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#27 - Pediatrics Hot Topic

Virtual Reality Helps Kids Escape From Pain

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Courtesy of UCSF Benioff Children's Hospital

A pilot study in San Francisco has shown that virtual reality (VR) can help children and teens escape from the pain of sickle cell disease, and future studies are planned to ease discomfort for youths being treated for cancer.

The idea came from video game developer Simon Robertson, who also happened to be a volunteer at the University of California San Francisco Benioff Children’s Hospital in Oakland.

Decreasing the Pain Felt

Robertson said he had read about pioneering research led by Hunter Hoffman at the University of Washington in 2000, showing that VR helped decrease the pain felt by adolescent burn patients as they had their wounds dressed.

“I remember reading that and thinking, ‘Oh, that is fantastic that they do that,’” said Robertson. “I just assumed they did that in every hospital now because this research is really convincing. But I was disappointed to discover that they were not doing it at my local hospital, and they were not doing it elsewhere.”

So Robertson began creating relaxing virtual environments to help distract young people from pain.

Coping With Sickle Cell Disease

He offered his technology to Anne Marsh, director of the pediatric sickle cell program at the University of California San Francisco Benioff Children’s Hospital Oakland.

“We are constantly looking for non-pharmacologic ways that we can help our patients cope with the pain of sickle cell disease,” said Marsh.

We thought this would be a perfect population of patients to try this on.

“We thought this would be a perfect population of patients to try this on.”

Robertson’s company, Kind VR, provided the headsets (Samsung Gear VR) and software.

A total of 30 hospitalized patients enrolled in the study (which should be published soon), between the ages of eight and 25.

Before putting on the VR headset, patients completed a survey to assess their pain — including where and how intense it was — and they were asked to describe the nature of the pain.

Then, they dove into a virtual underwater world, complete with dolphins, coral reefs and rainbow bubbles.

A New Kind of Relief

For Briana Nathaniel, 14, sickle cell disease causes throbbing in her arms, legs and back. She said that the only drug that helps her is morphine.

But trying VR from her hospital bed offered a new kind of relief.

It was really like you were in a different world

“It takes your mind off everything, what time it may be, the day, any worries you may have,” she said.

“It was really like you were in a different world and it is very different from the real world and that is what I really like about it.”

Experts say VR offers an even greater distraction than movies or mobile phone games.

“It really hijacks the brain’s senses,” explained Robertson.

“When you have the goggles on, it totally covers everything you see. If you move your head left and right it updates the image to make you feel as though you are looking around.”

Pain Distraction

In Robertson’s VR, there is also an interactive cognitive task in which patients, using a wireless Bluetooth controller or a touchpad located on the side of the headset, throw little rainbow bubbles at fish in an underwater scuba environment to help to bring color back into the ocean.

“That really helps with pain distraction because that just gives you a goal. It gives you a task and it helps you problem solve and you don’t know what is going to be ahead,” Robertson said.

All three of those domains were statistically and clinically significant for those kids

After the 15-minute VR session, patients answered the pain assessment questions again, and reported less intense pain, fewer areas of their body that were hurting. They also said their experience of pain had also changed.

“All three of those domains were statistically and clinically significant for those kids,” said Marsh.

No Significant Side Effect

Even though VR can cause motion sickness or headaches in some users, Marsh’s study found no significant side effects, she said.

VR also appeals to youth because, even though they are a digital-native generation, accustomed to a range of electronic devices and technology, VR is something novel that they are eager to try, Marsh said.

She is planning a future study to examine how long the positive effects last.

For kids who have tried it, the pain does return eventually.

“But the good thing is it helps enough for us to get a break,” Nathaniel said.

Robertson is also working with other hospitals in Sacramento and Toronto, Canada, to begin using Kind VR for pediatric patients with cancer — to distract young patients from the pain of having a subcutaneous port accessed for chemotherapy — and for use on young patients with burn wounds.

Pediatric VR is not available everywhere in the United States, not by a long shot.

“It is very much an emerging field and I think we are just at the forefront of it now,” said Marsh.

“I think in the next five years you are going to see an explosion of the use of VR for applications such as healthcare.”


About the Author

Kerry Sheridan is an author and health journalist based in Miami, Florida.

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