ClinicalTrials.gg
CompletedNCT03521076Updated Sep 25, 2026

Randomized Controlled Trial of Virtual Reality

An interventional study of Virtual Reality in Muscle Spasticity, sponsored by Gillette Children's Specialty Healthcare. Completed at 1 site in United States. Open to participants aged 4 Years and older. Per ClinicalTrials.gov, last updated 2026-09-25.

Sponsored by Gillette Children's Specialty Healthcare · Not applicable, Interventional, and Supportive care

From the registry’s dates

  • Primary completion was May 2023, 3 years 5 months ago, and no results have been posted to the registry.
Updated Sep 25, 2026Now CompletedPrimary completion moved+2 moreGo to Updates ↓
Phase
Not applicable
Study type
Interventional
Enrollment
49
Allocation
Randomized
Ages
4 Years and older
Sex
All
01

Where this study stands

Counted across the records on this site · 2026-11-12

Among 165 studies in Muscle Spasticity with a site in United States — 34 open to participants now, 44 under way, none of them phase 3. Muscle Spasticity · United States.

Enrollment
49th of 130
49 · median 31
Started
2018
with 10 others
No phase
59 of 165
18 open now
Registered
99th of 165
by date

Among the 165 studies in Muscle Spasticity with a site in United States, this one is the 49th largest by enrollment of the 130 interventional ones that give a count, is one of 11 that started in 2018, is one of 59 with no phase, and was the 99th registered.

Muscle Spasticity

621 studies on the registry are indexed under Muscle Spasticity; 127 are open to participants now.

Browse Muscle Spasticity studies →

Open to participants now

34 of the 165 studies in Muscle Spasticity with a site in United States are open now. Recruiting first, the newest first:

29 more — sign in →

All 34 open studies →

A study can be open while its sites in United States have not opened yet or have stopped. Only those recruiting at a site in United States →

Who these studies take

Of the 88 Muscle Spasticity studies recruiting now, 29 (33%) set no upper age limit and 47 (53%) stop at 75 or younger; 34 take children under 18; 11 take healthy volunteers.

This study: 4 Years and older · all sexes · no healthy volunteers.

The full table on the hub →

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02

Study summary

Measure pain and anxiety during a putative painful medical procedure (i.e., botulinum toxin injections) when Virtual Reality is employed compared to standard of care only using a Randomized Controlled Trial study design.

03

Conditions studied

  • Muscle Spasticity

Browse trials for

Keywords

  • Botulinum Toxin Injections
  • Virtual Reality
04

Who can participate

Ages eligible
4 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Patients receiving botulinum toxin injections at Gillette Children's Specialty Healthcare

Exclusion criteria

Exclusion Criteria:

  • Patients who are fully anesthetized during their medical procedure
  • Non-English speaking parents/patients
  • Patients with history of motion sickness
  • Patients with epilepsy
  • Patients with a ventricular shunt
  • Patients who have surgery during the study time period
05

Study design

Phase
Not applicable
Primary purpose
Supportive care
Allocation
Randomized
Intervention model
Crossover assignment
Masking
Single (Outcomes assessor)
Enrollment
49 participants (actual)

Study arms

  • Experimental
    Virtual Reality for distraction

    The application of VR during the putative painful treatment (botulinum toxin injections) will provide a) active and engaging distraction during the procedure, and will b) block the view and auditory noise related to the procedure.

    Device: Virtual Reality

  • No intervention
    Standard of Care

    Patients will receive the standard of care for the putative painful treatment (botulinum toxin injections).

Interventions

  • DeviceVirtual Reality

    Participants will have the opportunity to choose a game or relaxation experience to utilize during a botulinum toxin injection to distract from pain and anxiety during one visit. Virtual Reality will not be available during the other visit. AppliedVR has a number of games and relaxation experiences available for participants to chose from.

    Also known as: AppliedVR

06

What researchers measure

Primary outcomes

  1. The Faces Pain Scale - Revised (FPS-R) to assess intensity of pain during injections.

    The Faces Pain Scale - Revised (FPS-R) will be used to assess pain intensity before, during, and after the treatment session. The FPS-R is a self-report measure of pain intensity developed for children. This scale shows a serious of six faces depicting increasing intensity of pain expression. The FPS-R instructions orient the child to the series of faces and then ask the child to point to the face that shows how much they hurt right now. Each face corresponds to a numerical rating between 0 and 10 (0, 2, 4, 6, 8, and 10). This rating scale corresponds to the widely accepted 0-to-10 metric for pain. The "0" equals no pain and the "10" equals very much pain. The score is reported as a total score.

    Time frame: 2 days

Secondary outcomes

  1. A series of visual analogue scales (VAS) to assess pain, anxiety, satisfaction with pain management, and perceived benefits of VR.

    A visual analogue scale (VAS) will be used to quantify multiple aspects of the treatment experience expected to be impacted by the use of VR. The VAS will be a 10 cm 0-100 scale and will assess the following: patient anxiety before, during and after the procedure; parent/caregiver anxiety before, during, and after the procedure; proportion of the treatment time spent thinking about pain; worst pain during treatment; satisfaction with pain management; and nausea during treatment. This will be done at both visits (VR and no-VR).

    Time frame: 2 days

  2. Information collected from the medical record (e.g., medication use during procedure).

    Following the signing of a HIPPA release, the medical record will be accessed to obtain such information as: patient diagnosis, date of birth, ethnicity, number of botulinum toxin injections, muscles injected, patient weight, height, and temperature, heart rate, blood pressure and oxygen saturation during treatment, clinical description of the context of VR use; provider description of whether VR enhanced clinical care; reduction or avoidance of medication due to VR; total amounts of medications given (e.g., valium, nitrous oxide, opioids; mg/kg); and notation of patient side effects from VR. This will be done at both visits (VR and no-VR).

    Time frame: 2 days

  3. The Pain Opinion Questionnaire (POQ)

    The Pain Opinion Questionnaire (POQ) requires caregivers to respond to 5 questions in 3 separate sections regarding children with mild, moderate, and severe/profound intellectual and developmental disabilities. A description of the abilities and limitations of a typical individual with each level of impairment is provided in each section. The questions address 5 facets of pain: (a) the ability of the children to sense painful stimuli (Sensation), (b) how upset or distressed the children feel while in pain (Emotional Reaction), (c) how strongly the children react behaviorally to pain (Behavioral Reaction), (d) how much the children communicate their pain to others (Communication), and (e) how much pain the children suffer (Frequency). We are modifying the scale to require parents or caregivers to estimate whether they believe their child (not a hypothetical child) would experience that aspect of pain the "same as", "less than", or "more than" children without impairment.

    Time frame: 2 days

  4. The Dalhousie Pain Interview (DPI)

    The Dalhousie Pain Interview (DPI) will provide a measure of pain experience in the previous week, including pain frequency (number of pain episodes), intensity (rated 0-10) and duration (number of seconds or minutes in pain). The measure consists of 10 items and was designed explicitly as an interview/survey script.

    Time frame: 2 days

  5. The Brief Pain Inventory (BPI)

    The Brief Pain Inventory (BPI) will provide a measure of pain interference in the previous week (i.e., the degree to which ongoing pain interferes with daily living). The BPI is a 10-item, 11-point scale (0 = does not interfere, 10 = completely interferes). The items include general activity, mood, mobility, normal work, relationships with other people, sleep, enjoyment of life, self-care, recreational activities, and social activities. Total score (sum of all 12 items combined; range 0-120) and average score (average item score; range 0-10) will be assessed.

    Time frame: 2 days

07

Study locations

1 site
  • GilletteChildren's Specialty Healthcare
    Saint Paul, Minnesota 55101, United States
08

References and documents

Publications

  • Breau LM, Burkitt C. Assessing pain in children with intellectual disabilities. Pain Res Manag. 2009 Mar-Apr;14(2):116-20. doi: 10.1155/2009/642352. PubMed 19532853 ↗
  • Vega-Avelaira D, McKelvey R, Hathway G, Fitzgerald M. The emergence of adolescent onset pain hypersensitivity following neonatal nerve injury. Mol Pain. 2012 Apr 24;8:30. doi: 10.1186/1744-8069-8-30. PubMed 22531549 ↗
  • Victoria NC, Inoue K, Young LJ, Murphy AZ. A single neonatal injury induces life-long deficits in response to stress. Dev Neurosci. 2013;35(4):326-37. doi: 10.1159/000351121. Epub 2013 Jul 5. PubMed 23838073 ↗
  • Santosh PJ, Baird G. Psychopharmacotherapy in children and adults with intellectual disability. Lancet. 1999 Jul 17;354(9174):233-42. doi: 10.1016/S0140-6736(98)07059-7. PubMed 10421318 ↗
  • Hoffman HG, Doctor JN, Patterson DR, Carrougher GJ, Furness TA 3rd. Virtual reality as an adjunctive pain control during burn wound care in adolescent patients. Pain. 2000 Mar;85(1-2):305-9. doi: 10.1016/s0304-3959(99)00275-4. PubMed 10692634 ↗
  • Sharar SR, Carrougher GJ, Nakamura D, Hoffman HG, Blough DK, Patterson DR. Factors influencing the efficacy of virtual reality distraction analgesia during postburn physical therapy: preliminary results from 3 ongoing studies. Arch Phys Med Rehabil. 2007 Dec;88(12 Suppl 2):S43-9. doi: 10.1016/j.apmr.2007.09.004. PubMed 18036981 ↗
  • Schmitt YS, Hoffman HG, Blough DK, Patterson DR, Jensen MP, Soltani M, Carrougher GJ, Nakamura D, Sharar SR. A randomized, controlled trial of immersive virtual reality analgesia, during physical therapy for pediatric burns. Burns. 2011 Feb;37(1):61-8. doi: 10.1016/j.burns.2010.07.007. Epub 2010 Aug 7. PubMed 20692769 ↗
  • Gold JI, Kim SH, Kant AJ, Joseph MH, Rizzo AS. Effectiveness of virtual reality for pediatric pain distraction during i.v. placement. Cyberpsychol Behav. 2006 Apr;9(2):207-12. doi: 10.1089/cpb.2006.9.207. PubMed 16640481 ↗
  • Asl Aminabadi N, Erfanparast L, Sohrabi A, Ghertasi Oskouei S, Naghili A. The Impact of Virtual Reality Distraction on Pain and Anxiety during Dental Treatment in 4-6 Year-Old Children: a Randomized Controlled Clinical Trial. J Dent Res Dent Clin Dent Prospects. 2012 Fall;6(4):117-24. doi: 10.5681/joddd.2012.025. Epub 2012 Nov 12. PubMed 23277857 ↗
  • Hua Y, Qiu R, Yao WY, Zhang Q, Chen XL. The Effect of Virtual Reality Distraction on Pain Relief During Dressing Changes in Children with Chronic Wounds on Lower Limbs. Pain Manag Nurs. 2015 Oct;16(5):685-91. doi: 10.1016/j.pmn.2015.03.001. Epub 2015 May 9. PubMed 25972074 ↗
  • Cacau Lde A, Oliveira GU, Maynard LG, Araujo Filho AA, Silva WM Jr, Cerqueria Neto ML, Antoniolli AR, Santana-Filho VJ. The use of the virtual reality as intervention tool in the postoperative of cardiac surgery. Rev Bras Cir Cardiovasc. 2013 Jun;28(2):281-9. doi: 10.5935/1678-9741.20130039. PubMed 23939326 ↗
  • Jones T, Moore T, Choo J. The Impact of Virtual Reality on Chronic Pain. PLoS One. 2016 Dec 20;11(12):e0167523. doi: 10.1371/journal.pone.0167523. eCollection 2016. PubMed 27997539 ↗
  • Malloy KM, Milling LS. The effectiveness of virtual reality distraction for pain reduction: a systematic review. Clin Psychol Rev. 2010 Dec;30(8):1011-8. doi: 10.1016/j.cpr.2010.07.001. Epub 2010 Jul 13. PubMed 20691523 ↗
  • Steele E, Grimmer K, Thomas B, Mulley B, Fulton I, Hoffman H. Virtual reality as a pediatric pain modulation technique: a case study. Cyberpsychol Behav. 2003 Dec;6(6):633-8. doi: 10.1089/109493103322725405. PubMed 14756928 ↗
  • Bieri D, Reeve RA, Champion DG, Addicoat L, Ziegler JB. The Faces Pain Scale for the self-assessment of the severity of pain experienced by children: development, initial validation, and preliminary investigation for ratio scale properties. Pain. 1990 May;41(2):139-150. doi: 10.1016/0304-3959(90)90018-9. PubMed 2367140 ↗
  • Ramstad K, Jahnsen R, Skjeldal OH, Diseth TH. Characteristics of recurrent musculoskeletal pain in children with cerebral palsy aged 8 to 18 years. Dev Med Child Neurol. 2011 Nov;53(11):1013-8. doi: 10.1111/j.1469-8749.2011.04070.x. PubMed 22014321 ↗
  • Hoffman HG, Patterson DR, Carrougher GJ. Use of virtual reality for adjunctive treatment of adult burn pain during physical therapy: a controlled study. Clin J Pain. 2000 Sep;16(3):244-50. doi: 10.1097/00002508-200009000-00010. PubMed 11014398 ↗
  • Sharar SR, Miller W, Teeley A, Soltani M, Hoffman HG, Jensen MP, Patterson DR. Applications of virtual reality for pain management in burn-injured patients. Expert Rev Neurother. 2008 Nov;8(11):1667-74. doi: 10.1586/14737175.8.11.1667. PubMed 18986237 ↗
  • Hoffman HG, Seibel EJ, Richards TL, Furness TA, Patterson DR, Sharar SR. Virtual reality helmet display quality influences the magnitude of virtual reality analgesia. J Pain. 2006 Nov;7(11):843-50. doi: 10.1016/j.jpain.2006.04.006. PubMed 17074626 ↗
  • Hoffman HG, Sharar SR, Coda B, Everett JJ, Ciol M, Richards T, Patterson DR. Manipulating presence influences the magnitude of virtual reality analgesia. Pain. 2004 Sep;111(1-2):162-8. doi: 10.1016/j.pain.2004.06.013. PubMed 15327820 ↗
  • Shinde SK, Danov S, Chen CC, Clary J, Harper V, Bodfish JW, Symons FJ. Convergent validity evidence for the Pain and Discomfort Scale (PADS) for pain assessment among adults with intellectual disability. Clin J Pain. 2014 Jun;30(6):536-43. doi: 10.1097/AJP.0000000000000020. PubMed 24135902 ↗
  • Breau LM, McGrath PJ, Camfield CS, Finley GA. Psychometric properties of the non-communicating children's pain checklist-revised. Pain. 2002 Sep;99(1-2):349-57. doi: 10.1016/s0304-3959(02)00179-3. PubMed 12237214 ↗
  • Phan A, Edwards CL, Robinson EL. The assessment of pain and discomfort in individuals with mental retardation. Res Dev Disabil. 2005 Sep-Oct;26(5):433-9. doi: 10.1016/j.ridd.2004.10.001. PubMed 16039095 ↗
  • Hoffman HG, Richards TL, Coda B, Bills AR, Blough D, Richards AL, Sharar SR. Modulation of thermal pain-related brain activity with virtual reality: evidence from fMRI. Neuroreport. 2004 Jun 7;15(8):1245-8. doi: 10.1097/01.wnr.0000127826.73576.91. PubMed 15167542 ↗
  • Wittwer A, Krummenacher P, La Marca R, Ehlert U, Folkers G. Salivary Alpha-Amylase Correlates with Subjective Heat Pain Perception. Pain Med. 2016 Jun;17(6):1131-6. doi: 10.1093/pm/pnv085. Epub 2016 Jan 13. PubMed 26764337 ↗
  • Norton M, Holm JE, McSherry WC 2nd. Behavioral assessment of relaxation: the validity of a Behavioral Rating Scale. J Behav Ther Exp Psychiatry. 1997 Jun;28(2):129-37. doi: 10.1016/s0005-7916(97)00004-9. PubMed 9194010 ↗
  • Barney CC, Krach LE, Rivard PF, Belew JL, Symons FJ. Motor function predicts parent-reported musculoskeletal pain in children with cerebral palsy. Pain Res Manag. 2013 Nov-Dec;18(6):323-7. doi: 10.1155/2013/813867. PubMed 24308022 ↗
  • Barney CC, Feyma T, Beisang A, Symons FJ. Pain experience and expression in Rett syndrome: Subjective and objective measurement approaches. J Dev Phys Disabil. 2015 Aug 1;27(4):417-429. doi: 10.1007/s10882-015-9427-3. Epub 2015 Mar 1. PubMed 26425056 ↗
  • Fernandez-Blazquez MA, Avila-Villanueva M, Lopez-Pina JA, Zea-Sevilla MA, Frades-Payo B. Psychometric properties of a new short version of the State-Trait Anxiety Inventory (STAI) for the assessment of anxiety in the elderly. Neurologia. 2015 Jul-Aug;30(6):352-8. doi: 10.1016/j.nrl.2013.12.015. Epub 2014 Jan 28. English, Spanish. PubMed 24484757 ↗
  • Perpina-Galvan J, Richart-Martinez M, Cabanero-Martinez MJ, Martinez-Dura I. Content validity of the short version of the subscale of the State-Trait Anxiety Inventory (STAI). Rev Lat Am Enfermagem. 2011 Jul-Aug;19(4):882-7. doi: 10.1590/s0104-11692011000400005. English, Portuguese, Spanish. PubMed 21876939 ↗

Individual participant data

Plan to share: No

09

Timeline

1 registry update since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedDate before it movedWhere the date was before it movedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Ran from Sep 2018 to primary completion in May 2023, 55 months.

Of 226 non-industry interventional studies with no phase under Muscle Spasticity, half reached primary completion within 15 months of starting (the median), counting those still running; a quarter within 6 and three quarters within 37. This study's 55 months is above that.

Counting every sponsor, half of 234 studies reached it within 15 months; a quarter within 7 and three quarters within 34.

Since we started tracking on Sep 25, 2026, the dates moved once, on Sep 25, 2026: primary completion Dec 2023 → May 2023 and completion Dec 2024 → May 2023.

Earlier changes are on the record history on ClinicalTrials.gov ↗

How these figures are worked out, and which studies are left out of them.

Registered
Apr 24, 2018
First posted
May 11, 2018
StartActual
Sep 21, 2018
Primary completionActual
May 17, 2023was Dec 2023
CompletionActual
May 17, 2023was Dec 2024
Last update
Sep 25, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
Status
Status unknown→Completed
changed Sep 25, 2026
Primary completion
Dec 2023→May 17, 2023 (actual)
Sep 25, 2026
Study completion
Dec 2024→May 17, 2023 (actual)
Sep 25, 2026
Show all 1 update
  1. Sep 25, 2026
    Status unknown→Completed
    Primary completion Dec 2023→May 17, 2023 (now actual)
    Study completion Dec 2024→May 17, 2023 (now actual)
    + 2 other changes: verification date and index terms

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT03521076
Lead sponsor
Gillette Children's Specialty Healthcare
Responsible party
Chantel Burkitt (Clinical Scientist, Gillette Children's Specialty Healthcare) — Principal investigator
First posted
May 11, 2018
Start date
Sep 21, 2018
Primary completion
May 17, 2023
Completion
May 17, 2023
Last update
Sep 25, 2026

Study contacts

Chantel Burkitt, PhD
principal investigator · Gillette Children's Specialty Healthcare

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Mar 2025. You cannot join it, but the record below documents what was studied.

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