Use of Virtual Reality in Burn Rehabilitation: A Systematic Review and Meta-analysis

Lan，Xiaodong1; Tan，Ziming1; Zhou，Tao1; Huang，Zhenjia1; Huang，Zhiyong1; Wang，Chao1; Chen，Zhenwei1; Ma，Yan1; Kang，Tao1; Gu，Yan1; Wang，Dehuai1; Huang，Yuesheng2

2022

10.1016/j.apmr.2022.08.005

ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION   Impact Factor & Quartile

0003-9993

1532-821X

Objectives: We systematically reviewed published clinical trials to evaluate the effectiveness of virtual reality (VR) technology on functional improvement, pain relief, and reduction of mental distress among burn patients undergoing rehabilitation. Data Sources: Systematic searches were conducted in 4 databases, including PubMed, the Cochrane Library, Embase, and Web of Science, from inception to August 2021. Study Selection: Randomized controlled trials (RCTs) evaluating any type of VR for the rehabilitation in burn patients with dysfunction were included. Data Extraction: Two reviewers evaluated the eligibility, and another 2 reviewers used the Cochrane risk of bias assessment tool to assess the risk of bias. The extracted data included the main results of rehabilitation evaluation (quality of life [QOL], work performance, range of motion [ROM] of joints, hand grip and pinch strength, pain, fun, anxiety), the application performance of VR (realness and presence), adverse effects (fatigue and nausea), and characteristics of the included studies. Heterogeneity was evaluated using the chi-square tests and I statistics. Random- or fixed-effects models were conducted to pool the effect sizes expressed as standardized mean differences (SMDs). Data Synthesis: Sixteen RCTs with 535 burn patients were included. VR-based interventions were superior to usual rehabilitation in QOL and work performance of burn patients and produced positive effect on the average gain of ROM (SMD=0.72) as well. VR was not associated with improved hand grip and pinch strength (SMD=0.50, 1.22, respectively) but was associated with reduced intensity, affective, and cognitive components of pain (SMD=−1.26, −0.71, −1.01, respectively) compared with control conditions. Ratings of fun in rehabilitation therapy were higher (SMD=2.38), and anxiety scores were lower (SMD=−0.73) than in control conditions. Conclusions: VR-based burn rehabilitation significantly improves the QOL and work performance of burn patients, increases the ROM gain in the joints, reduces the intensity and unpleasantness of pain and the time spent thinking about pain, increases the fun in the rehabilitation therapy, reduces the anxiety caused by the treatment, and has no obvious adverse effects. However, it did not significantly improve hand grip or pinch strength.

Burns Rehabilitation Systematic review Virtual reality

English

Corresponding

CLINICAL MEDICINE

2-s2.0-85138582273

Scopus

1.Department of Burn and Plastic Surgery,Chengdu Second People's Hospital,Chengdu,China
2.Institute of Wound Repair and Regeneration Medicine,Southern University of Science and Technology School of Medicine; Department of Wound Repair,Southern University of Science and Technology Hospital,Shenzhen,China

Lan，Xiaodong,Tan，Ziming,Zhou，Tao,et al. Use of Virtual Reality in Burn Rehabilitation: A Systematic Review and Meta-analysis[J]. ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION,2022,104(3):502-513.

Lan，Xiaodong.,Tan，Ziming.,Zhou，Tao.,Huang，Zhenjia.,Huang，Zhiyong.,...&Huang，Yuesheng.(2022).Use of Virtual Reality in Burn Rehabilitation: A Systematic Review and Meta-analysis.ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION,104(3),502-513.

Lan，Xiaodong,et al."Use of Virtual Reality in Burn Rehabilitation: A Systematic Review and Meta-analysis".ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION 104.3(2022):502-513.