Affiliations: [a] Department of Physical Medicine and Rehabilitation, Loma Linda University Health, Loma Linda, CA, USA | [b] Veteran Affairs Loma Linda Healthcare System, Loma Linda, CA, USA | [c] Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
Correspondence:
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Corresponding author: Bradley Chi, Department of Physical Medicine and Rehabilitation, Loma Linda University Health, 11406 Loma Linda Drive, Suite 516, Loma Linda, CA 92354, USA. Tel.: +1 909 558 6202; Fax: +1 909 558 6110; E-mail: bchi1@pride.hofstra.edu.
Abstract: PURPOSE: Recurrent botulinum toxin (BoNT) injections are used in the pediatric population for management of spasticity, but the procedure is often associated with significant pain and anxiety for patients. Non-pharmacologic treatment alternatives for procedural discomfort are limited. Immersive virtual reality (VR) has shown efficacy in treatment of procedural discomfort in pediatric patients. A retrospective chart review was performed to assess feasibility and use of treating BoNT procedure-related discomfort in pediatric patients with VR. METHODS: Fourteen patients undergoing elective BoNT injections viewed VR videos using a mobile VR headset during the procedure. Face, Legs, Activity, Cry, Consolability scale (FLACC) scores were obtained and feedback was elicited following injections. RESULTS: The VR intervention was well tolerated, and patients’ guardians requested that it be used again in 9/14 cases. The remainder either had high FLACC scores despite VR and neutral or negative guardian impressions of intervention, or were unable to utilize the device. CONCLUSION: VR was helpful in reducing BoNT procedure-related discomfort in a majority of patients. Challenges with VR setup, patient tolerance, and selecting viewing experiences were identified to guide further research and use of VR in a clinical environment.
