Virtual Reality Animal Rescue World: Pediatric virtual reality analgesia during just noticeable pressure pain in children aged 2-10 years old (crossover design)

Taima Alrimy; Wadee Alhalabi; Areej A Malibari; Fatma Salih Alzahrani; Sharifah Alrajhi; Mohammed Alhalabi; Hunter G Hoffman

doi:10.3389/fpsyg.2022.963765

Virtual Reality Animal Rescue World: Pediatric virtual reality analgesia during just noticeable pressure pain in children aged 2-10 years old (crossover design)

Front Psychol. 2022 Oct 28:13:963765. doi: 10.3389/fpsyg.2022.963765. eCollection 2022.

Authors

Taima Alrimy¹, Wadee Alhalabi^{1

2

3}, Areej A Malibari¹, Fatma Salih Alzahrani⁴, Sharifah Alrajhi⁵, Mohammed Alhalabi², Hunter G Hoffman^{1

6}

Affiliations

¹ Department of Computer Science, Faculty of Computing and Information Technology, King Abdulaziz University, Jeddah, Saudi Arabia.
² Immersive Virtual Reality Research Group, King Abdulaziz University, Jeddah, Saudi Arabia.
³ Department of Computer Science, School of Engineering, Computing and Informatics, Dar Al-Hekma University, Jeddah, Saudi Arabia.
⁴ Department of Paediatric, King Abdulaziz University, Jeddah, Saudi Arabia.
⁵ Department of Statistics, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia.
⁶ Department of Mechanical Engineering, University of Washington, Seattle, WA, United States.

Abstract

Background and aims: Excessive pain during medical procedures is a worldwide medical problem. Most scald burns occur in children under 6, who are often undermedicated. Adjunctive Virtual Reality (VR) distraction has been shown to reduce pain in children aged 6-17, but little is known about VR analgesia in young children. This study tests whether desktop VR (VR Animal Rescue World) can reduce the just noticeable pressure pain of children aged 2-10.

Methods: A within-subject repeated measures design was used. With treatment order randomized, each healthy volunteer pediatric participant underwent brief cutaneous pressure stimuli under three conditions: (1) no distraction, (2) a verbal color naming task (no VR), and (3) a large TV-based desktop VR distraction. A hand-held Wagner pressure pain stimulation device was used to generate just noticeable pain sensations. Participants indicated when a steadily increasing non-painful pressure stimulus first turned into a painful pressure sensation (just noticeable pain).

Results: A total of 40 healthy children participated (43% aged 2-5 years; and 57% aged 6-10 years). Compared to the no distraction condition, the 40 children showed significant VR analgesia (i.e., a significant reduction in pain sensitivity during the VR Animal Rescue World condition), t(39) = 9.83, p < 0.001, SD = 6.24. VR was also significantly more effective at reducing pain sensitivity vs. an auditory color naming task, t(39) = 5.42, p < 0.001, SD = 5.94. The subset of children aged 2-5 showed significant reductions in pain during VR. Children under 6 showed greater sensitivity to pain during no distraction than children aged 6-10.

Conclusion: During no distraction, children under 6 years old were significantly more sensitive to pain than children aged 6-10. Virtual reality (VR) significantly reduced the "just noticeable" pressure pain sensitivity of children in both age groups.

Keywords: analgesia; non-pharmacologic; pain; pain management; pediatric; virtual reality.