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Updated: Sep 27, 2025
Virtual Reality Experiments with Physiological Measures
Published on: August 29, 2018
Virtual Reality in the Pediatric Intensive Care Unit: Patient Emotional and Physiologic Responses
Colleen M Badke1,2,3, Sheila Krogh-Jespersen4,5, Rachel M Flynn4,5
1Division of Critical Care, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.
Insights
Virtual reality (VR) significantly engages critically ill children in the Pediatric Intensive Care Unit (PICU), with most enjoying the immersive experience and finding it calming. Physiologic data supports VR's calming effects, showing improved heart rate variability during use.
Area of Science:
- Pediatric Intensive Care
- Medical Technology
- Child Psychology
Background:
- Hospitalization in the Pediatric Intensive Care Unit (PICU) can limit children's activity and engagement, increasing risks of delirium and delayed recovery.
- Virtual reality (VR) shows promise in managing pain, distress, and enhancing rehabilitation for pediatric patients.
Purpose of the Study:
- To assess the engagement, experience, and physiological effects of virtual reality (VR) in critically ill children.
- To evaluate the calming impact of VR on pediatric patients in an intensive care setting.
Main Methods:
- A cross-sectional study involving 115 children (ages 3-17) in a PICU using VR headsets for immersive experiences.
- Mixed-methods approach including behavioral coding, participant/parent surveys, and heart rate variability (HRVi) measurements before, during, and after VR use.
Main Results:
- Most children (79%) were highly engaged with VR, with 83% smiling and 36% laughing.
- 72% of children made positive comments, and 92% of parents reported VR calmed their child.
- Heart rate variability (HRVi) significantly increased during VR use, returning to baseline post-intervention, indicating a temporary physiological effect.
Conclusions:
- Children in the PICU demonstrate high engagement and enjoyment with VR, finding it a calming intervention.
- VR can effectively augment the hospital environment for critically ill children, offering immersive and positive experiences.
- The study supports VR as a safe and acceptable tool for pediatric intensive care, improving patient experience and potentially aiding recovery.
Context:
Patients in the Pediatric Intensive Care Unit (PICU) are limited in their ability to engage in developmentally typical activity. Long-term hospitalization, especially with minimal interpersonal engagement, is associated with risk for delirium and delayed recovery. Virtual reality (VR) has growing evidence as a safe, efficacious, and acceptable intervention for pain and distress management in the context of uncomfortable healthcare procedures, and for enhancing engagement in, and improving outcomes of rehabilitation therapy.
Hypothesis:
Critically ill children may experience high levels of engagement and physiologic effects while engaging with VR.
Methods And Models:
This cross-sectional study of 3-17-year-old children admitted to a PICU used a VR headset to deliver 360-degree immersive experiences. This study had a mixed-method approach, including standardized behavioral coding, participant and parent surveys, and participant physiologic responses. Investigators noted comments the child made about VR, observed emotional responses, and documented an engagement score. To determine physiologic response to VR, integer heart rate variability (HRVi) was collected 30 min before, during, and 30 min after VR.
Results:
One hundred fifteen participants were enrolled from 6/18 to 10/19, and they interacted with VR for a median of 10 min (interquartile range 7-17). Most children enjoyed the experience; 83% of participants smiled and 36% laughed while using VR. Seventy-two percent made positive comments while using VR. The strongest age-related pattern regarding comments was that the youngest children were more likely to share the experience with others. Seventy-nine percent of participants were highly engaged with VR. Ninety-two percent of parents reported that VR calmed their child, and 78% of participants felt that VR was calming. HRVi Minimum scores were significantly higher during VR than pre- (p < 0.001) or post-VR (p < 0.001). There was no significant difference between pre-and post-VR (p = 0.387); therefore, children returned to their pre-intervention state following VR.
Interpretations And Conclusions:
Children admitted to the PICU are highly engaged with and consistently enjoyed using VR. Both participants and parents found VR to be calming, consistent with intra-intervention physiologic improvements in HRVi. VR is an immersive tool that can augment the hospital environment for children.
