Effectiveness of Virtual Reality in Reducing Anxiety and Pain During the First Postoperative Orthopedic Dressing Change in Pediatric Patients (VR OrthoPed)

July 22, 2026 updated by: Gianluca Catania

Effectiveness of Virtual Reality in Reducing Anxiety and Pain During the First Postoperative Orthopedic Dressing Change in Pediatric Patients: A Randomized Controlled Trial

The goal of this randomized clinical trial is to learn whether immersive virtual reality can reduce anxiety and pain in children and adolescents undergoing postoperative orthopedic dressing changes. The main questions it aims to answer are:

Does immersive virtual reality reduce anxiety during postoperative dressing changes compared with standard care?

Does immersive virtual reality reduce pain and physiological signs of distress, such as changes in heart rate and respiratory rate?

Researchers will compare participants who use an immersive virtual reality headset during the dressing change with participants who receive standard care without virtual reality.

Participants will:

Be randomly assigned to the virtual reality group or the standard care group

Undergo a postoperative orthopedic dressing change with or without immersive virtual reality

Report their anxiety and pain before and after the procedure

Have their heart rate and respiratory rate measured before, during, and after the dressing change

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Postoperative orthopedic dressing changes can cause anxiety, pain, and physiological distress in pediatric patients. Immersive virtual reality may provide a non-pharmacological form of distraction by directing the participant's attention away from the clinical procedure and toward an engaging virtual environment.

This randomized clinical trial was conducted in a pediatric orthopedic unit to evaluate the use of immersive virtual reality during postoperative dressing changes. After enrollment and baseline assessment, participants were randomly assigned to receive either immersive virtual reality in addition to the usual dressing procedure or standard care alone.

Participants assigned to the virtual reality group wore a head-mounted display and viewed an immersive virtual environment during the dressing change. Participants assigned to the standard care group underwent the same clinical procedure according to usual practice without virtual reality. The dressing change was performed by the clinical team in accordance with routine postoperative care.

Anxiety, pain, heart rate, respiratory rate and peripheral oxygen saturation were assessed at predefined time points before, during, and after the procedure, as applicable. These measurements were used to examine whether immersive virtual reality was associated with reduced psychological and physiological distress during the dressing change.

The study was designed to provide evidence on the potential usefulness of immersive virtual reality as a non-drug supportive intervention during postoperative procedures in pediatric orthopedic care.

Study Type

Interventional

Enrollment (Actual)

48

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Italy
    • Liguria
      • Genoa, Liguria, Italy, 16132
        • Dipartimento di scienze della salute, DISSAL - UNIGE

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria

  • Patients aged 6-18 years.
  • Undergoing corrective orthopedic surgery for congenital or acquired limb deformities, with or without external fixation devices, or spinal arthrodesis for scoliosis or spondylolisthesis.
  • Undergoing the first postoperative wound dressing procedure.
  • Written informed consent obtained from a parent or legal guardian.
  • Assent obtained from the participant, when appropriate. Exclusion Criteria
  • Neurological disorders.
  • History of epilepsy.
  • Prematurity.
  • Sensory impairments preventing the use of the virtual reality headset.
  • Cognitive impairments preventing the use of the virtual reality headset.
  • Motor limitations preventing the use of the virtual reality headset.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

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

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Immersive Virtual Reality Plus Standard Care
Participants received the first postoperative orthopedic dressing procedure according to routine clinical practice while using an immersive virtual reality headset. The headset displayed an immersive virtual environment throughout the dressing procedure as a non-pharmacological distraction intervention. Standard clinical monitoring and nursing care were provided.
Device: Immersive Virtual Reality Distraction
Participants used an immersive virtual reality headset during the first postoperative orthopedic dressing procedure. The headset presented an immersive virtual environment intended to divert attention from the clinical procedure and reduce anxiety, pain, and physiological stress. The virtual reality intervention was provided in addition to the routine postoperative dressing care delivered by the clinical team. The headset was worn during the dressing procedure and removed after its completion.
Active Comparator: Standard Care Alone
Participants received the first postoperative orthopedic dressing procedure according to routine clinical practice without the use of immersive virtual reality. Standard clinical monitoring and nursing care were provided.
Other: Standard Postoperative Dressing Care
Participants underwent the first postoperative orthopedic dressing procedure according to routine clinical practice without the use of immersive virtual reality. Standard nursing care and clinical monitoring were provided throughout the procedure.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Anxiety Assessed Using the Visual Analogue Scale for Anxiety
Time Frame: Immediately before and immediately after the first postoperative orthopedic dressing procedure
Anxiety was assessed using the Visual Analogue Scale for Anxiety (VAS-A), a 100 mm horizontal scale ranging from 0, indicating no anxiety, to 100, indicating maximum anxiety. Higher scores indicate greater anxiety. Change in anxiety was calculated as the score immediately after the procedure minus the score immediately before the procedure. A negative change score indicates a reduction in anxiety.
Immediately before and immediately after the first postoperative orthopedic dressing procedure

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Pain Intensity Assessed Using the Faces Pain Scale
Time Frame: Immediately before and immediately after the first postoperative orthopedic dressing procedure
Pain intensity in participants aged 6 to 10 years was assessed immediately before and immediately after the first postoperative orthopedic dressing procedure using the Faces Pain Scale. Higher scores indicate greater pain intensity. Change in pain was calculated as the post-procedure score minus the pre-procedure score.
Immediately before and immediately after the first postoperative orthopedic dressing procedure
Change in Pain Intensity Assessed Using the Numeric Rating Scale
Time Frame: Immediately before and immediately after the first postoperative orthopedic dressing procedure.
Pain intensity in participants older than 10 years was assessed immediately before and immediately after the first postoperative orthopedic dressing procedure using the Numeric Rating Scale (0-10). Higher scores indicate greater pain intensity. Change in pain was calculated as the post-procedure score minus the pre-procedure score.
Immediately before and immediately after the first postoperative orthopedic dressing procedure.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Gianluca Catania

Collaborators

Istituto Giannina Gaslini

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

September 1, 2020

Primary Completion (Actual)

December 31, 2025

Study Completion (Actual)

December 31, 2025

Study Registration Dates

First Submitted

July 14, 2026

First Submitted That Met QC Criteria

July 22, 2026

First Posted (Actual)

July 27, 2026

Study Record Updates

Last Update Posted (Actual)

July 27, 2026

Last Update Submitted That Met QC Criteria

July 22, 2026

Last Verified

July 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • VR OrthoPed

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

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

Subscribe