JMIR Publications

ABSTRACT

Background:

Early rehabilitative mobilization for children is safe and feasible. However, there is a lack of published rehabilitation strategies and treatments that can maximize engagement and outcomes among children in the pediatric intensive care unit (PICU). Virtual reality (VR) gaming using a head mounted display (HMD) and adaptive software can allow active and non-active gameplay at the bedside for people with limited arm mobility, making it a potentially inclusive and enjoyable treatment modality for children in the PICU.

Objective:

The purpose of this brief case study is to report on the preliminary feasibility of incorporating adaptive VR gaming using a HMD with two children who received early mobility treatment within the PICU.

Methods:

This study was a mini-ethnographic investigation of two children (15 years, m / 13 years, m) in the PICU who underwent VR gaming sessions as part of their early mobilization care, using an Oculus Rift HMD and adaptive software (WalkinVR) that promoted full gameplay in bed. The Rift was plugged into a gaming laptop that was setup on a table within the patient’s room prior to each session. The intervention was delivered by an adapted exercise professional and supervised by a physical therapist. Patients had access to a variety of active (e.g., boxing, rhythmic movement-to-music, and exploratory adventure) and non-active games (e.g., racing and narrative adventure). Gaming sessions were scheduled between usual care, when tolerable and requested by the participant. The interventionist and therapists took audio recorded and written notes after completing each gaming session. These data were analyzed and presented in a narrative format from the perspective of the research team.

Results:

Case 1 participated in four gaming sessions with an average of 18 minutes per session. Case 2 participated in two sessions, an average of 35 minutes per session. Both cases were capable of performing active gaming at a moderate level of exercise intensity, as indicated by their heart rate. However, their health and symptoms fluctuated on a daily basis, which prompted gameplay of adventure or non-active games. Gameplay appeared to improve participants affect and alertness and motivate them to be more engaged in early mobilization therapy. Gameplay without the WalkinVR software caused several usability issues. There were no serious adverse events, but both cases experienced symptomology from their conditions.

Conclusions:

Study findings suggested that VR gaming with HMDs and adaptive software is likely a feasible supplement to usual care for children within the PICU, and these findings warrant further investigation. Recommendations for future studies aiming to incorporate VR gaming within early mobilization are presented herein.