Inhalation of toxic gases and chemical irritants during the fire leads to damage to the respiratory tract or the alveolar tissue, which is known as smoke inhalation injury. Acute Respiratory Distress Syndrome (ARDS) is associated with smoke inhalation injury. These patients usually need physiotherapy in the form of chest mobilization and breathing exercises for up to 4 to 6 weeks after discharge from the burns care centre. The patients during this phase are usually in pain and extremely anxious about these exercises. Virtual reality distraction (VRD) is one such technique that is gaining immense popularity recently, it has more immersive distraction when compared to traditional distraction techniques. This study aims to investigate the effect of a virtual reality distraction (VRD) technique as a pain alleviation tool for reducing pain during physiotherapy in burns patients with acute respiratory distress syndrome (ARDS) in a hospital setting.
Burns of the chest region (Chest burns - CB) constitute a common burn (29%) among other types of burn, in which second and third-degree burns are the most common type of injuries noted. Additionally, inhalation of toxic gases and chemical irritants during the fire leads to damage to the respiratory tract or the alveolar tissue, which is known as smoke inhalation injury. Acute Respiratory Distress Syndrome (ARDS) is associated with smoke inhalation injury, which is one of the infectious complications after a burn injury. According to the present data, the incidence of ARDS in burn patients is about 20 - 56% and is one of the main causes of death among burn patients. Management of ARDS generally includes mechanical ventilation, prophylaxis treatment, proper diet and physiotherapy treatment. These patients usually need physiotherapy in the form of chest mobilization and breathing exercises for up to 4 to 6 weeks after discharge from the burns care centre. The patients during this phase are usually in pain and extremely anxious about these exercises, hence pain and anti-anxiety drugs may be prescribed. Virtual reality distraction (VRD) is one such technique that is gaining immense popularity recently, it has more immersive distraction when compared to traditional distraction techniques like inhibition exercises, meditation or progressive muscle relaxation exercises. This study aims to investigate the effect of a virtual reality distraction (VRD) technique as a pain alleviation tool for reducing pain during physiotherapy in burns patients with acute respiratory distress syndrome (ARDS) in a hospital setting.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
60
The Oculus Rift's (Lenovo, Beijing, China) "Fujii - Mystical Journey" was the game played by the VRD group on a tablet. The game is a peaceful, ethereal voyage that passes through several surreal, natural locations. The game combines elements of adventure, agriculture and revitalizing music. It alternates between outdoor exploration and inventive gardening. Players explore three different magical biomes. The life force in each biome is restored by interacting with the plants and animals there.
The patients of the control group performed Progressive muscle relaxation technique, a relaxation technique used to control pain. It is believed that anxiety-inducing thoughts result in muscle tension and hence muscle relaxation can reduce anxiety. The relaxation technique consisted of tensing and relaxing different muscles, starting from the toes and finally involving muscles of the head and neck. It was recommended that this be done in a peaceful, distraction-free environment. The muscle groups were tensed for a period of 5 seconds and then relaxed for 30 seconds.
Dr. Gopal Nambi
Al Kharj, Riyadh Region, Saudi Arabia
Pain intensity - Visual analog scale (VAS)
The participants were asked to mark their level of pain intensity between 0 and 10, in which '0' denotes "no pain at all" and '10' denotes "the worst pain ever possible". It is a reliable and valid tool to assess pain intensity as proven by studies and a 2-point change or response in the NPRS is considered a clinically meaningful change that exceeds measurement error.
Time frame: Baseline
Pain intensity - Visual analog scale (VAS)
The participants were asked to mark their level of pain intensity between 0 and 10, in which '0' denotes "no pain at all" and '10' denotes "the worst pain ever possible". It is a reliable and valid tool to assess pain intensity as proven by studies and a 2-point change or response in the NPRS is considered a clinically meaningful change that exceeds measurement error.
Time frame: 4 weeks
Pain intensity - Visual analog scale (VAS)
The participants were asked to mark their level of pain intensity between 0 and 10, in which '0' denotes "no pain at all" and '10' denotes "the worst pain ever possible". It is a reliable and valid tool to assess pain intensity as proven by studies and a 2-point change or response in the NPRS is considered a clinically meaningful change that exceeds measurement error.
Time frame: 8 weeks
Pain intensity - Visual analog scale (VAS)
The participants were asked to mark their level of pain intensity between 0 and 10, in which '0' denotes "no pain at all" and '10' denotes "the worst pain ever possible". It is a reliable and valid tool to assess pain intensity as proven by studies and a 2-point change or response in the NPRS is considered a clinically meaningful change that exceeds measurement error.
Time frame: 6 months
Pulmonary function test - forced vital capacity (FVC)
Pulmonary function test (PFT) was undertaken to determine the degree of functional impairment and was performed with spirometer (MasterScreen Body; Jaeger, Wurzburg, Germany). The lung functions were determined by blowing through the mouth piece in the spirometer. The test was repeated three times or more and average score was considered, and all values were expressed as a percentage of the predicted values.
Time frame: Baseline
Pulmonary function test - forced vital capacity (FVC)
Pulmonary function test (PFT) was undertaken to determine the degree of functional impairment and was performed with spirometer (MasterScreen Body; Jaeger, Wurzburg, Germany). The lung functions were determined by blowing through the mouth piece in the spirometer. The test was repeated three times or more and average score was considered, and all values were expressed as a percentage of the predicted values.
Time frame: 4 weeks
Pulmonary function test - forced vital capacity (FVC)
Pulmonary function test (PFT) was undertaken to determine the degree of functional impairment and was performed with spirometer (MasterScreen Body; Jaeger, Wurzburg, Germany). The lung functions were determined by blowing through the mouth piece in the spirometer. The test was repeated three times or more and average score was considered, and all values were expressed as a percentage of the predicted values.
Time frame: 8 weeks
Pulmonary function test - forced vital capacity (FVC)
Pulmonary function test (PFT) was undertaken to determine the degree of functional impairment and was performed with spirometer (MasterScreen Body; Jaeger, Wurzburg, Germany). The lung functions were determined by blowing through the mouth piece in the spirometer. The test was repeated three times or more and average score was considered, and all values were expressed as a percentage of the predicted values.
Time frame: 6 months
Pulmonary function test - forced expiratory volume in 1 second (FEV1)
Pulmonary function test (PFT) was undertaken to determine the degree of functional impairment and was performed with spirometer (MasterScreen Body; Jaeger, Wurzburg, Germany). The lung functions were determined by blowing through the mouth piece in the spirometer. The test was repeated three times or more and average score was considered, and all values were expressed as a percentage of the predicted values.
Time frame: Baseline
Pulmonary function test - forced expiratory volume in 1 second (FEV1)
Pulmonary function test (PFT) was undertaken to determine the degree of functional impairment and was performed with spirometer (MasterScreen Body; Jaeger, Wurzburg, Germany). The lung functions were determined by blowing through the mouth piece in the spirometer. The test was repeated three times or more and average score was considered, and all values were expressed as a percentage of the predicted values.
Time frame: 4 weeks
Pulmonary function test - forced expiratory volume in 1 second (FEV1)
Pulmonary function test (PFT) was undertaken to determine the degree of functional impairment and was performed with spirometer (MasterScreen Body; Jaeger, Wurzburg, Germany). The lung functions were determined by blowing through the mouth piece in the spirometer. The test was repeated three times or more and average score was considered, and all values were expressed as a percentage of the predicted values.
Time frame: 8 weeks
Pulmonary function test - forced expiratory volume in 1 second (FEV1)
Pulmonary function test (PFT) was undertaken to determine the degree of functional impairment and was performed with spirometer (MasterScreen Body; Jaeger, Wurzburg, Germany). The lung functions were determined by blowing through the mouth piece in the spirometer. The test was repeated three times or more and average score was considered, and all values were expressed as a percentage of the predicted values.
Time frame: 6 months
Pulmonary function test - FEV1/FVC
Pulmonary function test (PFT) was undertaken to determine the degree of functional impairment and was performed with spirometer (MasterScreen Body; Jaeger, Wurzburg, Germany). The lung functions were determined by blowing through the mouth piece in the spirometer. The test was repeated three times or more and average score was considered, and all values were expressed as a percentage of the predicted values.
Time frame: Baseline
Pulmonary function test - FEV1/FVC
Pulmonary function test (PFT) was undertaken to determine the degree of functional impairment and was performed with spirometer (MasterScreen Body; Jaeger, Wurzburg, Germany). The lung functions were determined by blowing through the mouth piece in the spirometer. The test was repeated three times or more and average score was considered, and all values were expressed as a percentage of the predicted values.
Time frame: 4 weeks
Pulmonary function test - FEV1/FVC
Pulmonary function test (PFT) was undertaken to determine the degree of functional impairment and was performed with spirometer (MasterScreen Body; Jaeger, Wurzburg, Germany). The lung functions were determined by blowing through the mouth piece in the spirometer. The test was repeated three times or more and average score was considered, and all values were expressed as a percentage of the predicted values.
Time frame: 8 weeks
Pulmonary function test - FEV1/FVC
Pulmonary function test (PFT) was undertaken to determine the degree of functional impairment and was performed with spirometer (MasterScreen Body; Jaeger, Wurzburg, Germany). The lung functions were determined by blowing through the mouth piece in the spirometer. The test was repeated three times or more and average score was considered, and all values were expressed as a percentage of the predicted values.
Time frame: 6 months
Pulmonary function test - peak expiratory flow (PEF)
Pulmonary function test (PFT) was undertaken to determine the degree of functional impairment and was performed with spirometer (MasterScreen Body; Jaeger, Wurzburg, Germany). The lung functions were determined by blowing through the mouth piece in the spirometer. The test was repeated three times or more and average score was considered, and all values were expressed as a percentage of the predicted values.
Time frame: Baseline
Pulmonary function test - peak expiratory flow (PEF)
Pulmonary function test (PFT) was undertaken to determine the degree of functional impairment and was performed with spirometer (MasterScreen Body; Jaeger, Wurzburg, Germany). The lung functions were determined by blowing through the mouth piece in the spirometer. The test was repeated three times or more and average score was considered, and all values were expressed as a percentage of the predicted values.
Time frame: 4 weeks
Pulmonary function test - peak expiratory flow (PEF)
Pulmonary function test (PFT) was undertaken to determine the degree of functional impairment and was performed with spirometer (MasterScreen Body; Jaeger, Wurzburg, Germany). The lung functions were determined by blowing through the mouth piece in the spirometer. The test was repeated three times or more and average score was considered, and all values were expressed as a percentage of the predicted values.
Time frame: 8 weeks
Pulmonary function test - peak expiratory flow (PEF)
Pulmonary function test (PFT) was undertaken to determine the degree of functional impairment and was performed with spirometer (MasterScreen Body; Jaeger, Wurzburg, Germany). The lung functions were determined by blowing through the mouth piece in the spirometer. The test was repeated three times or more and average score was considered, and all values were expressed as a percentage of the predicted values.
Time frame: 6 months
Pulmonary function test - residual volume (RV)
Pulmonary function test (PFT) was undertaken to determine the degree of functional impairment and was performed with spirometer (MasterScreen Body; Jaeger, Wurzburg, Germany). The lung functions were determined by blowing through the mouth piece in the spirometer. The test was repeated three times or more and average score was considered, and all values were expressed as a percentage of the predicted values.
Time frame: Baseline
Pulmonary function test - residual volume (RV)
Pulmonary function test (PFT) was undertaken to determine the degree of functional impairment and was performed with spirometer (MasterScreen Body; Jaeger, Wurzburg, Germany). The lung functions were determined by blowing through the mouth piece in the spirometer. The test was repeated three times or more and average score was considered, and all values were expressed as a percentage of the predicted values.
Time frame: 4 weeks
Pulmonary function test - residual volume (RV)
Pulmonary function test (PFT) was undertaken to determine the degree of functional impairment and was performed with spirometer (MasterScreen Body; Jaeger, Wurzburg, Germany). The lung functions were determined by blowing through the mouth piece in the spirometer. The test was repeated three times or more and average score was considered, and all values were expressed as a percentage of the predicted values.
Time frame: 8 weeks
Pulmonary function test - residual volume (RV)
Pulmonary function test (PFT) was undertaken to determine the degree of functional impairment and was performed with spirometer (MasterScreen Body; Jaeger, Wurzburg, Germany). The lung functions were determined by blowing through the mouth piece in the spirometer. The test was repeated three times or more and average score was considered, and all values were expressed as a percentage of the predicted values.
Time frame: 6 months
Pulmonary function test - functional residual capacity (FRC)
Pulmonary function test (PFT) was undertaken to determine the degree of functional impairment and was performed with spirometer (MasterScreen Body; Jaeger, Wurzburg, Germany). The lung functions were determined by blowing through the mouth piece in the spirometer. The test was repeated three times or more and average score was considered, and all values were expressed as a percentage of the predicted values.
Time frame: Baseline
Pulmonary function test - functional residual capacity (FRC)
Pulmonary function test (PFT) was undertaken to determine the degree of functional impairment and was performed with spirometer (MasterScreen Body; Jaeger, Wurzburg, Germany). The lung functions were determined by blowing through the mouth piece in the spirometer. The test was repeated three times or more and average score was considered, and all values were expressed as a percentage of the predicted values.
Time frame: 4 weeks
Pulmonary function test - functional residual capacity (FRC)
Pulmonary function test (PFT) was undertaken to determine the degree of functional impairment and was performed with spirometer (MasterScreen Body; Jaeger, Wurzburg, Germany). The lung functions were determined by blowing through the mouth piece in the spirometer. The test was repeated three times or more and average score was considered, and all values were expressed as a percentage of the predicted values.
Time frame: 8 weeks
Pulmonary function test - functional residual capacity (FRC)
Pulmonary function test (PFT) was undertaken to determine the degree of functional impairment and was performed with spirometer (MasterScreen Body; Jaeger, Wurzburg, Germany). The lung functions were determined by blowing through the mouth piece in the spirometer. The test was repeated three times or more and average score was considered, and all values were expressed as a percentage of the predicted values.
Time frame: 6 months
Pulmonary function test - total lung capacity (TLC)
Pulmonary function test (PFT) was undertaken to determine the degree of functional impairment and was performed with spirometer (MasterScreen Body; Jaeger, Wurzburg, Germany). The lung functions were determined by blowing through the mouth piece in the spirometer. The test was repeated three times or more and average score was considered, and all values were expressed as a percentage of the predicted values.
Time frame: Baseline
Pulmonary function test - total lung capacity (TLC)
Pulmonary function test (PFT) was undertaken to determine the degree of functional impairment and was performed with spirometer (MasterScreen Body; Jaeger, Wurzburg, Germany). The lung functions were determined by blowing through the mouth piece in the spirometer. The test was repeated three times or more and average score was considered, and all values were expressed as a percentage of the predicted values.
Time frame: 4 weeks
Pulmonary function test - total lung capacity (TLC)
Pulmonary function test (PFT) was undertaken to determine the degree of functional impairment and was performed with spirometer (MasterScreen Body; Jaeger, Wurzburg, Germany). The lung functions were determined by blowing through the mouth piece in the spirometer. The test was repeated three times or more and average score was considered, and all values were expressed as a percentage of the predicted values.
Time frame: 8 weeks
Pulmonary function test - total lung capacity (TLC)
Pulmonary function test (PFT) was undertaken to determine the degree of functional impairment and was performed with spirometer (MasterScreen Body; Jaeger, Wurzburg, Germany). The lung functions were determined by blowing through the mouth piece in the spirometer. The test was repeated three times or more and average score was considered, and all values were expressed as a percentage of the predicted values.
Time frame: 6 months
Pulmonary function test - RV/TLC
Pulmonary function test (PFT) was undertaken to determine the degree of functional impairment and was performed with spirometer (MasterScreen Body; Jaeger, Wurzburg, Germany). The lung functions were determined by blowing through the mouth piece in the spirometer. The test was repeated three times or more and average score was considered, and all values were expressed as a percentage of the predicted values.
Time frame: Baseline
Pulmonary function test - RV/TLC
Pulmonary function test (PFT) was undertaken to determine the degree of functional impairment and was performed with spirometer (MasterScreen Body; Jaeger, Wurzburg, Germany). The lung functions were determined by blowing through the mouth piece in the spirometer. The test was repeated three times or more and average score was considered, and all values were expressed as a percentage of the predicted values.
Time frame: 4 weeks
Pulmonary function test - RV/TLC
Pulmonary function test (PFT) was undertaken to determine the degree of functional impairment and was performed with spirometer (MasterScreen Body; Jaeger, Wurzburg, Germany). The lung functions were determined by blowing through the mouth piece in the spirometer. The test was repeated three times or more and average score was considered, and all values were expressed as a percentage of the predicted values.
Time frame: 8 weeks
Pulmonary function test - RV/TLC
Pulmonary function test (PFT) was undertaken to determine the degree of functional impairment and was performed with spirometer (MasterScreen Body; Jaeger, Wurzburg, Germany). The lung functions were determined by blowing through the mouth piece in the spirometer. The test was repeated three times or more and average score was considered, and all values were expressed as a percentage of the predicted values.
Time frame: 6 months
Pulmonary function test - diffusing capacity for carbon monoxide of the lungs (DLCO)
Pulmonary function test (PFT) was undertaken to determine the degree of functional impairment and was performed with spirometer (MasterScreen Body; Jaeger, Wurzburg, Germany). The lung functions were determined by blowing through the mouth piece in the spirometer. The test was repeated three times or more and average score was considered, and all values were expressed as a percentage of the predicted values.
Time frame: Baseline
Pulmonary function test - diffusing capacity for carbon monoxide of the lungs (DLCO)
Pulmonary function test (PFT) was undertaken to determine the degree of functional impairment and was performed with spirometer (MasterScreen Body; Jaeger, Wurzburg, Germany). The lung functions were determined by blowing through the mouth piece in the spirometer. The test was repeated three times or more and average score was considered, and all values were expressed as a percentage of the predicted values.
Time frame: 4 weeks
Pulmonary function test - diffusing capacity for carbon monoxide of the lungs (DLCO)
Pulmonary function test (PFT) was undertaken to determine the degree of functional impairment and was performed with spirometer (MasterScreen Body; Jaeger, Wurzburg, Germany). The lung functions were determined by blowing through the mouth piece in the spirometer. The test was repeated three times or more and average score was considered, and all values were expressed as a percentage of the predicted values.
Time frame: 8 weeks
Pulmonary function test - diffusing capacity for carbon monoxide of the lungs (DLCO)
Pulmonary function test (PFT) was undertaken to determine the degree of functional impairment and was performed with spirometer (MasterScreen Body; Jaeger, Wurzburg, Germany). The lung functions were determined by blowing through the mouth piece in the spirometer. The test was repeated three times or more and average score was considered, and all values were expressed as a percentage of the predicted values.
Time frame: 6 months
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