Varzeshi Maryam, Deldar Kolsoum, Tavousi Seyed Hasan, Froutan Razieh, Nezami Hossein
Department of Medical Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Health Information Technology, School of Allied Medical Sciences, Shahroud University of Medical Sciences, Shahroud, Iran.
BMC Pediatr. 2025 Aug 11;25(1):618. doi: 10.1186/s12887-025-05972-3.
Burn injuries in children often impair joint mobility and motor function, with concomitant pain often compromising rehabilitation compliance. Active video games (AVGs) may offer a motivating, fear-reducing alternative, yet their effects on burn-related outcomes remain understudied. This study aimed to evaluate AVGs' impact on pain intensity, range of motion (ROM), and motor function in pediatric burn patients.
This two-phase study was conducted in 2024 at Imam Reza Hospital, Mashhad, Iran. First, an active video game was developed; then, a single-blind randomized controlled trial was conducted with 69 children aged 5-15 years with second-degree upper limb burns. Participants were block-randomized (1:1) using Stata 17. The intervention group received Kinect Xbox-based game therapy; the control group used traditional physiotherapy. Each session included a 15-minute warm-up followed by gameplay/ physiotherapy, held 10 times per week for two weeks. Pain, range of motion (ROM), and motor function were assessed using the Wong-Baker FACES scale, goniometry, and the Activities Scale for Kids (ASK), respectively. Data were analyzed using chi-square, t-test, Mann-Whitney U, repeated measures ANOVA, and Friedman tests in SPSS 28 (p < 0.05).
The mean age was 7.94 ± 2.22 years in the intervention group and 8.29 ± 2.29 years in the control group (p = 0.890). The findings showed a significant reduction in pain intensity after the intervention in both groups compared to pre-intervention levels (p < 0.001, 95% CI: 0.87-1.30). Moreover, the increase in wrist joint range of motion after the intervention was significantly different between the two groups (p < 0.001, 95% CI: 2.61-10.62). However, no significant difference was observed between the groups regarding shoulder and elbow joint range of motion (p = 0.490, 95% CI: -39.91-26.86; p = 0.060, 95% CI: -1.70-19.14, respectively). Additionally, no significant difference was found in motor function between the two groups after the intervention (p = 0.058, 95% CI: -0.16-9.68).
Our results demonstrated that active video game intervention significantly reduced pain intensity and improved wrist range of motion in children with burns. These findings suggest that active video games could serve as a complementary approach for wrist rehabilitation in pediatric burn patients. Future studies should validate these effects on other joints (shoulder/elbow) and functional outcomes.
This RCT was registered in the Iran Registry of Clinical Trials (IRCT20230723058891N1, https//irct.behdasht.gov.ir/trial/72575) on 11/04/2023.
儿童烧伤常损害关节活动度和运动功能，伴随的疼痛往往会影响康复依从性。主动式电子游戏（AVG）可能提供一种激发动力、减轻恐惧的替代方法，但其对烧伤相关结局的影响仍未得到充分研究。本研究旨在评估主动式电子游戏对小儿烧伤患者疼痛强度、关节活动范围（ROM）和运动功能的影响。
这项两阶段研究于2024年在伊朗马什哈德的伊玛目礼萨医院进行。首先，开发了一款主动式电子游戏；然后，对69名年龄在5至15岁的上肢二度烧伤儿童进行了单盲随机对照试验。使用Stata 17进行区组随机化（1:1）。干预组接受基于Xbox Kinect的游戏治疗；对照组采用传统物理治疗。每次治疗包括15分钟的热身，随后进行游戏/物理治疗，每周进行10次，共两周。分别使用面部表情疼痛评分量表（Wong-Baker FACES scale）、测角法和儿童活动量表（ASK）评估疼痛、关节活动范围（ROM）和运动功能。在SPSS 28中使用卡方检验、t检验、曼-惠特尼U检验、重复测量方差分析和弗里德曼检验进行数据分析（p < 0.05）。
干预组的平均年龄为7.94 ± 2.22岁，对照组为8.29 ± 2.29岁（p = 0.890）。结果显示，与干预前相比，两组干预后疼痛强度均显著降低（p < 0.001，95%可信区间：0.87 - 1.30）。此外，两组干预后腕关节活动范围的增加有显著差异（p < 0.001，95%可信区间：2.61 - 10.62）。然而，两组在肩关节和肘关节活动范围方面未观察到显著差异（分别为p = 0.490，95%可信区间：-39.91 - 26.86；p = 0.060，95%可信区间：-1.70 - 19.14）。此外，干预后两组在运动功能方面未发现显著差异（p = 0.058，95%可信区间：-0.16 - 9.68）。
我们的结果表明，主动式电子游戏干预显著降低了烧伤儿童的疼痛强度，并改善了腕关节活动范围。这些发现表明，主动式电子游戏可作为小儿烧伤患者腕关节康复的辅助方法。未来的研究应验证其对其他关节（肩/肘）和功能结局的影响。
该随机对照试验于2023年4月11日在伊朗临床试验注册中心（IRCT20230723058891N1，https//irct.behdasht.gov.ir/trial/72575）注册。
