Abstract
BACKGROUND: Burn injuries in children often impair joint mobility and motor function, with concomitant pain often compromising rehabilitation compliance. Active video games (AVGs) may offer a motivating, fear-reducing alternative, yet their effects on burn-related outcomes remain understudied. This study aimed to evaluate AVGs' impact on pain intensity, range of motion (ROM), and motor function in pediatric burn patients. METHODS: This two-phase study was conducted in 2024 at Imam Reza Hospital, Mashhad, Iran. First, an active video game was developed; then, a single-blind randomized controlled trial was conducted with 69 children aged 5-15 years with second-degree upper limb burns. Participants were block-randomized (1:1) using Stata 17. The intervention group received Kinect Xbox-based game therapy; the control group used traditional physiotherapy. Each session included a 15-minute warm-up followed by gameplay/ physiotherapy, held 10 times per week for two weeks. Pain, range of motion (ROM), and motor function were assessed using the Wong-Baker FACES(®) scale, goniometry, and the Activities Scale for Kids (ASK), respectively. Data were analyzed using chi-square, t-test, Mann-Whitney U, repeated measures ANOVA, and Friedman tests in SPSS 28 (p < 0.05). RESULTS: The mean age was 7.94 ± 2.22 years in the intervention group and 8.29 ± 2.29 years in the control group (p = 0.890). The findings showed a significant reduction in pain intensity after the intervention in both groups compared to pre-intervention levels (p < 0.001, 95% CI: 0.87-1.30). Moreover, the increase in wrist joint range of motion after the intervention was significantly different between the two groups (p < 0.001, 95% CI: 2.61-10.62). However, no significant difference was observed between the groups regarding shoulder and elbow joint range of motion (p = 0.490, 95% CI: -39.91-26.86; p = 0.060, 95% CI: -1.70-19.14, respectively). Additionally, no significant difference was found in motor function between the two groups after the intervention (p = 0.058, 95% CI: -0.16-9.68). CONCLUSION: Our results demonstrated that active video game intervention significantly reduced pain intensity and improved wrist range of motion in children with burns. These findings suggest that active video games could serve as a complementary approach for wrist rehabilitation in pediatric burn patients. Future studies should validate these effects on other joints (shoulder/elbow) and functional outcomes. TRIAL REGISTRATION: This RCT was registered in the Iran Registry of Clinical Trials (IRCT20230723058891N1, https//irct.behdasht.gov.ir/trial/72575) on 11/04/2023.