Virtual Reality During Pediatric Cast Removal

NCT ID: NCT03903510

Last Updated: 2021-02-11

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

184 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-05-21

Study Completion Date

2021-09-30

Brief Summary

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This study is a randomized control trial of Virtual Reality during cast removal procedures at a pediatric tertiary care center.

Detailed Description

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Cast removal is a common outpatient procedure and is a source of pain and anxiety for children. Children are often frightened by the appearance and the noise of the saw. Additionally, the saw blade can become warm, and this can be uncomfortable. Multiple methods have been used and studied to try to make this experience easier for children. These methods include: soft music, therapeutic play, and headphones. Virtual reality (VR) devices are now increasingly affordable and portable. VR could be a way to distract children from the appearance and sound of the procedure. VR has been used in other clinical settings to help patients with the anxiety associated with medical procedures. The investigators propose a randomized trial to assess the responses (e.g. questionnaires and monitors) of children to cast removal with VR versus the standard noise reduction headphones.

Conditions

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Fractures, Bone

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Virtual Reality

Participants will experience Virtual Reality during their cast removal

Group Type EXPERIMENTAL

Virtual Reality (VR)

Intervention Type DEVICE

Participants in the experimental group will receive an AppliedVR virtual reality headset during their cast removal.

Standard of care

Participants will receive their usual standard of care treatment during cast removal

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Virtual Reality (VR)

Participants in the experimental group will receive an AppliedVR virtual reality headset during their cast removal.

Intervention Type DEVICE

Other Intervention Names

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AppliedVR

Eligibility Criteria

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Inclusion Criteria

* Sustained a fracture in their arm/leg
* No previous experience with a cast removal
* Must have at least one wrist free of immobilization (for heart rate monitor)
* Parents and patient are English speaking

Exclusion Criteria

* Patients with a history of epilepsy, ventricular shunt, motion sickness
* Patients with any history of cognitive, visual or hearing impairment
Minimum Eligible Age

4 Years

Maximum Eligible Age

12 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Gillette Children's Specialty Healthcare

OTHER

Sponsor Role lead

Responsible Party

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Andrew G. Geoergiadis

Pediatric Orthopedic Surgeon

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Andrew G Georgiadis, MD

Role: PRINCIPAL_INVESTIGATOR

Pediatric Orthopedic Surgeon

Locations

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Gillette Children's Specialty Healthcare

Saint Paul, Minnesota, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Andrew G Georgiadis, MD

Role: CONTACT

651-602-3262

Christine K Santa Ana, BS

Role: CONTACT

651-229-1763

Facility Contacts

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Andrew G Georgiadis, MD

Role: primary

651-602-3262

Christine K Santa Ana, BS

Role: backup

651-229-1763

References

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Naranje SM, Erali RA, Warner WC Jr, Sawyer JR, Kelly DM. Epidemiology of Pediatric Fractures Presenting to Emergency Departments in the United States. J Pediatr Orthop. 2016 Jun;36(4):e45-8. doi: 10.1097/BPO.0000000000000595.

Reference Type BACKGROUND
PMID: 26177059 (View on PubMed)

Wiggins CE, Brown KD. Hearing protection and cast saw noise. J South Orthop Assoc. 1996 Spring;5(1):1-4.

Reference Type BACKGROUND
PMID: 8673584 (View on PubMed)

Katz K, Fogelman R, Attias J, Baron E, Soudry M. Anxiety reaction in children during removal of their plaster cast with a saw. J Bone Joint Surg Br. 2001 Apr;83(3):388-90. doi: 10.1302/0301-620x.83b3.10487.

Reference Type BACKGROUND
PMID: 11341425 (View on PubMed)

Post JM, Switzer KD, Brown DK, Meinzen-Derr J, Dively J, Dunkin BS, Mehlman CT. Cast saw noise does not reach occupational hazard levels. J Pediatr Orthop. 2013 Jul-Aug;33(5):580-4. doi: 10.1097/BPO.0b013e318288b5e4.

Reference Type BACKGROUND
PMID: 23752160 (View on PubMed)

Liu RW, Mehta P, Fortuna S, Armstrong DG, Cooperman DR, Thompson GH, Gilmore A. A randomized prospective study of music therapy for reducing anxiety during cast room procedures. J Pediatr Orthop. 2007 Oct-Nov;27(7):831-3. doi: 10.1097/BPO.0b013e3181558a4e.

Reference Type BACKGROUND
PMID: 17878794 (View on PubMed)

Wong CL, Ip WY, Kwok BMC, Choi KC, Ng BKW, Chan CWH. Effects of therapeutic play on children undergoing cast-removal procedures: a randomised controlled trial. BMJ Open. 2018 Jul 5;8(7):e021071. doi: 10.1136/bmjopen-2017-021071.

Reference Type BACKGROUND
PMID: 29980545 (View on PubMed)

Carmichael KD, Westmoreland J. Effectiveness of ear protection in reducing anxiety during cast removal in children. Am J Orthop (Belle Mead NJ). 2005 Jan;34(1):43-6.

Reference Type BACKGROUND
PMID: 15707139 (View on PubMed)

Mahan ST, Harris MS, Lierhaus AM, Miller PE, DiFazio RL. Noise Reduction to Reduce Patient Anxiety During Cast Removal: Can We Decrease Patient Anxiety With Cast Removal by Wearing Noise Reduction Headphones During Cast Saw Use? Orthop Nurs. 2017 Jul/Aug;36(4):271-278. doi: 10.1097/NOR.0000000000000365.

Reference Type BACKGROUND
PMID: 28737634 (View on PubMed)

Hoffmann C. COX-2 in brain and spinal cord implications for therapeutic use. Curr Med Chem. 2000 Nov;7(11):1113-20. doi: 10.2174/0929867003374282.

Reference Type BACKGROUND
PMID: 11032961 (View on PubMed)

Gold JI, Kim SH, Kant AJ, Joseph MH, Rizzo AS. Effectiveness of virtual reality for pediatric pain distraction during i.v. placement. Cyberpsychol Behav. 2006 Apr;9(2):207-12. doi: 10.1089/cpb.2006.9.207.

Reference Type BACKGROUND
PMID: 16640481 (View on PubMed)

Asl Aminabadi N, Erfanparast L, Sohrabi A, Ghertasi Oskouei S, Naghili A. The Impact of Virtual Reality Distraction on Pain and Anxiety during Dental Treatment in 4-6 Year-Old Children: a Randomized Controlled Clinical Trial. J Dent Res Dent Clin Dent Prospects. 2012 Fall;6(4):117-24. doi: 10.5681/joddd.2012.025. Epub 2012 Nov 12.

Reference Type BACKGROUND
PMID: 23277857 (View on PubMed)

Nilsson S, Finnstrom B, Kokinsky E. The FLACC behavioral scale for procedural pain assessment in children aged 5-16 years. Paediatr Anaesth. 2008 Aug;18(8):767-74. doi: 10.1111/j.1460-9592.2008.02655.x.

Reference Type BACKGROUND
PMID: 18613934 (View on PubMed)

Steele E, Grimmer K, Thomas B, Mulley B, Fulton I, Hoffman H. Virtual reality as a pediatric pain modulation technique: a case study. Cyberpsychol Behav. 2003 Dec;6(6):633-8. doi: 10.1089/109493103322725405.

Reference Type BACKGROUND
PMID: 14756928 (View on PubMed)

Hoffman HG, Doctor JN, Patterson DR, Carrougher GJ, Furness TA 3rd. Virtual reality as an adjunctive pain control during burn wound care in adolescent patients. Pain. 2000 Mar;85(1-2):305-9. doi: 10.1016/s0304-3959(99)00275-4.

Reference Type BACKGROUND
PMID: 10692634 (View on PubMed)

Hoffman HG, Patterson DR, Carrougher GJ. Use of virtual reality for adjunctive treatment of adult burn pain during physical therapy: a controlled study. Clin J Pain. 2000 Sep;16(3):244-50. doi: 10.1097/00002508-200009000-00010.

Reference Type BACKGROUND
PMID: 11014398 (View on PubMed)

Sharar SR, Miller W, Teeley A, Soltani M, Hoffman HG, Jensen MP, Patterson DR. Applications of virtual reality for pain management in burn-injured patients. Expert Rev Neurother. 2008 Nov;8(11):1667-74. doi: 10.1586/14737175.8.11.1667.

Reference Type BACKGROUND
PMID: 18986237 (View on PubMed)

Hoffman HG, Seibel EJ, Richards TL, Furness TA, Patterson DR, Sharar SR. Virtual reality helmet display quality influences the magnitude of virtual reality analgesia. J Pain. 2006 Nov;7(11):843-50. doi: 10.1016/j.jpain.2006.04.006.

Reference Type BACKGROUND
PMID: 17074626 (View on PubMed)

Schmitt YS, Hoffman HG, Blough DK, Patterson DR, Jensen MP, Soltani M, Carrougher GJ, Nakamura D, Sharar SR. A randomized, controlled trial of immersive virtual reality analgesia, during physical therapy for pediatric burns. Burns. 2011 Feb;37(1):61-8. doi: 10.1016/j.burns.2010.07.007. Epub 2010 Aug 7.

Reference Type BACKGROUND
PMID: 20692769 (View on PubMed)

Hoffman HG, Sharar SR, Coda B, Everett JJ, Ciol M, Richards T, Patterson DR. Manipulating presence influences the magnitude of virtual reality analgesia. Pain. 2004 Sep;111(1-2):162-8. doi: 10.1016/j.pain.2004.06.013.

Reference Type BACKGROUND
PMID: 15327820 (View on PubMed)

Other Identifiers

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STUDY00005315

Identifier Type: -

Identifier Source: org_study_id

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