JMIR Publications

ABSTRACT

Background:

Adequate pain relief, early restoration of breathing, and rapid mobilization pose a clinical challenge in patients with blunt chest trauma. Virtual reality (VR) has the potential to achieve these three interrelated treatment objectives with enhanced self-efficacy and autonomy of patients and limited support by clinicians.

Objective:

To assess the effectivity of breathing and physical exercises using VR on the pulmonary recovery of patients with blunt chest trauma at the ward.

Methods:

A randomized controlled trial was performed. The control group received usual physiotherapy consisting of breathing and physical exercises according to protocol. The VR group was instructed to perform these exercises using VR. Primary outcome was vital lung capacity at day 5 or earlier at discharge. Secondary outcomes were patient mobility, clinical outcomes, pain, activities of daily living, patient reported outcome measures. Patient experiences and barriers and facilitators towards implementation were assessed through interviews.

Results:

The study was prematurely ended due to enrolment failure combined with poor protocol adherence to exercises in both groups. 27 patients were included. Vital lung capacity at 5 days (or last measurement) was equal between groups with 1830mL (±591) and 1857 mL (SD 435) in the control and VR group respectively. No important differences were observed in secondary outcomes. Patient interviews showed positive attitudes towards the use of VR. However, patients did not experience added value over usual care and reported that better integration in treatment and the hectic hospital environment could improve use of the VR exercises.

Conclusions:

The suitability of patients to use Virtual Reality therapy in a hospital (trauma) ward setting is lower than generally expected. Effective application of VR therapy requires professional guidance and needs thorough alignment with clinical practice. Clinical Trial: ClinicalTrial.gov NCT05194176