Skip to main content
. 2022 Oct 24;10(1):e84. doi: 10.22037/aaem.v10i1.1756

Table 1.

Basic characteristics of the studies included in this systematic review and meta-analysis

First Author/year Location Study characteristics
1. Design
2. Sample Size (I/C)
3. Intervention
4. Duration of study
5. Duration of intervention
6. Duration of follow-up		 M/F ratio (%) Age
(mean±SD)		 Control group Tool characteristics
1. Name of the questionnaire
2. Number of items
3. Overall scoring of items 		Intervention type Key results JBI Score
Hoffman et al., 2001
(40)		 USA 1. Quasi-experimental
2. 7
3. VR
4. N/A
5. N/A
6. 3 days		 85.71/14.29 21.90 All participants served as their own control when had not received VR distraction. 1. VAS
2. 100
3. 0 to 100		 Immersive The mean score of pain in participants was decreased during the intervention in the intervention group compared to the control group (P< 0.010). Good
Das et al., 2005
(41)		 Australia

  1. RCT (Crossover)

  2. 7

  3. VR

  4. N/A

  5. 27.5 minutes

  6. 0

 N/A 11.10 (SD=3.50) All participants served as their own control when had not received VR. 1. Face scale
2. 10
3. 0 to 10		 Immersive The mean score of pain in patients was decreased after the intervention in the intervention group compared to the control group (P<0.01). Fair
Sharar et al., 2007
(42)		 USA 1. RCT
2. 234 (88/146)
3. VR
4. N/A
5. 15 minutes
6. 0		 82.91/17.09 N/A Participants in the control group had not received VR. 1. GRS
2. 100 mm
3. 0 to 100		 Immersive The mean score of pain in participants was decreased after the intervention in the intervention group compared to the control group (P<0.05). Good
van Twillert et al., 2007
(43)		 Netherland 1. RCT
2. 19
3. VR
4. 13 months
5. 19.2 minutes
6. 2 days		 63.16/36.84 30.00 All participants served as their own control when had not received VR. 1. VAT
2. 100 mm
3. 0 to 100		 Immersive The mean score of pain in participants was decreased during and a day after the intervention in the intervention group compared to the control group (P<0.05). Good
Hoffman et al., 2008
(44)		 USA

  1. RCT (Crossover)

  2. 11

  3. VR

4. N/A
5. 3 minutes
6. N/A		 100/0 27.00 All participants served as their own control when had not received VR. 1. GRS
2. 10 cm
3. 0 to 10		 Immersive The mean score of pain in patients was decreased during the intervention in the intervention group compared to the control group (P=0.015). Fair
Mott et al., 2008
(45)		 Australia 1. RCT
2. 42 (20/22)
3. AR
4. N/A
5. N/A
6. 0		 69.05/30.95 N/A Participants in the control group had not received the AR. 1. FLACC pain assessment tool
2. 5 items
3. 0 to 10
1. FPS-R
2. N/A
3. N/A
1. VAS
2. 5 cm
3. 0 to 5		 Non-immersive The mean score of pain in participants (long dressing times) was decreased during the intervention in the intervention group compared to the control group (P=0.006). Good
Carrougher et al., 2009
(46)		 USA 1. RCT (Crossover)
2. 39
3. VR
4. N/A
5. 10 minutes
6. 0		 89.74/10.26 35.00 (SD=11.00) Participants in the control group had not received VR. 1. GRS
2.100 mm
3.0 to 100		 Immersive The mean score of pain in participants was decreased after the intervention in the intervention group compared to the control group (P=0.004). Fair
Konstantatos et al., 2009
(32)		 Australia 1. RCT
2. 86 (43/43)
3. VR
4. N/A
5. 18 minutes
6. 0		 N/A 38.60 (SD=15.95) Participants in the control group had not received VR. 1. BSAR
2.10 cm
3.0 to 10		 Non-Immersive The mean score of pain in participants was increased during and after the intervention in the intervention group compared to the control group (P<0.05). Good
Morris et al., 2010
(47)		 South Africa 1. RCT (Crossover)
2. 11
3. VR
4. 4 months
5. 18 minutes
6. 0		 N/A N/A All participants served as their own control when had not received VR. 1.NPRS
2.N/A
3.N/A
1.BSPAS
2.100 mm
3.0 to 100		 Non-immersive There was no significant difference in pain scores during the intervention between the intervention and control groups (P=0.13). Good
Maani et al., 2011
(48)		 USA 1. RCT (Crossover)
2. 12
3. VR
4. N/A
5. 12 minutes
6. 0		 100/0 N/A All participants served as their own control when had not received VR. 1. GRS
2.100 mm
3.0 to 100		 Immersive The mean score of pain in participants was decreased during the intervention in the intervention group compared to the control group (P<0.05). Fair
Schmitt et al., 2011
(49)		 USA 1. RCT (Crossover)
2. 54
3. VR
4. N/A
5. 6.5 minutes
6. 0		 81.48/18.52 12.00
(SD= 3.90)		 All participants served as their own control when had not received VR. 1. GRS

  1. mm

3.0 to 100		 Immersive The mean score of pain in participants was decreased after the intervention in the intervention group compared to the control group (P< 0.05). Fair
Kipping et al., 2012
(50)		 Australia 1. RCT
2. 41 (20/21)
3. VR
4. 15 months
5. N/A
6. 0		 68.29/31.71 13.05 (SD=1.55) Participants in the control group had not received the VR. 1. FLACC pain assessment tool
2.5 items
3. 0 to 10
1. VAS
2.10 cm
3. 0 to 10		 Immersive There was no significant difference between the intervention and the control group in pain score during dressing removal and application (P>0.05). Good
Faber et al., 2013
(51)		 Netherlands 1. Quasi-experimental
2. 36
3. VR
4. 40 months
5. N/A
6. 7 days		 83.33/16.67 27.70 (SD=15.20) N/A 1. VAT
2.10 cm
3.0 to 10		 Immersive The mean score of pain in participants was decreased during the intervention on days one, two, and three (P< 0.05). Fair
Jeffs et al., 2014
(52)		 USA 1. RCT
2. 28 (18/10)
3. VR
4. 22 months
5. 52.5 minutes
6. 0		 32.14/67.86 13.50 (SD=2.30) Participants in the control group had not received the VR. 1.APPT
2.115 mm
3.0 to 115		 Immersive There was no significant difference in pain scores between the intervention and control groups during the intervention (P=0.32). Good
Hua et al., 2015
(53)		 China 1. RCT
2. 65 (33/32)
3. VR
4. 12 months
5. N/A
6. 0		 47.69/52.31 8.72 (SD=3.38) Participants in the control group had not perceived the VR. 1. Faces picture scale
2.10 items
3.0 to 10
1. FLACC pain assessment tool
2.5 items
3. 0 to 10
1. VAS
2.10 cm
3. 0 to 10		 Immersive The mean score of pain in participants was decreased after the intervention in the intervention group compared to the control group (P<0.05). Good
Ebrahimi et al., 2017
(54)		 Iran 1. RCT
2. 60 (40/20)
3. VR
4. N/A
5. N/A
6. 5 days		 56.67/43.33 35.00 (SD=10.00) Participants in the control group had not received the VR. 1. VAS
2.10 cm
3.0 to 10		 Non-immersive There was no significant difference in pain scores before and after the intervention between intervention and control groups from day one to five (P>0.05). Good
Khadra et al., 2018
(55)		 Canada 1. Quasi-experimental
2. 15
3. VR
4. 7 months
5. 18.4 minutes
6. 0		 40.00/60.00 2.20 (SD=2.10) N/A 1. FLACC pain assessment tool
2.5 items
3. 0 to 10		 Non-immersive There was no significant difference in pain scores before and after the intervention in the intervention group (P>0.05). Fair
McSherry et al., 2018
(56)		 USA 1. RCT (Crossover)
2. 18
3. VR
4. 29 months
5. N/A
6. 0		 72.22/27.78 38.40 (SD=15.50) All participants served as their own control when had not received VR. 1. VNS
2.10 cm
3.0 to 10		 Immersive There was no significant difference in pain intensity between intervention and control groups after intervention (P>0.05). Fair
Soltani et al., 2018
(30)		 USA 1. RCT (Crossover)
2. 39
3. VR
4. N/A
5. 6 minutes
6. 0		 N/A 36.00 All participants served as their own control when performing ROM exercises without VR distraction. 1. GRS

  1. mm

3.0 to 100		 Immersive The mean score of pain in participants was decreased after the intervention in the intervention group compared to the control group (P< 0.005). Fair
Fatma & Ghada, 2019
(57)		 Egypt 1. Quasi-experimental
2. 60 (30/30)
3. VR
4. N/A
5. N/A
6. 0		 60.00/40.00 N/A Participants in the control group had not received VR. 1. Faces picture scale
2.10 items
3.0 to 10
1. FLACC pain assessment tool
2.5 items
3. 0 to 10
1. VAS
2.10 cm
3. 0 to 10		 Immersive The mean score of pain in participants was decreased during and after the intervention in the intervention group compared to the control group (P<0.001). Good
Hoffman et al., 2019
(25)		 USA 1. RCT
2. 48
3. VR
4. 35 months
5. 5 minutes
6. N/A		 70.83/29.17 12.00 All participants served as their own control when had not received VR. 1. GRS
2.10 cm
3.0 to 10		 Immersive The mean score of pain in participants was decreased during the intervention in the intervention group compared to the control group (P<0.001). Good
Phelan et al., 2019
(58)		 UK 1. Quasi-experimental
2. 15
3. VR
4. N/A
5. 5 minutes
6. 0		 66.67/33.33 25.00 N/A 1. VAS
2.100
3.0 to 100		 Immersive and non-immersive

  • The pain threshold time was increased after the intervention in participants (P=0.003).

  • The pain tolerance time was increased after intervention in participants (P<0.001).

  • The pain tolerance time was significantly different between VR scenarios in participants (P<0.05).

  • The mean score of maximum pain in participants was significantly different in VR scenarios (P=0.002).

 Fair
Hoffman et al., 2020
(59)		 USA 1. RCT
2. 50
3. VR
4. 29 months
5. N/A
6. 10 days		 84.00/16.00 N/A Participants in the control group had not received VR. 1. GRS
2.10 cm
3. 0 to 10		 Immersive The mean score of pain in participants was decreased after the intervention in the intervention group compared to the control group (P<0.05). Good
Joo et al., 2020
(60)		 South Korea 1. RCT
2. 57 (28/29)
3. VR
4. 4 months
5. 30 minutes
6. 0		 94.74/5.26 44.88 (SD=11.09) Participants in the control group had not received VR. 1. MHQ
2. N/A
3.0 to 100		 Immersive The mean score of pain in participants was decreased after the intervention in the intervention group compared to the control group (P=0.002). Good
Khadra et al., 2020
(28)		 Canada 1. RCT
2. 38
3. VR
4. N/A
5. 25 minutes
6. 0		 71.05/28.95 1.82
(SD=1.32)		 All participants served as their own control when had not received VR. 1. FLACC

  1. items

3.0 to 10
1. NRS-obs
2.N/A
3.N/A		 Non-immersive The mean score of pain in participants was decreased after the intervention in the intervention group compared to the control group (P<0.05). Good
Kiani et al., 2020
(61)		 Iran 1. Quasi-experimental
2. 45 (30/15)
3. VR
4. N/A
5. N/A
6. 0		 N/A 31.38 (SD=8.47) Participants in the control group had not received VR. 1. GRS
2.100 mm
3.0 to 100
1.BSPAS
2.100 mm
3.0 to 100		 Immersive There was no significant difference in pain intensity between intervention and control groups during the intervention (P>0.05). Good
Phelan et al., 2021
(29)		 UK 1. Quasi-experimental
2. 20 (15/5)
3. VR
4. N/A
5. 36.9 minutes
6. 0		 60.00/40.00 48.20
(SD= 19.68)		 Participants in the control group had not received the VR. 1. VAS
2.100 mm
3.0 to 100		 Immersive The mean score of pain in participants was decreased after the intervention in the intervention group compared to the control group (P= 0.007). Good
Xiang et al., 2021
(62)		 USA 1. RCT
2. 90 (61/29)
3. VR
4. 25 months
5. N/A
6. 0		 50.00/50.00 11.30 Participants in the control group had not received the VR. 1. VAS3.0 to 100
1. FLACC

  1. items

3.0 to 10		 Immersive and non-immersive The mean score of pain in participants was decreased after the intervention in the intervention group compared to the control group (P<0.05). Good
Ali et al., 2022
(63)		 Egypt 1. RCT
2. 22 (11/11)
3. VR
4. N/A
5. 20 minutes
6. 0		 59.09/40.91 13.18 (SD=1.73) Participants in the control group had not received the VR. 1. VAS
2.10 cm
3.0 to 10		 Immersive The mean score of pain in participants was decreased after the intervention in the intervention group compared to the control group (P<0.001). Good
Armstrong et al., 2022
(64)		 USA 1. RCT
2. 24 (11/13)
3. VR
4. N/A
5. N/A
6. 7 days		 79.17/20.83 11.50 (SD=3.10) Participants in the control group had not received the VR. 1. VAS
2.10 cm
3.0 to 10		 Non-immersive The mean score of pain in participants was decreased after the intervention in the intervention group compared to the control group (P<0.05). Good

RCT: Randomized clinical trial; ANOVA: Analysis of variance; VAS: Visual analog scale; VR: Virtual reality; AR: Augmented reality; FLACC: Faces, legs, activity, cry and consolability; FPS-R: Faces pain scale-revised; GRS: Graph rating scale; VR-PAT: Virtual reality pain alleviation tool; BSAR: Burns specific anxiety rating; VNS: Verbal numeric scale; MHQ: Michigan hand outcomes questionnaire; BSPAS: Burn specific pain anxiety scale; APPT: Adolescent pediatric pain tool; NPRS: Numeric pain rating scale; VAT: Visual analog thermometer; NRS-obs: Numeric Rating Scale-observational; N/A: not applicable; SD: standard deviation; JBI: Joanna Briggs Institute; ROM: Range of motion.