Immersive virtual reality rehabilitation after lower limb surgery in paediatric patients

Purpose
Patients who have undergone lower limb surgery require rehabilitation to regain movement and function in the affected leg. Unfortunately, physical rehabilitation can be painful, reducing compliance and recovery. This feasibility study aimed to demonstrate that immersive virtual reality (IVR) applications can provide potential benefits of anxiety reduction and pain distraction for children during gait rehabilitation, increased engagement and enjoyment, and improved perceived walking quality.
Methods
This study included 15 children aged 11–16 who required weight-bearing rehabilitation following lower limb surgery. A mixed methods (quantitative and qualitative) approach and a multidirectional perspective (patients, parents and physiotherapists) were adopted to measure. Changes in anxiety (General Anxiety Disorder-7) and pain (visual analogue scale) before and after the intervention were assessed. Qualitative data were collected through interviews with children, their parents, and physiotherapists, focusing on their experiences, satisfaction, perceived effectiveness, and acceptability of the IVR intervention.
Results
Results demonstrated that IVR for rehabilitation after lower limb surgery in children (1) reduced anticipatory anxiety; (2) reduced the level of pain experienced during gait rehabilitation; (3) improved rehabilitation, such that children were walking more than expected and with better quality; (4) increased confidence; (5) made rehabilitation more enjoyable; and (6) was delivered via a system that was easy to learn and accept.
Conclusion
This rehabilitation IVR is the first product of its class for paediatric lower limb postoperative rehabilitation. These preliminary results will inform improvements to the system in a future multi-site study with a large calculated sample size to demonstrate its clinical effectiveness and safety in acquiring medical device markings and adoption.