Virtual reality therapy to control burn pain: systematic review of randomized controlled trials

Background Virtual reality therapy has been shown to be an excellent alternative to non-pharmacological treatment for the control of burn pain. Objective To evaluate the effects of virtual reality therapy on pain control in people who have suffered burns published in the scientific literature. Method Systematic review carried out as recommended by Cochrane®. The search was carried out in the Embase, PubMed, Lilacs and Cochrane Library databases, in the period from March 2021. Randomized clinical trials were included without language restriction and year of publication. The risk of bias was assessed using the Cochrane® tool. Results Of the 3755 articles found, only 17 articles were selected for reading in full. Of these, only four articles met the inclusion criteria. The results of the studies showed that the use of virtual reality therapy reduced the intensity of pain in children and adolescents with burns, despite the fact that most results are not statistically significant. No selected study had a high risk of bias. Conclusions Virtual reality therapy has been shown to be effective in controlling pain, reducing the time spent thinking about it and greater distraction during the procedures. However, most randomized clinical trials results were not statistically significant in at least one of the moments when pain was assessed. It is noteworthy that randomized clinical trials are still necessary to administer virtual reality therapy, especially in adults.

Recovering arm function in chronic stroke patients using combined anodal HD-tDCS and virtual reality therapy (ReArm): a study protocol for a randomized controlled trial

Background After a stroke, 80% of the chronic patients have difficulties to use their paretic upper limb (UL) in activities of daily life (ADL) even after rehabilitation. Virtual reality therapy (VRT) and anodal transcranial direct current stimulation (tDCS) are two innovative methods that have shown independently to positively impact functional recovery of the paretic UL when combined with conventional therapy. The objective of the project will be to evaluate the impact of adding anodal high-definition (HD)-tDCS during an intensive 3-week UL VRT and conventional therapy program on paretic UL function in chronic stroke. Methods The ReArm project is a quadruple-blinded, randomized, sham-controlled, bi-centre, two-arm parallel, and interventional study design. Fifty-eight chronic (> 3 months) stroke patients will be recruited from the Montpellier and Nimes University Hospitals. Patients will follow a standard 3-week in-patient rehabilitation program, which includes 13 days of VRT (Armeo Spring, 1 × 30 min session/day) and conventional therapy (3 × 30 min sessions/day). Twenty-nine patients will receive real stimulation (4x1 anodal HD-tDCS montage, 2 mA, 20 min) to the ipsilesional primary motor cortex during the VRT session and the other 29 patients will receive active sham stimulation (2 mA, 30 s). All outcome measures will be assessed at baseline, at the end of rehabilitation and again 3 months later. The primary outcome measure will be the wolf motor function test. Secondary outcomes will include measures of UL function (Box and Block Test), impairment (Fugl Meyer Upper Extremity), compensation (Proximal Arm Non-Use), ADL (Actimetry, Barthel Index). Other/exploratory outcomes will include pain, fatigue, effort and performance, kinematics, and motor cortical region activation during functional motor tasks. Discussion This will be the first trial to determine the impact of adding HD-tDCS during UL VRT and conventional therapy in chronic stroke patients. We hypothesize that improvements in UL function will be greater and longer-lasting with real stimulation than in those receiving sham. Trial registration The ReArm project was approved by The French Research Ethics Committee, (Comité de Protection des Personnes-CPP SUD-EST II, N°ID-RCB: 2019-A00506-51, http://www.cppsudest2.fr/). The ReArm project was registered on ClinicalTrials.gov (NCT04291573, 2nd March 2020.

E-HEALTH NURSING VIRTUAL REALITY TREND PADA PASIEN SKIZOFRENIA GUNA MENINGKATKAN KESEHATAN MENTAL: SYSTEMATIC REVIEW

permasalahan serius di dunia dan Indonesia. Data dari World Health Organization sekitar 21 juta orang mengalami skizofrenia. Prevalensi skizofrenia di Indonesia mengalami peningkatan proporsi per 1000 penduduk (1,7%) pada tahun 2013 menjadi (7%) pada tahun 2018. Faktanya terapi keperawatan untuk halusinasi belum optimal sedangkan teknologi terus berkembang seperti Virtual Reality (VR). VR mampu menurunkan gejala pada skizofrenia dengan kemampuan membuat perilaku interaktif dan tersimpan dalam otak agar tidak menimbulkan halusinasi. Teknologi ini digunakan untuk mengetahui manfaat E-Health Nursing VR sebagai terapi halusinasi pada pasien skizofrenia. Metode penelitian menggunakan systematic review dari 5 database yaitu Nature, Frontiers, BMC, Science Direct, NEJM sehingga didapat total 55 literatur. Mayoritas 63% mengulas terapi VR untuk mengurangi halusinasi pada skizofrenia. Perkembangan manfaat VR diverifikasi dalam beberapa pengobatan: skizofrenia, PTSD, kecemasan, akrofobia, ganguan citra tubuh, claustrophobia, dan lain-lain. Beberapa studi skizofrenia menyatakan terapi VR sangat efektif menangani delusi, halusinasi, gejala kepribadian skizoid. VR juga berguna dalam rehabilitas kognitif pada orang dewasa atau anak-anak autis dalam keterampilan dan kemandirian. Kesimpulan penelitian ini adalah VR terbukti efektif sebagai terapi kesehatan jiwa di masa mendatang. Disisi lain terdapat terapi psikologis pilihan seperti terapi perilaku kognitif, dan psikoterapi interpersonal. Oleh karenanya diperlukan kombinasi terapi VR dengan terapi komplementer tersebut dalam mengurangi halusinasi pada skizofrenia. Mental health become a severe problem in the world and Indonesia. Data from the World Health Organization (WHO, 2016) estimated that 21 million people have schizophrenia. The prevalence of schizophrenia in Indonesia has increased proportion per 1000 population (1,7%) in 2013 to (7%) in 2018. In fact of nursing, therapy for hallucination is not optimal while constantly evolving technology such as Virtual Reality (VR). VR can reduce symptoms in schizophrenia with the ability to create interactive behavior and stored in the brain in order to cause hallucinations. The objective of this study was to review the benefit of VR as a hallucination therapy in schizophrenia patients. This research used a systematic literature review from five databases Nature, Frontiers, BMC, Science Direct, NEJM, and resulted in the retrieval of 55 papers. The majority of a result found a 63% review in Virtual Reality therapy can reduce hallucination in schizophrenia. VR is a technology browser and manipulator sensory environment in real-time 3D. The progressing benefit of VR verified in the treatment of schizophrenia, PSTD, anxiety, acrophobia, body image disorder, claustrophobia, and others. Some studies of schizophrenia declare that virtual reality therapy is effective in treating delusions, hallucinations, and a symptom of schizoid behavior. VR also has benefits in cognitive rehabilitation in adults or children with autism's inability and self-reliance. VR has a bright future as the treatment of mental health. The progressing of technology and research has an excellent opportunity for VR to reduce schizophrenia. Moreover, there is psychological therapy, such as cognitive-behavioral therapy and interpersonal psychotherapy. Therefore a combination needed of virtual therapy with the complementary therapy for reducing hallucination in schizophrenia.