Blunt chest trauma comprises over 10% of all trauma patients presenting to emergency departments worldwide and is the most frequent injury in polytrauma patients. It is associated with high risk (\>10%) of pulmonary complications such as pneumonia. Pillars of treatment are adequate pain relief, respiratory function exercises and rapid mobilisation through physiotherapy. Inadequate pain control can result in restricted ventilatory function and in reduced mobility, both resulting in a higher risk of particularly pulmonary complications. Virtual Reality (VR) might be an easy to use, individualized, and harmless technique that can facilitate pulmonary recovery and aid in the prevention of complications through reducing pain and promoting exercising. The investigators hypothesize that VR improves respiratory function and mobilisation in the post-acute phase of blunt chest trauma by distracting patients from pain and stress, and by stimulating pulmonary and physical exercise.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
27
For all VR exercises a head mounted display (HMD), the PICO G2 4K (Barcelona, Spain) will be used. Together with SyncVRMedical (Utrecht, Netherlands) a VR dashboard has been created from which patients can chose the different exercises.
Radboud university medical center
Nijmegen, Gelderland, Netherlands
Inspiration volume, mean change from baseline
Mean change from baseline in inspiration volume in ml, measured with an incentive spirometer (Voldyne)
Time frame: From baseline to end of treatment at day 5.
Inspiration volume, repeated measures over 5 days
change in mean daily inspiration volume in mL, measured with an incentive spirometer (Voldyne)
Time frame: Twice daily from enrollment to day 5 of treatment
Time spent sitting or standing, mean change from baseline
Measured continuously using a wearable activity monitor, calculated as percentage of time spent sitting or standing.
Time frame: Continuously from enrollment to end of treatment at day 5.
Length of hospital stay
Length of hospital stay in days
Time frame: At end of follow-up, 30 days after discharge
Pulmonary complications during admission
Number and type of pulmonary complications during admission
Time frame: At end of follow-up, 30 days after discharge
Transfers to ICU
Participant transferred to ICU during admission yes/no?
Time frame: At end of follow-up, 30 days after discharge
Readmission within 30 days
Participant readmitted within 30 days, yes/no
Time frame: At end of follow-up, 30 days after discharge
Pain score during breathing exercise using Visual Analogue Score (VAS)
VAS pain score during breathing exercise (0-100mm). A higher score means a worse outcome.
Time frame: Daily from baseline to end of treatment at day 5.
Powerless in Daily living questionnaire
Powerless in Daily living questionnaire (0-21), a higher score means a worse outcome.
Time frame: Daily from baseline to end of treatment at day 5.
Quality of Recovery-15 questionnaire
Quality of Recovery-15 questionnaire (0-150), a higher score means a better outcome.
Time frame: Daily from baseline to end of treatment at day 5.
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