■在儿科骨科领域,使用虚拟现实等分散疗法是新颖的。在这项研究中,在儿科骨科队列中,我们使用主观和客观指标来评估虚拟现实对减轻焦虑和疼痛的疗效.
■一项前瞻性随机对照试验纳入了5至17岁的患者,向三级护理儿科骨科诊所介绍。平行组在临床上接受了骨科手术,利用沉浸式和交互式虚拟现实分心疗法与标准护理。程序包括演员申请,铸件去除,去骨针,和骨折复位。两组之间的所有术前参数相似。主要结果是最大手术心率和基线之间的差异。次要结果包括WongBakerFACES评定量表(Wong&Baker,1988年,俄克拉荷马州,美国)的疼痛和焦虑的视觉模拟量表评分。
■95名患者(66米,29F)进行了59次铸造拆除,26个演员应用程序,7个经皮销钉移除,和3个骨折复位。虚拟现实和对照组的平均患者年龄为10.1(5-17)和10.6(5-17),分别。虚拟现实组和对照组的最大心率平均变化为10.6±10.1对18.4±11.0(p=0.00048)。与对照组相比,虚拟现实组显示出更低的焦虑感(1.7±2.8对2.9±3.6,p=0.0666)。
■这项1级研究首次利用客观的生物识别测量来评估临床环境中多种类型的儿科骨科手术中交互式虚拟现实的使用。研究结果表明,交互式和身临其境的虚拟现实体验可以有效地减少疼痛和焦虑。
■1级,随机对照试验。
UNASSIGNED: Distraction therapy use such as virtual reality is novel in the pediatric orthopedic field. In this study, we use subjective and objective metrics to evaluate virtual reality efficacy to reduce anxiety and pain in a pediatric orthopedic cohort.
UNASSIGNED: A prospective randomized controlled trial included patients between age 5 and 17 years, presenting to a tertiary care pediatric orthopedic clinic. Parallel groups underwent orthopedic procedures in clinic, utilizing immersive and interactive virtual reality distraction therapies versus standard of care. Procedures included cast application, cast removal, bone pin removal, and fracture reduction. All preprocedure parameters were similar between the groups. Primary outcome was the difference between maximum procedural heart rate and baseline. Secondary outcomes included Wong Baker FACES Rating Scale (Wong & Baker, 1988, Oklahoma, USA) for pain and Visual Analog Scale scores for anxiety.
UNASSIGNED: Ninety-five patients (66 M, 29 F) underwent 59 cast removals, 26 cast applications, 7 percutaneous pin removals, and 3 fracture reductions. Average patient age in the virtual reality and control cohorts was 10.1 (5-17) and 10.6 (5-17), respectively. Average change in maximum heart rate in the virtual reality and control groups was 10.6 ± 10.1 versus 18.4 ± 11.0 (p = 0.00048). The virtual reality group demonstrated trends toward lower perceived anxiety (1.7 ± 2.8 versus 2.9 ± 3.6, p = 0.0666) when compared to controls.
UNASSIGNED: This level 1 study is the first to utilize objective biometric measurements to evaluate use of interactive virtual reality during multiple types of pediatric orthopedic procedures in the clinical setting. The findings suggest that an interactive and immersive virtual reality experience can be effective in reducing pain and anxiety.
UNASSIGNED: Level 1, Randomized Controlled Trial.