Immersive virtual reality for pediatric burn pain and early rehabilitation

Front Pediatr. 2026 Jul 29;14:1876793. doi: 10.3389/fped.2026.1876793. eCollection 2026.

ABSTRACT

Burn dressing changes are painful and distressing for children, and repeated procedural discomfort can reduce cooperation with wound care and early rehabilitation. This study was conducted in the burn unit of No.910 Hospital of the Chinese People's Liberation Army Joint Logistic Support Force between January 2023 and March 2026 to evaluate the effects of immersive virtual reality (VR) on procedural distress and treatment cooperation during repeated dressing changes and early rehabilitation in children with burns. Eighty pediatric patients requiring repeated dressing changes were randomly assigned to a control group or a VR group, with 40 children in each group. Children in the control group received routine burn care and standard distraction, whereas those in the VR group received routine care plus immersive VR animation during dressing changes and early rehabilitation sessions. Procedural pain was assessed using the Faces Pain Scale-Revised, procedure-related fear using the Children's Fear Scale, and behavioral distress using the COMFORT-B scale; treatment cooperation, rehabilitation completion, dressing duration, rescue analgesic use, and adverse events were also recorded. Baseline demographic and burn-related characteristics were similar between groups. No significant differences were found in pain, fear, or behavioral distress during the first dressing change, and a similar pattern was observed during the second dressing change. By the third dressing change, children in the VR group reported less pain (p = 0.0009), less fear (p = 0.0116), and lower behavioral distress (p = 0.0048) than those receiving routine care. The VR group also showed better dressing cooperation at the third dressing change (p = 0.0024) and better rehabilitation cooperation during the second and third rehabilitation sessions (p = 0.0352 and p = 0.0106, respectively). Exploratory sex-stratified analysis showed that VR-related improvements were reflected mainly in pain and fear among male patients and in pain and behavioral distress among female patients. Rehabilitation completion, dressing duration, and rescue analgesic use did not differ significantly between groups, and no serious adverse events occurred. These findings suggest that immersive VR may be a practical adjunct for making repeated pediatric burn care less distressing and more tolerable while improving cooperation during later treatment sessions.

PMID:42591295 | PMC:PMC13461591 | DOI:10.3389/fped.2026.1876793