Condition category
Injury, Occupational Diseases, Poisoning
Date applied
Date assigned
Last edited
Retrospectively registered
Overall trial status
Recruitment status
No longer recruiting
Publication status
Results overdue

Plain English Summary

Not provided at time of registration

Trial website

Contact information



Primary contact

Dr Charlotte Small


Contact details

B15 2TT
United Kingdom

Additional identifiers

EudraCT number number

Protocol/serial number


Study information

Scientific title

Investigation of virtual restorative environment therapy to aid pain control during dry burns dressing changes


Study hypothesis

The burns unit at the Queen Elizabeth Hospital Birmingham admits nearly 300 patients a year, including wounded military patients. The pain of a severe burn injury is characterised by an unremitting background pain, coupled with severe exacerbations associated with essential procedures such as dressing changes, staple removal from grafts and physiotherapy. A recent audit showed that 23% of patients experience moderate or severe pain during dressing changes. This study will evaluate the use of an interactive computer game, based on a virtual restorative environment (VRE), as an adjunct to pain management during burns dressing changes.The system has been developed specifically for this patient group to allow usability for all but the most severely injured patients. The study will be a single blinded (data collector only) within-subject crossover trial where patients who are undergoing dry burn dressing changes will be receive non-interactive VRE distraction, interactive VRE distraction and a control condition using standard analgesia over three consecutive dressing changes. The order of conditions will be randomised. The primary outcome will be highest pain score (numerical rating scale) during the dressing change. Secondary outcomes will be average pain scores during dressing change, pain score one hour after dressing change, anxiety, rescue analgesia, usability, level of immersion and satisfaction. Data will also be collected on staff satisfaction with and usability of the system.

Ethics approval


Study design

Randomised; Interventional; Design type: Not specified, Treatment

Primary study design


Secondary study design

Randomised controlled trial

Trial setting


Trial type


Patient information sheet


Topic: Generic Health Relevance and Cross Cutting Themes; Subtopic: Generic Health Relevance (all Subtopics); Disease: Anaesthetics


Virtual reality (active), Interactive game, based within Virtual Wembury, whereby the patient can control movement of a speedboat viewed on a high definition screen, listening to associated sounds via headphones. The speedboat will be controlled by a single-hand use hand controller. Points can be scored by collection objects and steering between buoys.

Virtual reality (passive), Viewing of a nature based virtual world based on Wembury Bay, South Devon coastal path. The VR system consists of a high definition TV screen and headphones to provide sounds of the VR environment. The image will be viewed as if through a window, the patient will not be able to change the field of view or navigate through the scene. There will be movement associated with the sea and foliage.

Intervention type



Drug names

Primary outcome measure

Worst pain (numerical rating scale); Timepoint(s): During dressing change

Secondary outcome measures

1. Anxiety; Timepoint(s): During dressing change
2. Average pain; Timepoint(s): During dressing change
3. Nausea; Timepoint(s): During dressing change
4. Nursing satisfaction with VR system; Timepoint(s): During dressing change
5. Satisfaction with pain management; Timepoint(s): During dressing change
6. Satisfaction with VR distraction; Timepoint(s): During dressing change
7. Worst pain; Timepoint(s): One hour after dressing change

Overall trial start date


Overall trial end date


Reason abandoned (if study stopped)


Participant inclusion criteria

1. Patients with burns (any cause) admitted to the Queen Elizabeth Hospital Burns Unit
2. Those above requiring at least three dressing changes.
3. Those above requiring opioid based analgesia (eg oral morphine, codeine phosphate or tramadol)or inhaled nitrous oxide (entonox) for the dressing change (ie, patients who may potentially experience moderate or severe pain)
Target Gender: Male & Female; Upper Age Limit 90 years ; Lower Age Limit 18 years

Participant type


Age group




Target number of participants

Planned Sample Size: 25; UK Sample Size: 25

Participant exclusion criteria

1. Inability to use the interactive distraction equipment eg blindness, severe bilateral hand injuries.
2. Requirement for general anaesthesia or sedation with ketamine or midazolam.
3. Poor cognitive state eg severe dementia, delirium or severe psychiatric illness.
4. Multi-drug resistant infection (due to potential equipment contamination, although low risk, this criteria is appropriate for the feasibility study)

Recruitment start date


Recruitment end date



Countries of recruitment

United Kingdom

Trial participating centre

University of Birmingham
B15 2TT
United Kingdom

Sponsor information


University of Birmingham (UK)

Sponsor details

B15 2TT
United Kingdom

Sponsor type




Funder type

Hospital/treatment centre

Funder name

Royal Centre for Defence Medicine (UK) Grant Codes: 20110914DMSRSGVRPLP

Alternative name(s)

Funding Body Type

Funding Body Subtype


Results and Publications

Publication and dissemination plan

Not provided at time of registration

2017 results presented at Pain Science in Motion 2017:

Intention to publish date

Participant level data

Not provided at time of registration

Basic results (scientific)

Publication list

2015 protocol in:

Publication citations

Additional files

Editorial Notes

21/11/2018: Poster reference added.