title: Virtual reality pain control during physical therapy range of motion exercises for a patient with multiple blunt force trauma injuries.
abstract: Patients with severe blunt force trauma injuries (e.g., multiple fractures and/or internal injuries) often experience severe to excruciating pain during medical procedures. We explored the adjunctive use of immersive virtual reality (VR) to distract a patient with multiple blunt trauma injuries from his procedural pain during physical therapy. The patient was a 32-year-old male hospitalized after suffering upper and lower extremity injuries when he was hit by a semi truck as a pedestrian. While a nurse assisted the patient's passive range of motion (ROM) leg exercises over two days, the patient spent a total of 10 minutes of physical therapy with no distraction and 10 minutes in VR (within-subjects design, order randomized). Three 0 to 10 graphic-rating-scale pain scores for each of the two treatment conditions served as the primary dependent variables. The patient reported a reduction in pain when distracted with VR. "Pain unpleasantness" ratings during physical therapy dropped from "severe" (mean = 8.5) to "mild/moderate" (4.5). The patient's ROM was 1 degree less during VR on day 1, but the patient achieved 15 degrees greater ROM during VR on day 2. The present study provides preliminary evidence that immersive VR can be an effective adjunctive, nonpharmacologic pain-reduction technique for a patient with multiple blunt trauma injuries experiencing severe pain during physical therapy. The potential utility of VR analgesia for movement or exercise therapy for patients with blunt force trauma injuries should be explored in controlled studies.
authors.affiliation: Human Interface Technology Laboratory and Department of Mechanical Engineering, University of Washington, Seattle, Washington 98104, USA.
authors.forename: Hunter G
authors.initials: HG
authors.lastname: Hoffman
authors.forename: David R
authors.initials: DR
authors.lastname: Patterson
authors.forename: Maryam
authors.initials: M
authors.lastname: Soltani
authors.forename: Aubriana
authors.initials: A
authors.lastname: Teeley
authors.forename: William
authors.initials: W
authors.lastname: Miller
authors.forename: Sam R
authors.initials: SR
authors.lastname: Sharar
mesh_terms: D000328:Adult; D000698:Analgesia / Q000295:instrumentation / Q000379:methods*; D001288:Attention; D003198:Computer Simulation; D005081:Exercise Therapy / Q000523:psychology*; D005364:Field Dependence-Independence; D006801:Humans; D008297:Male; D009104:Multiple Trauma / Q000150:complications / Q000523:psychology / Q000628:therapy*; D010146:Pain / Q000150:complications / Q000523:psychology*; D059408:Pain Management; D010147:Pain Measurement; D017288:Pain Threshold / Q000523:psychology; D016059:Range of Motion, Articular; D013813:Therapy, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome; D014584:User-Computer Interface; D014949:Wounds, Nonpenetrating / Q000150:complications