Pain Clinical Trial
Official title:
Virtual Reality in Reducing Pain and Anxiety in Pediatric Orthopaedics, a Pilot Randomized Controlled Trial
The main objective of the study is to evaluate the use of Virtual Reality (VR) in managing pain and anxiety levels during common pediatric orthopaedic outpatient procedures which include: cast application, cast removal, hardware removal (ie. pins and screws), and botox injections.
Immediately following recruitment, demographic data and diseased related information (ie.
location of cast/hardware, reason for cast/hardware placement and location and reason for
botox injection) will be collected through self and/or guardian report. All data will be
collected using REDCap (research electronic data capture). Using a parallel group design,
patients will then be stratified by age (4-7, 8-12 and 13-18 years), gender, and procedure
classifications (hardware or cast or staple or suture removal or cast application or botox
injection) site of hardware or cast or staple or suture or botox injection), and reason for
the procedure (trauma vs a preexisting orthopaedic condition). After randomization by the
REDCap system, patients are taken into the procedure room where a questionnaire (Short STAI)
is completed by the patient to collect pre-procedural state anxiety measurements. Following
this, patients in the control group will receive standard of care (SOC) which allows for the
technician and/or accompanying guardian to try and distract and or console the patient as
they normally would. The patients in the intervention group will receive SOC with Virtual
Reality (VR) interaction a few minutes before, during and following the procedure (around
5-10minutes total). During the procedure the researcher will complete an observational survey
(CEMS) to assess procedural state anxiety. Upon completion, both groups will then be asked to
complete a survey (Short STAI) to collect post-procedural anxiety levels and an additional
survey (Wong Baker Scale) to retrospectively collect pain levels from during the procedure
and their current pain levels post procedure while parent/guardians and cast technician will
be asked to complete their respective satisfaction questionnaires. Following this, the child
will be asked if they experienced any nausea at any point during the procedure, if they did,
they will be asked to complete the BARF questionnaire to measure the amount of nausea
experienced. Following completion of questionnaires, patients who were in the control group
are invited to interact with the VR simulation for a total of 5 minutes. This was chosen to
incentivize recruitment for the study.
SOC will consist of the technician/care provider explaining the procedure while using speech
to be comforting and supportive in addition to parent/guardians being allowed to console and
distract their child during the procedure.
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