title: A rapid evidence assessment of immersive virtual reality as an adjunct therapy in acute pain management in clinical practice.
abstract: OBJECTIVE
  Immersive virtual reality (IVR) therapy has been explored as an adjunct therapy for the management of acute pain among children and adults for several conditions. Therapeutic approaches have traditionally involved medication and physiotherapy but such approaches are limited over time by their cost and side effects. This review seeks to critically evaluate the evidence for and against IVR as an adjunctive therapy for acute clinical pain applications.
  
  
  METHODS
  A rapid evidence assessment (REA) strategy was used. CINAHL, Medline, Web of Science, IEEE Xplore Digital Library, and the Cochrane Library databases were screened in from December 2012 to March 2013 to identify studies exploring IVR therapies as an intervention to assist in the management of pain. Main outcome measures were for acute pain and functional impairment.
  
  
  RESULTS
  Seventeen research studies were included in total including 5 RCTs, 6 randomized crossover studies, 2 case series studies, and 4 single-patient case studies. This included a total of 337 patients. Of these studies only 4 had a low risk of bias. There was strong overall evidence for immediate and short-term pain reduction, whereas moderate evidence was found for short-term effects on physical function. Little evidence exists for longer-term benefits. IVR was not associated with any serious adverse events.
  
  
  CONCLUSIONS
  This review found moderate evidence for the reduction of pain and functional impairment after IVR in patients with acute pain. Further high-quality studies are required for the conclusive judgment of its effectiveness in acute pain, to establish potential benefits for chronic pain, and for safety.
authors.affiliation: *School of Nursing, University of British Columbia †School of Interactive Arts and Technology, Simon Fraser University ‡Vancouver General Hospital, Vancouver, BC, Canada.
authors.forename: Bernie
authors.initials: B
authors.lastname: Garrett
authors.forename: Tarnia
authors.initials: T
authors.lastname: Taverner
authors.forename: Wendy
authors.initials: W
authors.lastname: Masinde
authors.forename: Diane
authors.initials: D
authors.lastname: Gromala
authors.forename: Chris
authors.initials: C
authors.lastname: Shaw
authors.forename: Michael
authors.initials: M
authors.lastname: Negraeff
mesh_terms: D059787:Acute Pain / Q000534:rehabilitation*; D016208:Databases, Factual / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D000091402:Prohibitins; D016032:Randomized Controlled Trials as Topic; D063367:Virtual Reality Exposure Therapy / Q000379:methods*