Use of Virtual Reality in Children Undergoing Surgery

Effects of Early Mobilization With Virtual Reality on Postoperative Respiratory Function, Exercise Capacity, and Pain in Children: A Randomized Controlled Trial

Aim: Early mobilization and exercise after surgery are very important to reduce the impact on lung function. The aim of this study was to compare the effects of early mobilization with virtual reality and conservative physiotherapy methods on pulmonary function, dyspnea, exercise capacity, pain, and kinesiophobia in children undergoing surgery.

Methods: The study included 27 children aged 5-18 years who underwent surgery. Among the children randomly divided into two groups, the control group (n = 14) received physiotherapy for 40 min twice a day for 3 days in the hospital after surgery, and the children were mobilized in and out of bed. In the virtual reality group (n = 13), in addition to physiotherapy practices, children were allowed to play virtual reality games for 20 min twice a day. Respiratory function, exercise capacity, and pain assessment were performed before surgery and before discharge.

Study Overview

• Status: Completed
• Conditions: Child, Only
• Intervention / Treatment: Other: conventional physiotherapy; Other: Virtual reality

Detailed Description

Aim: Early mobilization and exercise after surgery are very important to reduce the impact on lung function. The aim of this study was to compare the effects of early mobilization with virtual reality and conservative physiotherapy methods on pulmonary function, dyspnea, exercise capacity, pain, and kinesiophobia in children undergoing surgery.

Methods: The study included 27 children aged 5-18 years who underwent surgery. Among the children randomly divided into two groups, the control group (n = 14) received physiotherapy for 40 min twice a day for 3 days in the hospital after surgery, and the children were mobilized in and out of bed. In the virtual reality group (n = 13), in addition to physiotherapy practices, children were allowed to play virtual reality games for 20 min twice a day. Respiratory function, exercise capacity, and pain assessment were performed before surgery and before discharge.

• Study Type: Interventional
• Enrollment (Actual): 27
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey
  • Hatay, Turkey, 31010
    • Sabiha Bezgin

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult
• Accepts Healthy Volunteers: No

Description

Inclusion criteria Between the ages of 5 and 18 undergone surgery for inguinal hernia, undescended testicle, hydrocele, cord cyst, umbilical hernia, circumcision, and distal hypospadias

Exclusion criteria

Children have visual and auditory sensory problems who required immobilization after surgery and had a chronic disease that would affect pulmonary function

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: control group; Only conventional physiotherapy was applied to this group, including normal joint movements, chest physiotherapy, and mobilization for 40 min each,	Other: conventional physiotherapy; normal joint movements, chest physiotherapy, and mobilization for 40 min
Experimental: virtual reality group; The CG received conventional physiotherapy, including normal joint movements, chest physiotherapy, and mobilization for 40 min each, whereas the other group received 20 min of VR application every day in addition to conventional physiotherapy interventions.	Other: Virtual reality; normal joint movements, chest physiotherapy, and mobilization for 40 min and 20 min virtual reality

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), ratio of forced expiratory volume in the first second to FVC (FEV1/FVC), peak expiratory flow rate (PEF), and forced mid-expiratory flow rate (FEF 25-75%)	The pulmonary function test was measured using a portable spirometer. According to American Torasic Society/European Respiratory Society (ATS/ERS) criteria, forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), ratio of forced expiratory volume in the first second to FVC (FEV1/FVC), peak expiratory flow rate (PEF), and forced mid-expiratory flow rate (FEF 25-75%) were measured. The test was performed in the sitting position. The best of at least three technically acceptable manoeuvres with 95% agreement with each other was selected for statistical analysis.	4 days

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Respiratory muscle strength Assessment	Respiratory muscle strength was evaluated using an intraoral pressure measuring device. Maximal inspiratory pressure (MIP), inspiratory muscle strength, maximal expiratory pressure (MEP), and expiratory muscle strength were evaluated. MIP was measured using the intraoral pressure measurement method by performing rapid and deep inspiration in the residual volume after maximal expiration. MEP was recorded by performing rapid and deep expiration at total lung capacity after maximum inspiration. Children were verbally encouraged to record the best performance	4 days
Modified Borg Scale	Dyspnea evaluation was performed via the Modified Borg Scale (MBS). The scale, which was developed to measure the effort expended during physical exercise, consists of 10 items describing the severity of dyspnea according to its degree. According to the scale, it shows that the severity of dyspnea increases from 0 to 10	4 days
The 1-min step	The 1-min step (1-ST) test was performed. In the 1-ST, children were instructed to step reciprocally up and down a 6-in-high step for 1 min, and the number of steps taken was recorded.	4 days
Timed Up and Go Test	Participants were evaluated using the Timed Up and Go Test (TUG). The TUG is a clinical test that measures various components, including walking speed, postural control, functional mobility, and balance. The child was asked to get up from a chair without armrests, return to a sign 3 m away, and sit down. The duration was recorded in seconds	4 days
Numerical Pain Scale	The Numerical Pain Scale was used for pain assessment. The numerical pain scale assesses numerical values between 0 and 10 points	4 days
Kinesiophobia	The Tampa Scale of Kinesiophobia was used to assess kinesiophobia. The scale consists of 17 questions questioning the person's fear of movement and is calculated on a total score between 17 and 68. A high score on the scale indicates a high level of kinesiophobia	4 days
BMI	Height was measured and recorded in meters. Body weight was measured and recorded in kilograms. BMI was calculated by dividing body weight by height squared.	measured once, independent of time
10 MWT test	In the 10 MWT, children walked at a normal walking speed within a 10-m section of a 14-m walking distance to prevent the effect of acceleration and deceleration phases of walking, and the time was recorded in seconds	4 days

Collaborators and Investigators

• Sponsor: Mustafa Kemal University

Study record dates

Study Major Dates

• Study Start (Actual): October 1, 2022
• Primary Completion (Actual): January 1, 2024
• Study Completion (Actual): January 1, 2024

Study Registration Dates

• First Submitted: March 6, 2025
• First Submitted That Met QC Criteria: March 12, 2025
• First Posted (Actual): March 25, 2025

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: March 12, 2025
• Last Verified: March 1, 2025

More Information

Terms related to this study

• Keywords: General Surgery; virtual reality; child
• Other Study ID Numbers: MKU-SB-1

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No