Faculty of Physiotherapy, Wroclaw University of Health and Sport Sciences, Wroclaw, Poland.
Department of Rehabilitation, University Hospital Brno, Czech Republic; Department of Public Health, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
Complement Ther Med. 2022 Sep;68:102837. doi: 10.1016/j.ctim.2022.102837. Epub 2022 Apr 29.
This systematic review and meta-analysis aimed to analyze and synthesize the evidence on the effectiveness of virtual reality (VR) interventions in the prevention of pain, fear and anxiety during burn wound care procedures.
In September and October 2021, PubMed, Scopus, Cochrane Library and Web of Science were searched for relevant randomized controlled and crossover studies. Two independent authors described the following inclusion criteria for the search: patients undergoing burn wound care with applied VR treatment compared to any other or non-VR intervention. From a total of 1171 records, 25 met the inclusion criteria. After full-text screening, seven publications were excluded. The risk of bias was assessed for 18 studies by two independent authors. RevMan 5.4 was used for the statistical analysis, meta-analysis and visual presentation of the results.
The meta-analysis showed a significant difference between VR treatment and standard care when analyzing pain outcome during wound care procedures (SMD = -0.49; 95% CI [-0.78, -0.15]; I = 41%) and in subgroup analysis when immersive VR was incorporated (SMD = -0.71; 95% CI [-1.07, -0.36]; I = 0%). No significant differences were found between VR treatment and standard care for range of motion outcome (SMD = 0.44; 95% CI [-0.23, 1.11]; I = 50%).
VR seems to be an effective therapeutic support in burn wound care procedures for reducing pain. However, this systematic review and meta-analysis highlights the need for more research into the use of VR as a distraction method. Studies on larger groups using similar conditions can provide unequivocal evidence of the effectiveness of VR and enable the inclusion of such intervention in standard medical procedures.
本系统评价和荟萃分析旨在分析和综合虚拟现实（VR）干预在预防烧伤伤口护理过程中的疼痛、恐惧和焦虑方面的有效性证据。
2021 年 9 月至 10 月，检索了 PubMed、Scopus、Cochrane 图书馆和 Web of Science 以获取相关的随机对照和交叉研究。两名独立作者描述了搜索的以下纳入标准：接受烧伤伤口护理并接受 VR 治疗的患者与任何其他或非 VR 干预措施进行比较。从总共 1171 条记录中，有 25 条符合纳入标准。经过全文筛选，有 7 篇出版物被排除在外。两名独立作者对 18 项研究的偏倚风险进行了评估。RevMan 5.4 用于统计分析、荟萃分析和结果的可视化呈现。
荟萃分析显示，在分析伤口护理过程中的疼痛结果时，VR 治疗与标准护理之间存在显著差异（SMD=-0.49；95%CI[-0.78，-0.15]；I=41%），并且在纳入沉浸式 VR 时进行亚组分析时也存在显著差异（SMD=-0.71；95%CI[-1.07，-0.36]；I=0%）。在运动范围结果方面，VR 治疗与标准护理之间没有发现显著差异（SMD=0.44；95%CI[-0.23，1.11]；I=50%）。
VR 似乎是烧伤伤口护理过程中减轻疼痛的有效治疗支持手段。然而，本系统评价和荟萃分析强调了需要更多研究 VR 作为分散注意力方法的使用。使用类似条件的更大群组的研究可以提供 VR 有效性的明确证据，并使此类干预措施纳入标准医疗程序。
