Affiliations: Child Health and Exercise Medicine Program, McMaster
University, Hamilton, ON, Canada | Department of Pediatrics, McMaster University,
Hamilton, ON, Canada | Department of Critical Care, McMaster University,
Hamilton, ON, Canada | Department of Clinical Epidemiology and Biostatistics,
McMaster University, Hamilton, ON, Canada
Note: [] Corresponding author: Karen Choong, McMaster University, 1280
Main Street West. Hamilton, ON L8S 4K1, Canada. Tel.: +1 905 5212100 Ext 75617;
E-mail: choongk@mcmaster.ca
Abstract: PURPOSE: To evaluate the safety and feasibility of virtual
reality (VR) exercise as a novel acute rehabilitation intervention in a
Pediatric Critical Care Unit (PCCU) setting. METHODS: Children aged 3–18
years with an anticipated PCCU stay > 48 hours, and baseline normal to
moderate cognitive and functional disability were eligible. Exclusion criteria
included: anticipated death, physical inability, or a contraindication to
mobilization. Nintendo Wii™ Boxing was prescribed for a minimum of 10
minutes twice a day for 2 days. Primary outcomes were feasibility and safety. RESULTS: Of 21 eligible patients, 12 (57.1%) were enrolled and 8
completed the study. 41.7% (5/12) were males, and the median age was 11
(3,16) years. Four of the 8 participants who received the intervention were
mechanically ventilated during Wii™ play. Participants used the
Wii™ a median of 2 times (1,5) over the 2-day intervention period,
for a median total duration of 54.5 (15, 224) minutes. There were no adverse
events attributable to the intervention. Upper limb activity during Wii™
was significantly greater than the average daily activity (p=0.049).
Grip strength did not change significantly from baseline (p=0.20). CONCLUSION: While the results of this pilot trial suggest that VR exercise may
be safely applied in a subset of critically ill children, we observed several
threats to its feasibility in this population.
Keywords: Pediatrics, critical care, acute rehabilitation, virtual reality gaming
