmacological122011J Trauma. 2011 Jul; 71(1 0): S125–S130.
Virtual Reality: A Distraction Intervention for Chemotherapy"VR was found to be a distraction intervention that was feasible to implement in the clinic setting. The current study employed the largest sample to date using VR as a distraction intervention. Patients found the headset easy to use during chemotherapy treatments. The intervention was noninvasive and cost effective. [...] Wearing the head-mounted display resulted in a significant elapsed time compression effect, which helps to validate the distracting capabilities of the VR. Evaluation of the intervention indicated that individuals believed the head-mounted display was easy to use, and more than 82% of patients expressed an interest in using the VR again during subsequent chemotherapy treatments.Anxiety, Digital Analgesic, Distraction, Nonpharmacological, Cancer, Chemotherapy1232007Oncol Nurs Forum. 2007 Jan; 34(1): 39–46.
Virtual-Reality Distraction and Cold-Pressor Pain Tolerance: Does Avatar Point of View Matter?"The results of this study provide further evidence that distraction techniques that utilize VR technology can improve pain tolerance in healthy adults undergoing laboratory-induced pain. Consistent with the findings of other studies of VR distraction participants were able to tolerate cold-pressor pain longer during VR-distraction trials than during a baseline trial without VR distraction."Digital Analgesic, Distraction, Nonpharmacological412010Cyberpsychol Behav Soc Netw. 2010 Oct; 13(5): 587–591.
Virtual Reality Analgesia in Labor: The VRAIL Pilot Study—A Preliminary Randomized Controlled Trial Suggesting Benefit of Immersive Virtual Reality Analgesia in Unmedicated Laboring Women"This pilot study investigated the use of virtual reality (VR) in laboring women. Twenty-seven women were observed for equivalent time during unmedicated contractions in the first stage of labor both with and without VR (order balanced and randomized). Numeric rating scale scores were collected after both study conditions. Significant decreases in sensory pain −1.5 (95% CI, −0.8 to −2.2), affective pain −2.5 (95% CI, −1.6 to −3.3), cognitive pain −3.1 (95% CI, −2.4 to −3.8), and anxiety −1.5 (95% CI, −0.8 to −2.3) were observed during VR. Results suggest that VR is a potentially effective technique for improving pain and anxiety during labor."Digital Analgesic, Distraction, Nonpharmacological272018Anesthesia & Analgesia: July 11, 2018
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