Blunt Chest Trauma
Conditions
Keywords
Virtual Reality, Trauma, Pulmonary Recovery
Brief summary
Blunt chest trauma comprises over 10% of all trauma patients presenting to emergency departments worldwide and is the most frequent injury in polytrauma patients. It is associated with high risk (\>10%) of pulmonary complications such as pneumonia. Pillars of treatment are adequate pain relief, respiratory function exercises and rapid mobilisation through physiotherapy. Inadequate pain control can result in restricted ventilatory function and in reduced mobility, both resulting in a higher risk of particularly pulmonary complications. Virtual Reality (VR) might be an easy to use, individualized, and harmless technique that can facilitate pulmonary recovery and aid in the prevention of complications through reducing pain and promoting exercising. The investigators hypothesize that VR improves respiratory function and mobilisation in the post-acute phase of blunt chest trauma by distracting patients from pain and stress, and by stimulating pulmonary and physical exercise.
Interventions
DEVICEVirtual Reality
For all VR exercises a head mounted display (HMD), the PICO G2 4K (Barcelona, Spain) will be used. Together with SyncVRMedical (Utrecht, Netherlands) a VR dashboard has been created from which patients can chose the different exercises.
Sponsors
Radboud University Medical Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
16 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Admitted to the trauma ward with sustained blunt chest trauma * Age≥16 * Patient is willing and able to comply with the study protocol
Exclusion criteria
* Neurotrauma with GCS ≤13 * History of dementia, seizures, epilepsy * Severe hearing/visual impairment not corrected * Head wounds or damaged skin with which comfortable and hygienic use is not possible. * Stay at intensive care unit (ICU) during current hospital admission. * Erect position in bed not possible/allowed.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Inspiration volume, mean change from baseline | From baseline to end of treatment at day 5. | Mean change from baseline in inspiration volume in ml, measured with an incentive spirometer (Voldyne) |
| Inspiration volume, repeated measures over 5 days | Twice daily from enrollment to day 5 of treatment | change in mean daily inspiration volume in mL, measured with an incentive spirometer (Voldyne) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Readmission within 30 days | At end of follow-up, 30 days after discharge | Participant readmitted within 30 days, yes/no |
| Time spent sitting or standing, mean change from baseline | Continuously from enrollment to end of treatment at day 5. | Measured continuously using a wearable activity monitor, calculated as percentage of time spent sitting or standing. |
| Length of hospital stay | At end of follow-up, 30 days after discharge | Length of hospital stay in days |
| Pulmonary complications during admission | At end of follow-up, 30 days after discharge | Number and type of pulmonary complications during admission |
| Powerless in Daily living questionnaire | Daily from baseline to end of treatment at day 5. | Powerless in Daily living questionnaire (0-21), a higher score means a worse outcome. |
| Quality of Recovery-15 questionnaire | Daily from baseline to end of treatment at day 5. | Quality of Recovery-15 questionnaire (0-150), a higher score means a better outcome. |
| Pain score during breathing exercise using Visual Analogue Score (VAS) | Daily from baseline to end of treatment at day 5. | VAS pain score during breathing exercise (0-100mm). A higher score means a worse outcome. |
| Transfers to ICU | At end of follow-up, 30 days after discharge | Participant transferred to ICU during admission yes/no? |
Countries
Netherlands
Outcome results
None listed