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Ezawa ID, Robinson N, Hollon SD. Prevalence Increases as Treatments Improve: An Evolutionary Perspective on the Treatment-Prevalence Paradox in Depression. Annu Rev Clin Psychol 2024; 20:201-228. [PMID: 38996078 DOI: 10.1146/annurev-clinpsy-080822-040442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2024]
Abstract
Depression is an eminently treatable disorder that responds to psychotherapy or medications; the efficacy of each has been established in hundreds of controlled trials. Nonetheless, the prevalence of depression has increased in recent years despite the existence of efficacious treatments-a phenomenon known as the treatment-prevalence paradox. We consider several possible explanations for this paradox, which range from a misunderstanding of the very nature of depression, inflated efficacy of the established treatments, and a lack of access to efficacious delivery of treatments. We find support for each of these possible explanations but especially the notion that large segments of the population lack access to efficacious treatments that are implemented as intended. We conclude by describing the potential of using lay therapists and digital technologies to overcome this lack of access and to reach historically underserved populations and simultaneously guarantee the quality of the interventions delivered.
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Affiliation(s)
- Iony D Ezawa
- Department of Psychology, University of Southern California, Los Angeles, California, USA;
| | - Noah Robinson
- Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA; ,
| | - Steven D Hollon
- Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA; ,
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2
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Blanco D, Roberts RM, Gannoni A, Cook S. Assessment and treatment of mental health conditions in children and adolescents: A systematic scoping review of how virtual reality environments have been used. Clin Child Psychol Psychiatry 2024; 29:1070-1086. [PMID: 37738029 PMCID: PMC11188554 DOI: 10.1177/13591045231204082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
Abstract
BACKGROUND There is growing interest in the use of virtual reality environments (VREs) in psychological treatment and assessment. Most research has focused on the application of VREs in adult psychological disorders with fewer studies focusing on its applicability with children and adolescents. A systematic scoping review was undertaken of research assessing how VREs have been used in the treatment and assessment of childhood mental health disorders to provide an overview of the current state of the literature and identify future research directions. METHOD Systematic searches of online databases were conducted in PsycInfo, PubMed, Embase, Scopus, and Web of Science. RESULTS Eleven studies met eligibility criteria and were included in this review, with the majority focusing on VRE interventions for anxiety-related disorders. There is also emerging support for VRE deep breathing training for anxiety, VRE assisted treatment of internet gaming disorder and anorexia nervosa, and VRE assessment of body image evaluation in anorexia nervosa. Most studies were pilot and feasibility studies with only three randomised-controlled trials (RCT). CONCLUSIONS The current literature shows some promise for the use of VRE assessments and interventions of childhood mental health problems, particularly for anxiety-related disorders such as social anxiety and specific phobias. However, high-quality RCTs are now needed to establish effectiveness of VREs in this population, and how it compares to existing evidence-based approaches, given its promise to improve both engagement and outcomes.
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Affiliation(s)
- Dana Blanco
- School of Psychology, University of Adelaide, Australia
| | | | - Anne Gannoni
- Child & Adolescent Mental Health Services, Women’s & Children’s Health Network, Australia
| | - Steve Cook
- School of Humanities, University of Adelaide, Australia
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Amonoo HL, Newcomb R, Lorenz KA, Psenka R, Holmbeck K, Farnam EJ, Tse A, Desai S, Vassev N, Waldman LP, El-Jawahri A. A novel psychosocial virtual reality intervention (BMT-VR) for patients undergoing hematopoietic stem cell transplantation: Pilot randomized clinical trial design and methods. Contemp Clin Trials 2024; 142:107550. [PMID: 38685401 PMCID: PMC11180582 DOI: 10.1016/j.cct.2024.107550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 04/22/2024] [Accepted: 04/26/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Although patients undergoing hematopoietic stem cell transplantation (HSCT) must cope with psychological distress and isolation during an extended transplant hospitalization, psychosocial interventions to address these unmet needs are lacking. Virtual reality offers an innovative modality to deliver a patient-centered psychosocial intervention to address psychosocial needs of patients undergoing HSCT. However, there are currently no supportive care interventions leveraging virtual reality in patients undergoing HSCT. OBJECTIVE To describe the methods of a randomized clinical trial (RCT) to assess the feasibility and preliminary efficacy of a self-administered, virtual reality-delivered psychosocial intervention (BMT-VR) to improve psychological distress and quality of life (QOL) for patients hospitalized for HSCT. METHODS This study entails a single-center RCT of BMT-VR compared to usual transplant care in 80 patients hospitalized for HSCT. Adult patients with hematologic malignancies hospitalized for autologous or allogeneic HSCT are eligible. BMT-VR includes psychoeducation about the HSCT process, psychosocial skill building to promote effective coping and acceptance, and self-care and positive psychology skills to promote post-HSCT recovery. The primary aim is to assess the feasibility defined a priori as ≥60% of eligible patients enrolling in the study, and of those enrolled and randomized to the BMT-VR, ≥ 60% completing 4/6 BMT-VR modules. Secondary objectives include assessing the preliminary effects on psychological distress and QOL. DISCUSSION This is the first RCT of a virtual reality-delivered psychosocial intervention for the HSCT population. If deemed feasible, a future larger multi-site clinical trial can evaluate the efficacy of BMT-VR on outcomes for patients hospitalized for HSCT.
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Affiliation(s)
- Hermioni L Amonoo
- Department of Psychosocial Oncology, Dana-Farber Cancer Institute, Boston, MA, USA; Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
| | - Richard Newcomb
- Harvard Medical School, Boston, MA, USA; Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Karl A Lorenz
- Division of Primary Care and Population Health, Section of Palliative Care, Palo Alto VA Health Care System, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Riley Psenka
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Katherine Holmbeck
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Emelia J Farnam
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | - Alexandra Tse
- Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
| | | | | | - Lauren P Waldman
- Harvard Medical School, Boston, MA, USA; Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Areej El-Jawahri
- Harvard Medical School, Boston, MA, USA; Division of Hematology and Oncology, Department of Medicine, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA
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Gaina MA, Sbarcea SV, Popa BS, Stefanescu BV, Gaina AM, Szalontay AS, Bolos A, Stefanescu C. SAFEvR MentalVeRse.app: Development of a Free Immersive Virtual Reality Exposure Therapy for Acrophobia and Claustrophobia. Brain Sci 2024; 14:651. [PMID: 39061393 DOI: 10.3390/brainsci14070651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 06/13/2024] [Accepted: 06/24/2024] [Indexed: 07/28/2024] Open
Abstract
Background: Specific phobias impact over 400 million people worldwide. Digitalizing mental health could alleviate the burden. Still, although the corporate-driven Metaverse is expanding rapidly, there needs to be more momentum in harnessing virtual reality exposure therapy uptake. Objective: This study aims to conceptualize, develop, and deploy a free Virtual Reality Exposure Therapy (VRET) application specifically designed for treating acrophobia and claustrophobia. This pilot study, which holds the promise of a future where mental health is more accessible and effective, explores the feasibility of leveraging transdisciplinary collaboration among specialists to create a safe, accessible, and effective VRET solution. Methods: We conducted a Delphi heuristic approach involving bioethicists, neuroscientists, and tech developers. Second, we reviewed the existing psychological theories and therapeutic strategies for addressing phobias in VR. Third, we conceptualized a thematic analysis-derived framework for a safe, adaptive-gamified free exposure to virtual reality acrophobia and claustrophobia (SAFEvR ACT). Finally, we provide an overview of the iterative improvements made during 12 workshops and 76 weekly briefings on developmental implementations. Results: We developed the SAFEvR ACT into a proof-of-concept application freely deployed on the MentalVerse app platform. Our safety-focused approach can benefit from prevalidation perspectives within future randomized control trials. Conclusions: The resulting application derived from the SAFEvR ACT framework represents a blueprint to counter the current lack of iVR mental health uptake by offering a free VRET alternative. Future research should aim towards developing similar free platforms to lessen mental health burdens and gather quantitative data. We conclude with a call to action to researchers to fine-tune our current approach and take a stand for free digital mental health within MentalVeRse.app.
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Affiliation(s)
- Marcel-Alexandru Gaina
- Psychiatry, Department of Medicine III, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 16 Universitatii Street, 700115 Iasi, Romania
- Institute of Psychiatry "Socola", 36 Bucium Street, 700282 Iasi, Romania
- The Association of Integrative Psychotherapy and Clinical Psychology, 700469 Iasi, Romania
| | | | - Bianca-Stefana Popa
- Faculty of Computer Science, "Alexandru Ioan Cuza" University, 700483 Iasi, Romania
| | - Bogdan-Victor Stefanescu
- Faculty of Medicine, University of Medicine and Pharmacy "Grigore T. Popa" Iași, 700115 Iasi, Romania
| | - Alexandra-Maria Gaina
- PhD Department, University of Medicine and Pharmacy "Grigore T. Popa" Iași, 700115 Iasi, Romania
| | - Andreea-Silvana Szalontay
- Psychiatry, Department of Medicine III, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 16 Universitatii Street, 700115 Iasi, Romania
- Institute of Psychiatry "Socola", 36 Bucium Street, 700282 Iasi, Romania
| | - Alexandra Bolos
- Psychiatry, Department of Medicine III, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 16 Universitatii Street, 700115 Iasi, Romania
- Institute of Psychiatry "Socola", 36 Bucium Street, 700282 Iasi, Romania
| | - Cristinel Stefanescu
- Psychiatry, Department of Medicine III, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 16 Universitatii Street, 700115 Iasi, Romania
- Institute of Psychiatry "Socola", 36 Bucium Street, 700282 Iasi, Romania
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Rooney T, Sharpe L, Todd J, Michalski SC, Van Ryckeghem D, Crombez G, Colagiuri B. Beyond the modified dot-probe task: A meta-analysis of the efficacy of alternate attention bias modification tasks across domains. Clin Psychol Rev 2024; 110:102436. [PMID: 38696911 DOI: 10.1016/j.cpr.2024.102436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 02/25/2024] [Accepted: 04/25/2024] [Indexed: 05/04/2024]
Abstract
Attention biases towards disease-relevant cues have been implicated in numerous disorders and health conditions, such as anxiety, cancer, drug-use disorders, and chronic pain. Attention bias modification (ABM) has shown that changing attention biases can change related emotional processes. ABM most commonly uses a modified dot-probe task, which has received increasing criticism regarding its reliability and inconsistent findings. The purpose of the present review was thus to systematically review and meta-analyse alternative tasks used in ABM research. We sought to examine whether alternative tasks significantly changed attention biases and emotional outcomes, and critically examined whether relevant sample, task and intervention characteristics moderated each of these effect sizes. Seventy-four (completer n = 15,294) study level comparisons were included in the meta-analysis. Overall, alternative ABM designs had a medium effect on changing biases (g = 0.488), and a small, but significant effect on improving clinical outcomes (g = 0.117). We found this effect to be significantly larger for studies which successfully changed biases compared to those that did not. Across all tasks, it appeared that targeting engagement biases results in the largest change to attention biases. Importantly, we found tasks incorporating gaze-contingency - encouraging engagement with non-biased stimuli - show the most promise for improving emotional outcomes.
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Affiliation(s)
- Tessa Rooney
- School of Psychology, Faculty of Science, The University of Sydney, Australia.
| | - Louise Sharpe
- School of Psychology, Faculty of Science, The University of Sydney, Australia
| | - Jemma Todd
- School of Psychology, Faculty of Science, The University of Sydney, Australia
| | - Stefan Carlo Michalski
- Department of Developmental Disability Neuropsychiatry, Faculty of Medicine and Health, The University of New South Wales, Australia
| | - Dimitri Van Ryckeghem
- Department of Experimental-Clinical and Health Psychology, Ghent University, Belgium; Department of Clinical Psychological Science, Maastricht University, Maastricht, Netherlands; Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Geert Crombez
- Department of Experimental-Clinical and Health Psychology, Ghent University, Belgium
| | - Ben Colagiuri
- School of Psychology, Faculty of Science, The University of Sydney, Australia
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Ferraioli F, Culicetto L, Cecchetti L, Falzone A, Tomaiuolo F, Quartarone A, Vicario CM. Virtual Reality Exposure Therapy for Treating Fear of Contamination Disorders: A Systematic Review of Healthy and Clinical Populations. Brain Sci 2024; 14:510. [PMID: 38790488 PMCID: PMC11118862 DOI: 10.3390/brainsci14050510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 05/08/2024] [Accepted: 05/14/2024] [Indexed: 05/26/2024] Open
Abstract
Virtual Reality Exposure Therapy (VRET), particularly immersive Virtual Reality Exposure Therapy (iVRET), has gained attraction as an innovative approach in exposure therapy (ET), notably for some anxiety disorders with a fear of contamination component, such as spider phobia (SP) and obsessive-compulsive disorder (OCD). This systematic work investigates iVRET's effectiveness in modulating disgust emotion-a shared aberrant feature across these disorders. Recent reviews have evaluated VRET's efficacy against in vivo ET. However, emerging evidence also highlights iVRET's potential in diminishing atypical disgust and related avoidance behaviors, expanding beyond traditional fear-focused outcomes. Our systematic synthesis, adhering to PRISMA guidelines, aims to fill this gap by assessing iVRET's efficacy in regulating disgust emotion within both clinical and at-risk populations, identified through standardized questionnaires and subjective disgust ratings. This research analyzes data from eight studies on clinical populations and five on healthy populations, offering an insight into iVRET's potential to mitigate the aberrant disgust response, a common transdiagnostic feature in varied psychopathologies. The findings support iVRET's clinical relevance in disgust management, providing evidence for a broader therapeutic application of iVRET and pointing out the need for more focused and complete investigations in this emergent field.
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Affiliation(s)
- Francesca Ferraioli
- Department of Cognitive Science, University of Messina, 98121 Messina, Italy; (L.C.); (A.F.)
| | - Laura Culicetto
- Department of Cognitive Science, University of Messina, 98121 Messina, Italy; (L.C.); (A.F.)
| | - Luca Cecchetti
- IMT School for Advanced Studies Lucca, 55100 Lucca, Italy;
| | - Alessandra Falzone
- Department of Cognitive Science, University of Messina, 98121 Messina, Italy; (L.C.); (A.F.)
| | - Francesco Tomaiuolo
- Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy;
| | - Angelo Quartarone
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Centro Neurolesi Bonino-Pulejo, 98124 Messina, Italy;
| | - Carmelo Mario Vicario
- Department of Cognitive Science, University of Messina, 98121 Messina, Italy; (L.C.); (A.F.)
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7
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El-Gabalawy R, Sommer JL, Hebbard P, Reynolds K, Logan GS, Smith MSD, Mutter TC, Mutch WA, Mota N, Proulx C, Gagnon Shaigetz V, Maples-Keller JL, Arora RC, Perrin D, Benedictson J, Jacobsohn E. An Immersive Virtual Reality Intervention for Preoperative Anxiety and Distress Among Adults Undergoing Oncological Surgery: Protocol for a 3-Phase Development and Feasibility Trial. JMIR Res Protoc 2024; 13:e55692. [PMID: 38743939 PMCID: PMC11134251 DOI: 10.2196/55692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 03/07/2024] [Accepted: 03/11/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Preoperative state anxiety (PSA) is distress and anxiety directly associated with perioperative events. PSA is associated with negative postoperative outcomes such as longer hospital length of stay, increased pain and opioid use, and higher rates of rehospitalization. Psychological prehabilitation, such as education, exposure to hospital environments, and relaxation strategies, has been shown to mitigate PSA; however, there are limited skilled personnel to deliver such interventions in clinical practice. Immersive virtual reality (VR) has the potential for greater accessibility and enhanced integration into an immersive and interactive experience. VR is rarely used in the preoperative setting, but similar forms of stress inoculation training involving exposure to stressful events have improved psychological preparation in contexts such as military deployment. OBJECTIVE This study seeks to develop and investigate a targeted PSA intervention in patients undergoing oncological surgery using a single preoperative VR exposure. The primary objectives are to (1) develop a novel VR program for patients undergoing oncological surgery with general anesthesia; (2) assess the feasibility, including acceptability, of a single exposure to this intervention; (3) assess the feasibility, including acceptability, of outcome measures of PSA; and (4) use these results to refine the VR content and outcome measures for a larger trial. A secondary objective is to preliminarily assess the clinical utility of the intervention for PSA. METHODS This study comprises 3 phases. Phase 1 (completed) involved the development of a VR prototype targeting PSA, using multidisciplinary iterative input. Phase 2 (data collection completed) involves examining the feasibility aspects of the VR intervention. This randomized feasibility trial involves assessing the novel VR preoperative intervention compared to a VR control (ie, nature trek) condition and a treatment-as-usual group among patients undergoing breast cancer surgery. Phase 3 will involve refining the prototype based on feasibility findings and input from people with lived experience for a future clinical trial, using focus groups with participants from phase 2. RESULTS This study was funded in March 2019. Phase 1 was completed in April 2020. Phase 2 data collection was completed in January 2024 and data analysis is ongoing. Focus groups were completed in February 2024. Both the feasibility study and focus groups will contribute to further refinement of the initial VR prototype (phase 3), with the final simulation to be completed by mid-2024. CONCLUSIONS The findings from this work will contribute to the limited body of research examining feasible and broadly accessible interventions for PSA. Knowledge gained from this research will contribute to the final development of a novel VR intervention to be tested in a large population of patients with cancer before surgery in a randomized clinical trial. TRIAL REGISTRATION ClinicalTrials.gov NCT04544618; https://www.clinicaltrials.gov/study/NCT04544618. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/55692.
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Affiliation(s)
- Renée El-Gabalawy
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB, Canada
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, MB, Canada
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
- CancerCare Manitoba, Winnipeg, MB, Canada
- Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada
| | - Jordana L Sommer
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB, Canada
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Pamela Hebbard
- CancerCare Manitoba, Winnipeg, MB, Canada
- Harrington Heart and Vascular Institute, University Hospitals, Cleveland, OH, United States
| | - Kristin Reynolds
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
- Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada
| | - Gabrielle S Logan
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB, Canada
| | | | - Thomas C Mutter
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - W Alan Mutch
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Natalie Mota
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, MB, Canada
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
- Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada
| | | | | | - Jessica L Maples-Keller
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Rakesh C Arora
- Harrington Heart and Vascular Institute, University Hospitals, Cleveland, OH, United States
| | - David Perrin
- CancerCare Manitoba, Winnipeg, MB, Canada
- Department of Surgery, Section of Orthopedic Surgery, University of Manitoba, Winnipeg, MB, Canada
| | - Jada Benedictson
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, MB, Canada
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Eric Jacobsohn
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB, Canada
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Hernan G, Ingale N, Somayaji S, Veerubhotla A. Virtual Reality-Based Interventions to Improve Balance in Patients with Traumatic Brain Injury: A Scoping Review. Brain Sci 2024; 14:429. [PMID: 38790408 PMCID: PMC11119161 DOI: 10.3390/brainsci14050429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 04/16/2024] [Accepted: 04/23/2024] [Indexed: 05/26/2024] Open
Abstract
INTRODUCTION Virtual reality (VR)-based interventions to improve balance and mobility are gaining increasing traction across patient populations. VR-based interventions are believed to be more enjoyable and engaging for patients with traumatic brain injury. This scoping review aims to summarize existing studies from the literature that used VR to improve balance and mobility and determine the gap in VR-based balance literature specific to individuals with traumatic brain injury. METHODS Two authors independently searched the literature using the search terms "Virtual Reality Traumatic Brain Injury Lower Limb", "Virtual Reality Traumatic Brain Injury Balance", and "Virtual Reality Traumatic Brain Injury Gait". RESULTS A total of seventeen studies, specifically, three randomized controlled trials, one one-arm experimental study, two retrospective studies, two case studies, one feasibility/usability study, one cohort study, and seven diagnostic (validation) studies, met the inclusion criteria for this review. The methodological quality of the studies evaluated using the PEDro scale was fair. DISCUSSION Future studies should focus on large-scale clinical trials using validated technology to determine its effectiveness and dose-response characteristics. Additionally, standard assessment tools need to be selected and utilized across interventional studies aimed at improving balance and mobility to help compare results between studies.
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Affiliation(s)
| | | | | | - Akhila Veerubhotla
- Department of Rehabilitation Medicine, Grossman School of Medicine, New York University, New York, NY 10016, USA; (G.H.); (N.I.); (S.S.)
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9
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Lin XP, Li BB, Yao ZN, Yang Z, Zhang M. The impact of virtual reality on student engagement in the classroom-a critical review of the literature. Front Psychol 2024; 15:1360574. [PMID: 38659670 PMCID: PMC11040080 DOI: 10.3389/fpsyg.2024.1360574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 03/22/2024] [Indexed: 04/26/2024] Open
Abstract
Objective The purpose of this review is to identify the impact of virtual reality (VR) technology on student engagement, specifically cognitive engagement, behavioral engagement, and affective engagement. Methods A comprehensive search of databases such as Google, Scopus, and Elsevier was conducted to identify English-language articles related to VR and classroom engagement for the period from 2014 to 2023. After systematic screening, 33 articles were finally reviewed. Results The use of VR in the classroom is expected to improve student engagement and learning outcomes, and is particularly effective for students with learning disabilities. However, introducing VR into middle school education poses several challenges, including difficulties in the education system to keep up with VR developments, increased demands on students' digital literacy, and insufficient proficiency of teachers in using VR. Conclusion To effectively utilize VR to increase student engagement, we advocate for educational policymakers to provide training and technical support to teachers to ensure that they can fully master and integrate VR to increase student engagement and instructional effectiveness.
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Affiliation(s)
- Xiao Ping Lin
- Faculty of Education, Silpakorn University, Nakhon Pathom, Thailand
| | - Bin Bin Li
- Melbourne Graduate School of Education, The University of Melbourne, Melbourne, VIC, Australia
| | - Zhen Ning Yao
- Graduate Department, Xi’an Physical Education University, Xi’an, China
| | - Zhi Yang
- Melbourne Graduate School of Education, The University of Melbourne, Melbourne, VIC, Australia
| | - Mingshu Zhang
- College of Commerce and Tourism, Hunan Vocational College for Nationalities, Yueyang, China
- Graduate Department, Sehan University, Yeongam County, Republic of Korea
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10
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Thuilier E, Carey J, Dempsey M, Dingliana J, Whelan B, Brennan A. Virtual rehabilitation for patients with osteoporosis or other musculoskeletal disorders: a systematic review. VIRTUAL REALITY 2024; 28:93. [PMID: 38595908 PMCID: PMC10999384 DOI: 10.1007/s10055-024-00980-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 02/25/2024] [Indexed: 04/11/2024]
Abstract
This study aims to identify effective ways to design virtual rehabilitation to obtain physical improvement (e.g. balance and gait) and support engagement (i.e. motivation) for people with osteoporosis or other musculoskeletal disorders. Osteoporosis is a systemic skeletal disorder and is among the most prevalent diseases globally, affecting 0.5 billion adults. Despite the fact that the number of people with osteoporosis is similar to, or greater than those diagnosed with cardiovascular disease and dementia, osteoporosis does not receive the same recognition. Worldwide, osteoporosis causes 8.9 million fractures annually; it is associated with substantial pain, suffering, disability and increased mortality. The importance of physical therapy as a rehabilitation strategy to avoid osteoporosis fracture cannot be over-emphasised. However, the main rehabilitation challenges relate to engagement and participation. The use of virtual rehabilitation to address such challenges in the delivery of physical improvement is gaining in popularity. As there currently is a paucity of literature applying virtual rehabilitation to patients with osteoporosis, the authors broadened the search parameters to include articles relating to the virtual rehabilitation of other skeletal disorders (e.g. Ankylosing spondylitis, spinal cord injury, motor rehabilitation, etc.). This systematic review initially identified 130 titles, from which 23 articles (involving 539 participants) met all eligibility and selection criteria. Four groups of devices supporting virtual rehabilitation were identified: a head-mounted display, a balance board, a camera and more specific devices. Each device supported physical improvement (i.e. balance, muscle strength and gait) post-training. This review has shown that: (a) each device allowed improvement with different degrees of immersion, (b) the technology choice is dependent on the care need and (c) virtual rehabilitation can be equivalent to and enhance conventional therapy and potentially increase the patient's engagement with physical therapy.
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Affiliation(s)
- Eléa Thuilier
- School of Computer Science, University of Galway, Galway, Ireland
| | - John Carey
- School of Medicine, University of Galway, Galway, Ireland
| | - Mary Dempsey
- School of Engineering, University of Galway, Galway, Ireland
| | - John Dingliana
- School of Computer Science and Statistics, Trinity College Dublin, Dublin, Ireland
| | - Bryan Whelan
- School of Medicine, University of Galway, Galway, Ireland
| | - Attracta Brennan
- School of Computer Science, University of Galway, Galway, Ireland
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Albert L, Potheegadoo J, Herbelin B, Bernasconi F, Blanke O. Numerosity estimation of virtual humans as a digital-robotic marker for hallucinations in Parkinson's disease. Nat Commun 2024; 15:1905. [PMID: 38472203 DOI: 10.1038/s41467-024-45912-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 02/07/2024] [Indexed: 03/14/2024] Open
Abstract
Hallucinations are frequent non-motor symptoms in Parkinson's disease (PD) associated with dementia and higher mortality. Despite their high clinical relevance, current assessments of hallucinations are based on verbal self-reports and interviews that are limited by important biases. Here, we used virtual reality (VR), robotics, and digital online technology to quantify presence hallucination (vivid sensations that another person is nearby when no one is actually present and can neither be seen nor heard) in laboratory and home-based settings. We establish that elevated numerosity estimation of virtual human agents in VR is a digital marker for experimentally induced presence hallucinations in healthy participants, as confirmed across several control conditions and analyses. We translated the digital marker (numerosity estimation) to an online procedure that 170 PD patients carried out remotely at their homes, revealing that PD patients with disease-related presence hallucinations (but not control PD patients) showed higher numerosity estimation. Numerosity estimation enables quantitative monitoring of hallucinations, is an easy-to-use unobtrusive online method, reaching people far away from medical centers, translating neuroscientific findings using robotics and VR, to patients' homes without specific equipment or trained staff.
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Affiliation(s)
- Louis Albert
- Laboratory of Cognitive Neuroscience, Neuro-X Institute, Faculty of Life Sciences, Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland
| | - Jevita Potheegadoo
- Laboratory of Cognitive Neuroscience, Neuro-X Institute, Faculty of Life Sciences, Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland
| | - Bruno Herbelin
- Laboratory of Cognitive Neuroscience, Neuro-X Institute, Faculty of Life Sciences, Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland
| | - Fosco Bernasconi
- Laboratory of Cognitive Neuroscience, Neuro-X Institute, Faculty of Life Sciences, Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland
| | - Olaf Blanke
- Laboratory of Cognitive Neuroscience, Neuro-X Institute, Faculty of Life Sciences, Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland.
- Department of Clinical Neurosciences, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
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12
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Martinez-Bernal D, Cross WF, Hasselberg M, Tapparello C, Stenz CFH, Kolokythas A. A brief virtual reality intervention for pre-operative anxiety in adults. Oral Surg Oral Med Oral Pathol Oral Radiol 2024; 137:209-214. [PMID: 38171998 DOI: 10.1016/j.oooo.2023.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/08/2023] [Accepted: 08/11/2023] [Indexed: 01/05/2024]
Abstract
OBJECTIVE Virtual reality (VR) is a promising non-pharmacologic tool for managing health care anxiety. We assessed the feasibility and acceptability of a pre-operative VR intervention by adult patients and medical staff and measured anxiety in adult patients pre- and post-VR intervention. STUDY DESIGN We recruited 30 patients scheduled to undergo oral surgery and 8 medical staff as participants. The patients completed a verbal demographic survey and rated their anxiety before the VR intervention and at 1 minute and 2 minutes post-intervention. We administered the Acceptability of Intervention Measure to the patients to measure their perceptions of the VR intervention and the Feasibility of Intervention Measure to the medical staff to assess their perception of VR implementation. We performed an analysis of variance to compare pre-operative anxiety over time and assess demographic differences. RESULTS The patients showed high and consistent acceptability of the pre-operative use of VR among patients, but acceptability varied among medical staff. The patients experienced a statistically significant reduction of pre-operative anxiety (P = .003). CONCLUSION A brief VR pre-intervention is highly accepted by and very beneficial for patients undergoing oral surgery, positively affecting anxiety reduction. The perception of VR by health care providers needs to be explored to increase acceptability.
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Affiliation(s)
| | - Wendi F Cross
- Department of Psychiatry and Pediatrics, University of Rochester Medical Center, Rochester, NY, USA.
| | - Michael Hasselberg
- Chief Digital Health Officer, University of Rochester Medical Center, Rochester, NY, USA
| | - Cristiano Tapparello
- Department of Electrical and Computer Engineering, University of Rochester, Rochester, NY, USA
| | - Colette F H Stenz
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Antonia Kolokythas
- Department of Oral and Maxillofacial Surgery, University of Augusta, Augusta, GA, USA
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13
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Twamley J, Hamer O, Hill J, Kenyon R, Twamley H, Casey R, Zhang J, Williams A, Clegg A. Exploring the perceptions of former ICU patients and clinical staff on barriers and facilitators to the implementation of virtual reality exposure therapy: A qualitative study. Nurs Crit Care 2024; 29:313-324. [PMID: 36458458 DOI: 10.1111/nicc.12868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 10/18/2022] [Accepted: 11/21/2022] [Indexed: 12/04/2022]
Abstract
BACKGROUND Virtual reality (VR) as a digital technology has developed rapidly, becoming more realistic, portable, sensory and easier to navigate. Although studies have found VR to be effective for many clinical applications, patients and clinicians have described several barriers to the successful implementation of this technology. To remove barriers for implementation of VR in health care, a greater understanding is needed of how VR can integrate into clinical environments, particularly complex settings such as an intensive care unit. AIM This study aimed to explore the perceived barriers and facilitators for the implementation of VR exposure therapy for intensive care patients and clinical staff. STUDY DESIGN A qualitative study using an Interpretative Description approach was undertaken. Semi-structured focus groups were conducted with 13 participants: nine patients and four health care professionals. Focus groups explored barriers and facilitators of using virtual reality (VR) exposure therapy in intensive care. Thematic analysis was employed to produce codes and themes. RESULTS In total, eight themes describing the perceived barriers and facilitators to implementing VR exposure therapy were identified. Four themes related to the perceived barriers of implementing VR exposure therapy in intensive care were identified: psychological, sensory, environmental and staff competency and confidence. There were a further four themes related to the perceived facilitators to the implementation of VR exposure therapy: staff training, patient capacity, orientation to technology and support during the intervention. CONCLUSIONS This study identified novel barriers and facilitators that could be expected when implementing VR exposure therapy for patients' post-intensive care unit stay. The findings suggest that psychological barriers of fear and apprehension were expected to provoke patient avoidance of exposure therapy. Perceived barriers for staff focused on preparedness to deliver the VR exposure therapy and a lack of technological competence. Both patients and staff stated that a comprehensive induction, orientation and training could facilitate VR exposure therapy, improving engagement. RELEVANCE TO CLINICAL PRACTICE This study has identified that with appropriate staff training, resources, and integration into current patient care pathways, VR exposure therapy may be a valuable intervention to support patient recovery following critical illness. Prior to undertaking VR exposure therapy, patients often need reassurance that side-effects can be managed, and that they can easily control their virtual exposure experience.
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Affiliation(s)
- Jacqueline Twamley
- Centre for Health Research and Innovation, NIHR Lancashire Clinical Research Facility, Chorley, UK
| | - Oliver Hamer
- Synthesis, Economic Evaluation and Decision Science (SEEDS) Group, University of Central Lancashire, Preston, UK
| | - James Hill
- Synthesis, Economic Evaluation and Decision Science (SEEDS) Group, University of Central Lancashire, Preston, UK
| | - Roger Kenyon
- Critical care survivor, University of Central Lancashire, Preston, UK
| | - Huw Twamley
- Intensive Care Department, Lancashire Teaching Hospitals NHS Foundation Trust, Chorley, UK
| | - Rob Casey
- Digital Therapy Solutions to empower Stroke, Dementia, Parkinson's Rehabilitation, DancingMind Pte Ltd, London, England, United Kingdom
| | | | - Alexandra Williams
- Intensive Care Department, Lancashire Teaching Hospitals NHS Foundation Trust, Chorley, Lancashire, United Kingdom
| | - Andrew Clegg
- Synthesis, Economic Evaluation and Decision Science (SEEDS) Group, University of Central Lancashire, Preston, UK
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14
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McGhee WRG, Doherty CJ, Graham-Wisener L, Fallis R, Stone C, Axiaq A, Dempster M. Immersive virtual reality and psychological well-being in adult chronic physical illness: systematic review. BMJ Support Palliat Care 2024; 14:14-24. [PMID: 37848219 DOI: 10.1136/spcare-2023-004502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 08/11/2023] [Indexed: 10/19/2023]
Abstract
INTRODUCTION Individuals with chronic physical illness are at increased risk of negative psychological sequelae. Immersive virtual reality (VR) is an emerging treatment that might reduce these negative effects and increase quality of life in individuals with chronic physical illness. OBJECTIVE To systematically review literature examining the use of immersive VR in adult populations with chronic physical illness to understand: (1) how immersive VR is used to improve psychological well-being of adults with chronic physical illness (2) what effect this immersive VR has on the psychological well-being of adults with chronic physical illness. DESIGN Systematic literature review and meta-analysis. Searches of Ovid Medline/PubMed, PsycINFO, Embase, Web of Science and Scopus between July 1993 and March 2023 inclusive. RESULTS 12 811 texts were identified; 31 met the inclusion criteria. Relaxing and engaging immersive VR interventions were shown to be acceptable and feasible among adults with cancer, dementia, cardiovascular disease, kidney disease and multiple sclerosis. Many of the studies reviewed were feasibility or pilot studies and so the evidence about effectiveness is more limited. The evidence, mostly from studies of people with cancer, suggests that immersive VR can have a positive effects on anticipatory anxiety symptoms and pain. CONCLUSIONS Environment-based and game-based relaxing immersive VR offer novel interventions, with beneficial effects among people with cancer and, potentially, beneficial effects in those with other long-term physical illness.
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Affiliation(s)
| | | | | | | | | | - Ariana Axiaq
- Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Martin Dempster
- School of Psychology, Queen's University Belfast, Belfast, UK
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15
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Shahid S, Kelson J, Saliba A. Effectiveness and User Experience of Virtual Reality for Social Anxiety Disorder: Systematic Review. JMIR Ment Health 2024; 11:e48916. [PMID: 38329804 PMCID: PMC10884902 DOI: 10.2196/48916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 11/24/2023] [Accepted: 12/05/2023] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Social anxiety disorder (SAD) is a debilitating psychiatric disorder that affects occupational and social functioning. Virtual reality (VR) therapies can provide effective treatment for people with SAD. However, with rapid innovations in immersive VR technology, more contemporary research is required to examine the effectiveness and concomitant user experience outcomes (ie, safety, usability, acceptability, and attrition) of emerging VR interventions for SAD. OBJECTIVE The aim of this systematic review was to examine the effectiveness and user experience of contemporary VR interventions among people with SAD. METHODS The Cochrane Library, Emcare, PsycINFO, PubMed, ScienceDirect, Scopus, and Web of Science databases were searched between January 1, 2012, and April 26, 2022. Deduplicated search results were screened based on title and abstract information. Full-text examination was conducted on 71 articles. Studies of all designs and comparator groups were included if they appraised the effectiveness and user experience outcomes of any immersive VR intervention among people with SAD. A standardized coding sheet was used to extract data on key participant, intervention, comparator, outcome, and study design items. RESULTS The findings were tabulated and discussed using a narrative synthesis. A total of 18 studies met the inclusion criteria. CONCLUSIONS The findings showed that VR exposure therapy-based interventions can generally provide effective, safe, usable, and acceptable treatments for adults with SAD. The average attrition rate from VR treatment was low (11.36%) despite some reported user experience difficulties, including potential simulator sickness, exposure-based emotional distress, and problems with managing treatment delivered in a synchronous group setting. This review also revealed several research gaps, including a lack of VR treatment studies on children and adolescents with SAD as well as a paucity of standardized assessments of VR user experience interactions. More studies are required to address these issues. TRIAL REGISTRATION PROSPERO CRD42022353891; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=353891.
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Affiliation(s)
- Simon Shahid
- Faculty of Business, Justice, and Behavioural Sciences, Charles Sturt University, Bathurst, Australia
| | - Joshua Kelson
- Faculty of Business, Justice, and Behavioural Sciences, Charles Sturt University, Bathurst, Australia
| | - Anthony Saliba
- Faculty of Business, Justice, and Behavioural Sciences, Charles Sturt University, Bathurst, Australia
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16
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Le Roy B, Martin-Krumm C, Poupon C, Richieri R, Malbos E, Barthélémy F, Guedj E, Trousselard M. Virtual Exercise in Medicine: A Proof of Concept in a Healthy Population. JMIR Form Res 2024; 8:e45637. [PMID: 38252484 PMCID: PMC10845022 DOI: 10.2196/45637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 05/19/2023] [Accepted: 08/31/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Science is beginning to establish the benefits of the use of virtual reality (VR) in health care. This therapeutic approach may be an appropriate complementary treatment for some mental illnesses. It could prevent high levels of morbidity and improve the physical health of patients. For many years, the literature has shown the health benefits of physical exercise. Physical exercise in a VR environment may improve the management of mild to moderate mental health conditions. In this context, we developed a virtual environment combined with an ergocycle (the augmented physical training for isolated and confined environments [APTICE] system). OBJECTIVE This study aims to investigate the impact of physical exercise in a VR environment. METHODS A total of 14 healthy participants (11 men and 3 women; mean age 43.28, SD 10.60 years) undertook 15 minutes of immersive physical exercise using the system. Measures included mindfulness and immersion disposition, subjective perceptions of sensory information, user experience, and VR experience (ie, psychological state, flow, and presence). RESULTS First, the APTICE system appears to be a useful tool because the user experience is positive (subscales in the AttrakDiff questionnaire: pragmatic quality=0.99; hedonic quality-stimulation=1.90; hedonic quality-identification=0.67; attractiveness=1.58). Second, the system can induce a positive psychological state (negative emotion, P=.06) and an experience of flow and presence (P values ranging from <.001 to .04). Third, individual immersive and mindful disposition plays a role in the VR experience (P values ranging from <.02 to .04). Finally, our findings suggest that there is a link between the subjective perception of sensory information and the VR experience (P values ranging from <.02 to .04). CONCLUSIONS These results indicate that the device is well accepted with positive psychological and exteroceptive outcomes. Overall, the APTICE system could be a proof of concept to explore the benefits of virtual physical exercise in clinical medicine.
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Affiliation(s)
- Barbara Le Roy
- Unité neurophysiologie du stress, Institut de recherche biomédicale des armées, Brétigny-sur-Orge, France
- Adaptation, mesure et évaluation en santé. Approches interdisciplinaires, Metz, France
| | - Charles Martin-Krumm
- Unité neurophysiologie du stress, Institut de recherche biomédicale des armées, Brétigny-sur-Orge, France
- Adaptation, mesure et évaluation en santé. Approches interdisciplinaires, Metz, France
- Vulnérabilité, capabilité, rétablissement, Unité religion, culture et société, Ecole des psychologues praticiens, Paris, France
| | - Charlotte Poupon
- École nationale supérieure de création industrielle, Paris, France
| | - Raphaëlle Richieri
- Département psychiatrie, Hôpital de la Conception, Institut Fresnel, Marseille, France
| | - Eric Malbos
- Département psychiatrie, Hôpital de la Conception, Institut Fresnel, Marseille, France
| | - Fanny Barthélémy
- Département de médecine nucléaire, Centre européen de recherche en imagerie médicale, Institut Fresnel, Marseille, France
| | - Eric Guedj
- Département de médecine nucléaire, Centre européen de recherche en imagerie médicale, Institut Fresnel, Marseille, France
| | - Marion Trousselard
- Unité neurophysiologie du stress, Institut de recherche biomédicale des armées, Brétigny-sur-Orge, France
- Adaptation, mesure et évaluation en santé. Approches interdisciplinaires, Metz, France
- Service de santé des armées, Paris, France
- Réseau ABC des Psychotraumas, Montpellier, France
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17
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Sommer JL, Reynolds K, Hebbard P, Smith MSD, Mota N, Mutch WAC, Maples-Keller J, Roos L, El-Gabalawy R. Preoperative Virtual Reality to Expose Patients With Breast Cancer to the Operating Room Environment: Feasibility and Pilot Case Series Study. JMIR Form Res 2024; 8:e46367. [PMID: 38231570 PMCID: PMC10831694 DOI: 10.2196/46367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 11/16/2023] [Accepted: 12/04/2023] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Clinically elevated preoperative distress and anxiety are common among patients undergoing cancer surgery. Preoperative interventions have been developed to mitigate this distress and anxiety but are inconsistent in efficacy and feasibility for broad implementation. OBJECTIVE This preliminary pilot study aims to assess the feasibility and utility of a newly developed virtual reality (VR) intervention to expose patients awaiting breast cancer surgery to the operating room environment and a simulation of anesthetic induction. METHODS Patients undergoing breast cancer surgery (N=7) were assigned to the VR intervention or control (treatment as usual) group and completed self-report measures of distress and anxiety before surgery, on the day of surgery, and after surgery (5 and 30 d postoperatively). Those in the intervention group trialed the VR simulation 1 to 2 weeks preoperatively and provided qualitative and quantitative feedback. We assessed the feasibility of recruitment capability and study design and evaluated participants' impressions of the intervention using self-report rating scales and open-ended questions. We also descriptively examined distress and anxiety levels throughout the duration of the study. RESULTS Recruitment occurred between December 2021 and December 2022 and progressed slowly (rate: 1 participant/7 wk on average; some hesitancy because of stress and being overwhelmed). All participants who consented to participate completed the entire study. All participants were female and aged 56 (SD 10.56) years on average. In total, 57% (4/7) of the participants were assigned to the intervention group. On average, intervention participants spent 12 minutes engaged in the VR simulation. In general, the intervention was rated favorably (eg, clear information, enjoyable, and attractive presentation; mean% agreement 95.00-96.25, SD 4.79-10.00) and as helpful (mean% agreement 87.50, SD 25.00). Participants described the intervention as realistic (eg, "It was realistic to my past surgical experiences"), impacting their degree of preparedness and expectations for surgery (eg, "The sounds and sights and procedures give you a test run; they prepare you for the actual day"), and having a calming or relaxing effect (eg, "You feel more relaxed for the surgery"). CONCLUSIONS This preoperative VR intervention demonstrated preliminary feasibility among a sample of patients undergoing breast cancer surgery. Results and participant feedback will inform modifications to the VR intervention and the study design of a large-scale randomized controlled trial to examine the efficacy of this intervention. TRIAL REGISTRATION ClinicalTrials.gov NCT04544618; https://clinicaltrials.gov/study/NCT04544618.
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Affiliation(s)
- Jordana L Sommer
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB, Canada
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Kristin Reynolds
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
- Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada
| | - Pamela Hebbard
- Department of Surgery, University of Manitoba, Winnipeg, MB, Canada
- CancerCare Manitoba, Winnipeg, MB, Canada
| | | | - Natalie Mota
- Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - W Alan C Mutch
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Jessica Maples-Keller
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Leslie Roos
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Renée El-Gabalawy
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB, Canada
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
- Department of Psychiatry, University of Manitoba, Winnipeg, MB, Canada
- CancerCare Manitoba, Winnipeg, MB, Canada
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, MB, Canada
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18
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Tortora C, Di Crosta A, La Malva P, Prete G, Ceccato I, Mammarella N, Di Domenico A, Palumbo R. Virtual reality and cognitive rehabilitation for older adults with mild cognitive impairment: A systematic review. Ageing Res Rev 2024; 93:102146. [PMID: 38036103 DOI: 10.1016/j.arr.2023.102146] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 11/23/2023] [Accepted: 11/23/2023] [Indexed: 12/02/2023]
Abstract
Virtual Reality (VR) has been gaining increasing attention as a potential ecological and effective intervention system for treating Mild Cognitive Impairment (MCI). However, it remains unclear the efficacy and effectiveness of VR-based cognitive rehabilitation therapy (VR-CRT) in comparison with cognitive rehabilitation therapy (CRT). Consequently, a systematic review on Pubmed, Scopus, PsycInfo, and Web Of Science was conducted to assess the state of the art of the literature published between 2003 and April 2023. Only articles that adopted CRT as control group and that included some measure of at least one domain among overall cognitive function, executive function and functional status were included. Participants needed to be older adults aged 65 or over with a diagnosis of MCI. The risk of bias and the quality of evidence were assessed using the Version 2 of the Cochrane risk-of-bias tool for randomized trials. Initially, 6503 records were considered and screened after removing duplicates (n = 1321). Subsequently, 81 full texts were assessed for eligibility. Four articles met the inclusion criteria but 2 of them were merged as they were describing different outcomes of the same research project. Consequently, 3 overall studies with a total of 130 participants were included in the final analysis. Due to the high heterogeneity in the methodology and outcome measures employed, it was not possible to conduct a meta-analysis. Included studies used semi-immersive (k = 2) and full-immersive (k = 1) VR systems in their research. Two articles evaluated overall cognitive function through the MoCA together with specific tests for executive functions (n = 69), while one study adopted a comprehensive neuropsychological battery to evaluate both cognitive function and executive function (n = 61). Finally, one study evaluated functional status through instrumental activities of daily living (n = 34). A However, the limited number of studies, the small sample size, and the potential issues with the quality and methodology of these studies that emerged from the risk of bias assessment may raise doubts about the reliability of their results. Nevertheless, although scarce, results of the present review suggest that VR-CRT may be paramount in treating MCI for its additional ecological and adaptive advantages, as all of the studies highlighted that it was at least as effective as conventional CRT for all the outcome measures. Therefore, more rigorous research that compares VR-CRT and CRT is needed to understand the degree to which VR-CRT is effective with older adults with MCI and the potential role of immersion to influence its efficacy. Indeed, these preliminary findings highlight the need for the development of standardized VR protocols, as the integration of such technology into clinical practice may help improve the quality of life and cognitive outcomes for this growing demographic.
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Affiliation(s)
- Carla Tortora
- Department of Psychological, Health and Territorial Sciences, University "G. D'Annunzio" of Chieti-Pescara, Via dei Vestini 31, Chieti, Italy
| | - Adolfo Di Crosta
- Department of Psychological, Health and Territorial Sciences, University "G. D'Annunzio" of Chieti-Pescara, Via dei Vestini 31, Chieti, Italy; Department of Medicine and Aging Sciences, University "G. D'Annunzio" of Chieti-Pescara, Via dei Vestini 31, Chieti, Italy.
| | - Pasquale La Malva
- Department of Psychological, Health and Territorial Sciences, University "G. D'Annunzio" of Chieti-Pescara, Via dei Vestini 31, Chieti, Italy
| | - Giulia Prete
- Department of Psychological, Health and Territorial Sciences, University "G. D'Annunzio" of Chieti-Pescara, Via dei Vestini 31, Chieti, Italy
| | - Irene Ceccato
- Department of Psychological, Health and Territorial Sciences, University "G. D'Annunzio" of Chieti-Pescara, Via dei Vestini 31, Chieti, Italy
| | - Nicola Mammarella
- Department of Psychological, Health and Territorial Sciences, University "G. D'Annunzio" of Chieti-Pescara, Via dei Vestini 31, Chieti, Italy
| | - Alberto Di Domenico
- Department of Psychological, Health and Territorial Sciences, University "G. D'Annunzio" of Chieti-Pescara, Via dei Vestini 31, Chieti, Italy
| | - Rocco Palumbo
- Department of Psychological, Health and Territorial Sciences, University "G. D'Annunzio" of Chieti-Pescara, Via dei Vestini 31, Chieti, Italy
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19
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Schröder D, Wrona KJ, Müller F, Heinemann S, Fischer F, Dockweiler C. Impact of virtual reality applications in the treatment of anxiety disorders: A systematic review and meta-analysis of randomized-controlled trials. J Behav Ther Exp Psychiatry 2023; 81:101893. [PMID: 37453405 DOI: 10.1016/j.jbtep.2023.101893] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/15/2023] [Accepted: 06/25/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND AND OBJECTIVES Anxiety disorders are the most prevalent mental disorders worldwide. Virtual reality (VR) treatment approaches have increasingly been studied. Before clinical implementation, it is necessary to evaluate the treatment effect of VR applications. The objective is to evaluate the treatment effect of virtual reality applications in the treatment of anxiety disorders compared to conventional therapy. METHODS A systematic literature review with meta-analysis was conducted. Four databases were used to identify randomized controlled trials published between April 2011 and April 2021 which compare VR applications with non-VR interventions or waiting lists. Study characteristics, pre- and post-treatment data were extracted. Hedges g was calculated as effect size. Primary outcome was anxiety symptoms. RESULTS Data from 17 studies from 827 participants was extracted. The studies examined specific phobia (n = 9), social anxiety disorder (n = 4), agoraphobia (n = 2) and panic disorder (n = 2). 16 out of 17 studies used head-mounted displays as VR application. A non-significant effect size with significant heterogeneity was observed in favor of the use of VR applications in anxiety symptoms (g, 0.33; 95%-CI, -0.20-0.87). Compared to passive control groups, VR applications are associated significant with lower anxiety symptoms (g, 1.29; 95%-CI, 0.68-1.90). LIMITATIONS The study and patient characteristics varied between the individual studies which is reflected in a high statistical heterogeneity of the effect sizes. CONCLUSIONS The added value of VR applications over waiting-list or psychoeducation only control groups is obvious. VR applications can be used as part of the treatment of anxiety disorders, especially when conventional therapy is unavailable.
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Affiliation(s)
- Dominik Schröder
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany.
| | - Kamil J Wrona
- Hochschule Bielefeld University of Applied Sciences and Arts, Bielefeld, Germany
| | - Frank Müller
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany; Department of Family Medicine, Michigan State University, Grand Rapids, Michigan, USA
| | - Stephanie Heinemann
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany; Department of Geriatrics, University Medical Center Göttingen, Göttingen, Germany
| | - Florian Fischer
- Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany; Bavarian Research Center for Digital Health and Social Care, Kempten University, Kempten, Germany
| | - Christoph Dockweiler
- Department Digital Biomedicine and Health Sciences, School of Life Sciences, University Siegen, Siegen, Germany; School of Public Health, Bielefeld University, Bielefeld, Germany
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Pardini S, Gabrielli S, Gios L, Dianti M, Mayora-Ibarra O, Appel L, Olivetto S, Torres A, Rigatti P, Trentini E, Leonardelli L, Bernardi M, Lucianer M, Forti S, Novara C. Customized virtual reality naturalistic scenarios promoting engagement and relaxation in patients with cognitive impairment: a proof-of-concept mixed-methods study. Sci Rep 2023; 13:20516. [PMID: 37993549 PMCID: PMC10665464 DOI: 10.1038/s41598-023-47876-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 11/16/2023] [Indexed: 11/24/2023] Open
Abstract
Being immersed in a natural context has a beneficial and pervasive impact on well-being. Virtual Reality (VR) is a technology that can help expose people to naturalistic scenarios virtually, overcoming obstacles that prevent them from visiting real natural environments. VR could also increase engagement and relaxation in older adults with and without cognitive impairment. The main aim of this study is to investigate the feasibility of a customized naturalistic VR scenario by assessing motion-sickness effects, engagement, pleasantness, and emotions felt. Twenty-three individuals with a diagnosis of cognitive impairment living in a long-term care home participated in our study. At the end of the entire VR experimental procedure with older adults, five health staff operators took part in a dedicated assessment phase focused on evaluating the VR procedure's usability from their individual perspectives. The tools administered were based on self-reported and observational tools used to obtain information from users and health care staff professionals. Feasibility and acceptance proved to be satisfactory, considering that the VR experience was well-tolerated and no adverse side effects were reported. One of the major advantages emerged was the opportunity to deploy customized environments that users are not able to experience in a real context.Trial Registration: National Institute of Health (NIH) U.S. National Library of Medicine, ClinicalTrials.gov NCT05863065 (17/05/2023).
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Affiliation(s)
- Susanna Pardini
- Department of General Psychology, University of Padova, Padua, Italy.
- Digital Health Research Unit, Centre for Health and Wellbeing, Fondazione Bruno Kessler, Trento, Italy.
- Human Inspired Technology Research Centre (HIT), University of Padova, Padua, Italy.
| | - Silvia Gabrielli
- Digital Health Research Unit, Centre for Health and Wellbeing, Fondazione Bruno Kessler, Trento, Italy
| | - Lorenzo Gios
- Competence Center for Digital Health, TrentinoSalute4.0, Trento, Italy
| | - Marco Dianti
- Digital Health Research Unit, Centre for Health and Wellbeing, Fondazione Bruno Kessler, Trento, Italy
| | - Oscar Mayora-Ibarra
- Digital Health Research Unit, Centre for Health and Wellbeing, Fondazione Bruno Kessler, Trento, Italy
| | - Lora Appel
- OpenLab, University Health Network, Toronto, ON, Canada
- Faculty of Health, School of Health Policy and Management, York University, Toronto, ON, Canada
- Michael Garron Hospital, Toronto, ON, Canada
| | - Silvia Olivetto
- Department of General Psychology, University of Padova, Padua, Italy
| | - Alina Torres
- Faculty of Science, University of Toronto, Toronto, ON, Canada
| | - Patty Rigatti
- Azienda Pubblica di Servizi alla Persona (APSP) "Margherita Grazioli", Trento, Italy
| | - Emanuela Trentini
- Azienda Pubblica di Servizi alla Persona (APSP) "Margherita Grazioli", Trento, Italy
| | - Lucia Leonardelli
- Azienda Pubblica di Servizi alla Persona (APSP) "Margherita Grazioli", Trento, Italy
| | - Michela Bernardi
- Azienda Pubblica di Servizi alla Persona (APSP) "Margherita Grazioli", Trento, Italy
| | - Marzia Lucianer
- Digital Health Research Unit, Centre for Health and Wellbeing, Fondazione Bruno Kessler, Trento, Italy
- Competence Center for Digital Health, TrentinoSalute4.0, Trento, Italy
| | - Stefano Forti
- Digital Health Research Unit, Centre for Health and Wellbeing, Fondazione Bruno Kessler, Trento, Italy
| | - Caterina Novara
- Department of General Psychology, University of Padova, Padua, Italy
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21
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Nazzal EM, Zsidai B, Hiemstra LA, Lustig S, Samuelsson K, Musahl V. Applications of Extended Reality in Orthopaedic Surgery. J Bone Joint Surg Am 2023; 105:1721-1729. [PMID: 37713502 DOI: 10.2106/jbjs.22.00805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/17/2023]
Abstract
➤ Extended reality is a term that encompasses different modalities, including virtual reality, augmented reality, and mixed reality.➤ Although fully immersive virtual reality has benefits for developing procedural memory and technical skills, augmented and mixed reality are more appropriate modalities for preoperative planning and intraoperative utilization.➤ Current investigations on the role of extended reality in preoperative planning and intraoperative utilization are still in the early stages, but preliminarily show that extended reality technologies can help surgeons to be more accurate and efficient.
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Affiliation(s)
- Ehab M Nazzal
- Department of Orthopaedic Surgery, UPMC Freddie Fu Sports Medicine Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Bálint Zsidai
- Department of Orthopaedic Surgery, UPMC Freddie Fu Sports Medicine Center, University of Pittsburgh, Pittsburgh, Pennsylvania
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Laurie A Hiemstra
- Banff Sport Medicine, Banff, Alberta, Canada
- Department of Surgery, University of Calgary, Calgary, Alberta, Canada
| | - Sébastien Lustig
- Department of Orthopaedic Surgery and Sports Medicine, FIFA Medical Center of Excellence, Croix-Rousse Hospital, Lyon University Hospital, Lyon, France
| | - Kristian Samuelsson
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Orthopaedics, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Volker Musahl
- Department of Orthopaedic Surgery, UPMC Freddie Fu Sports Medicine Center, University of Pittsburgh, Pittsburgh, Pennsylvania
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22
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Devane N, Behn N, Marshall J, Ramachandran A, Wilson S, Hilari K. The use of virtual reality in the rehabilitation of aphasia: a systematic review. Disabil Rehabil 2023; 45:3803-3822. [PMID: 36326199 DOI: 10.1080/09638288.2022.2138573] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 10/10/2022] [Accepted: 10/16/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE This systematic review explored how virtual reality (VR) has been used to rehabilitate aphasia. MATERIALS AND METHODS Empirical studies were included where VR was used to target language, well-being, or quality of life in adults with acquired language impairment. Degenerative communication disabilities were excluded. Seven health databases were searched in October 2021. Risk of Bias was assessed using published checklists and completeness of intervention reporting evaluated. Narrative synthesis described forms of VR, rationales given, outcome measures, communication functions targeted, characteristics of interventions, and outcomes achieved within the framework of impairment, activity, and participation. RESULTS Fourteen studies, involving 229 participants, met the criteria. The studies employed four forms of VR with various rationales given. Interventions used published and novel protocols. Primary outcomes targeted language impairment (12/14), activity (1/14), and well-being (1/14) and achieved positive outcomes in impairment and activity. All studies were exploratory. Risk of bias was high. Findings are discussed in the context of gains achieved by VR in other health contexts and the multi-user gaming literature. CONCLUSIONS Uses of VR in aphasia rehabilitation described in the literature are limited. Most applications target the remediation of language impairments. Opportunities to address activity, participation, and wider aspects of well-being are rare.IMPLICATIONS FOR REHABILITATIONResearch documenting the use of virtual reality (VR) to rehabilitate aphasia is limited and exploratory, so does not yet offer clear guidance for clinicians.Many of the identified studies have used known published protocols (e.g., naming therapy or scripts therapy) delivered through the novel VR format and focus on language impairment outcomes.VR offers clinicians a unique opportunity to address communication activity and participation through the use of multi-user virtual worlds, but this has only been explored by only two research teams.
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Affiliation(s)
- Niamh Devane
- Division of Language and Communication Science, School of Health and Psychological Sciences, City University of London, London, UK
| | - Nicholas Behn
- Division of Language and Communication Science, School of Health and Psychological Sciences, City University of London, London, UK
| | - Jane Marshall
- Division of Language and Communication Science, School of Health and Psychological Sciences, City University of London, London, UK
| | - Aparna Ramachandran
- Division of Health Services Research and Management, School of Health and Psychological Sciences, City University of London, London, UK
| | - Stephanie Wilson
- Centre for Human-Computer Design, School of Mathematics, Computer Science and Engineering, City University of London, London, UK
| | - Katerina Hilari
- Division of Language and Communication Science, School of Health and Psychological Sciences, City University of London, London, UK
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23
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Arias-Amezquita E, Alkureishi L, Purnell C, Zhao L, Lee O, Mathis SA, Patel PK, Cohen M. Virtual Reality Planning in Reconstructive Surgery for Orbital Prosthetic Rehabilitation Using ImmersiveTouch Platform: Preliminary Report. J Craniofac Surg 2023:00001665-990000000-01138. [PMID: 37889858 DOI: 10.1097/scs.0000000000009794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 10/01/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND/PURPOSE Virtual reality (VR) is emerging as an effective and intuitive surgical planning and 3D visualization tool. Digital surgical planning is the gold standard for planning the placement of implants in maxillofacial prosthetics, but the field lacks a platform exclusively designed to perform the task. Virtual reality planning (VRP) specific for maxillofacial prosthetics offers the clinician improved control of the presurgical planning and the potential to limit the need to adapt other advanced segmentation software. Furthermore, the virtual plan can be directly translated to the patient through custom 3D printed (3DP) surgical guides and visual aids. To the best of our knowledge, this article outlines the development of the world's first virtual reality planning platform and workflow for pre-operatory planning within a VR environment for clinical use specific to facial prosthetics and anaplastology. METHOD The workflow was applied to managing 2 patients presenting with unilateral total exenteration and severe contracture enucleation, respectively (n=2). A cone-beam CT was acquired for each patient, and their data set was directly imported into the ImmersiveView Surgical Plan VR environment (ImmersiveTouch Inc, Chicago, IL). The clinicians virtually selected appropriately sized craniofacial implants and placed the implants in the desired orientation. Various measurement tools are available to aid in clinical decision-making. The ideal location of craniofacial implants was set according to an orbital and auricular prosthetic reconstruction. The resultant VR plan was exported for 3DP. The patients were evaluated preoperatively and postoperatively using the proposed VRP treatment. The workflow's data accuracy was validated postoperatively by comparing posterative CT data and the proposed VRP. Analysis was performed using Mimics software (Materialise, Leuven, Belgium). RESULT It takes, on average, 10 minutes to place 4 implants in the virtual reality space. The 3DP files resulting from VRP take ~2 hours to print and are constructed with a biocompatible resin appropriate for clinical use as surgical guides. Our user-friendly VRP workflow allows for an accurate simulation of surgical and nonsurgical procedures with an average displacement in XYZ of 0.6 mm and an SD of 0.3 mm. In addition, VRP is an excellent tool to simulate the craniofacial placement procedure and improves unsupervised self-learning teaching. CONCLUSION VRP is an exciting tool for training clinicians and students in complex surgical procedures. This study shows the promising applicability and efficiency of VR in clinical planning and management of facial rehabilitation. Patients allowed to interact with VR have been engaged, which would aid their treatment acceptance and patient education. A valuable advantage of surgical simulation is the reduced costs associated with renting instruments, buying implant dummies, and surgical hardware. The authors will explore VR to plan and treat surgical and nonsurgical reconstructive procedures and improve soft tissue manipulation. This study outlines the development of an original platform and workflow for segmentation, preoperative planning, and digital design within a VR environment and the clinical use in reconstructive surgery and anaplastology.
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Affiliation(s)
- Eduardo Arias-Amezquita
- Department of Surgery, The Craniofacial Center, Division of Plastic, Cosmetic, and Reconstructive Surgery, The University of Illinois, Chicago, IL
| | - Lee Alkureishi
- Department of Surgery, The Craniofacial Center, Division of Plastic, Cosmetic, and Reconstructive Surgery, The University of Illinois, Chicago, IL
| | - Chad Purnell
- Department of Surgery, The Craniofacial Center, Division of Plastic, Cosmetic, and Reconstructive Surgery, The University of Illinois, Chicago, IL
| | - Linping Zhao
- Department of Surgery, The Craniofacial Center, Division of Plastic, Cosmetic, and Reconstructive Surgery, The University of Illinois, Chicago, IL
| | - Olivia Lee
- The University of Illinois College of Medicine, Chicago, IL
| | | | - Pravin K Patel
- Department of Surgery, The Craniofacial Center, Division of Plastic, Cosmetic, and Reconstructive Surgery, The University of Illinois, Chicago, IL
| | - Mimis Cohen
- Department of Surgery, The Craniofacial Center, Division of Plastic, Cosmetic, and Reconstructive Surgery, The University of Illinois, Chicago, IL
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24
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Raila H, Avanesyan T, Valentine KE, Koo B, Huang C, Tsutsumi Y, Andreeff E, Qiu T, Muñoz Rodríguez PA, Varias A, Filippou-Frye M, van Roessel P, Bullock K, Periyakoil VS, Rodríguez CI. Augmenting group hoarding disorder treatment with virtual reality discarding: A pilot study in older adults. J Psychiatr Res 2023; 166:25-31. [PMID: 37716272 PMCID: PMC10803069 DOI: 10.1016/j.jpsychires.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/26/2023] [Accepted: 08/08/2023] [Indexed: 09/18/2023]
Abstract
Hoarding disorder is common and debilitating, especially in older adults, and novel treatment approaches are needed. Many current treatments emphasize skills related to discarding and decision-making about possessions, which can be practiced in the patient's home. However in many cases, in-home visits are unfeasible, or real-life discarding is too difficult. Virtual reality (VR) offers the ability to create a virtual "home" including 3D scans of the patient's actual possessions that can be moved or discarded. VR discarding is an alternative to in-home visits and an approach that provides a stepping stone to real-life discarding. VR has been successfully utilized to treat many disorders but tested minimally in hoarding disorder. In nine older adults with hoarding disorder, we tested an 8-week VR intervention administered to augment a 16-week Buried in Treasures group treatment. Individualized VR rooms were uniquely modeled after each patient's home. During clinician-administered VR sessions, patients practiced sorting and discarding their virtual possessions. The intervention was feasible to administer. Open-ended participant responses, examined by two independent evaluators, indicated that VR sessions were well-tolerated and that participants found them useful, with nearly all participants noting that VR helped them increase real-life discarding. Self-reported hoarding symptoms decreased from baseline to close, with seven of the nine participants showing reliable improvement in this timeframe and none showing deterioration. Results from this exploratory pilot study suggest that VR is a feasible way to simulate an at-home sorting and discarding experience in a manner that may augment skills acquisition. It remains an open question whether VR discarding practice yields greater improvement than existing treatments. VR for this population merits further clinical investigation.
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Affiliation(s)
- Hannah Raila
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA; Department of Psychology, University of California Santa Cruz, Santa Cruz, CA, USA.
| | - Tatevik Avanesyan
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Keara E Valentine
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Brenden Koo
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Chloe Huang
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Yuri Tsutsumi
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Elisabeth Andreeff
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Tori Qiu
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Paula Andrea Muñoz Rodríguez
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA; Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, USA
| | - Andrea Varias
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Maria Filippou-Frye
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Peter van Roessel
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA; Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Kim Bullock
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Vyjeyanthi S Periyakoil
- Department of Medicine, Stanford University, Palo Alto, CA, USA; Extended Care and Palliative Medicine Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Carolyn I Rodríguez
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.
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25
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Draschkow D, Anderson NC, David E, Gauge N, Kingstone A, Kumle L, Laurent X, Nobre AC, Shiels S, Võ MLH. Using XR (Extended Reality) for Behavioral, Clinical, and Learning Sciences Requires Updates in Infrastructure and Funding. POLICY INSIGHTS FROM THE BEHAVIORAL AND BRAIN SCIENCES 2023; 10:317-323. [PMID: 37900910 PMCID: PMC10602770 DOI: 10.1177/23727322231196305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
Extended reality (XR, including augmented and virtual reality) creates a powerful intersection between information technology and cognitive, clinical, and education sciences. XR technology has long captured the public imagination, and its development is the focus of major technology companies. This article demonstrates the potential of XR to (1) deliver behavioral insights, (2) transform clinical treatments, and (3) improve learning and education. However, without appropriate policy, funding, and infrastructural investment, many research institutions will struggle to keep pace with the advances and opportunities of XR. To realize the full potential of XR for basic and translational research, funding should incentivize (1) appropriate training, (2) open software solutions, and (3) collaborations between complementary academic and industry partners. Bolstering the XR research infrastructure with the right investments and incentives is vital for delivering on the potential for transformative discoveries, innovations, and applications.
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Affiliation(s)
- Dejan Draschkow
- Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Nicola C. Anderson
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Erwan David
- Department of Psychology, Scene Grammar Lab, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Nathan Gauge
- OxSTaR Oxford Simulation Teaching and Research, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Alan Kingstone
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Levi Kumle
- Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Xavier Laurent
- Centre for Teaching and Learning, University of Oxford, Oxford, UK
| | - Anna C. Nobre
- Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
- Department of Experimental Psychology, University of Oxford, Oxford, UK
- Wu Tsai Institute, Yale University, New Haven, USA
| | - Sally Shiels
- OxSTaR Oxford Simulation Teaching and Research, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Melissa L.-H. Võ
- Department of Psychology, Scene Grammar Lab, Goethe University Frankfurt, Frankfurt am Main, Germany
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26
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Rejbrand C, Fure B, Sonnby K. Stand-alone virtual reality exposure therapy as a treatment for social anxiety symptoms: a systematic review and meta-analysis. Ups J Med Sci 2023; 128:9289. [PMID: 37807998 PMCID: PMC10552696 DOI: 10.48101/ujms.v128.9289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 08/09/2023] [Indexed: 10/10/2023] Open
Abstract
Introduction Social anxiety is common and can have far-reaching implications for affected individuals, both on social life and working performance. Usage of virtual reality exposure therapy (VRET) has gained traction. The aim of the present systematic review was to evaluate the effect of stand-alone VRET on social anxiety symptoms. Method We searched systematically in PubMed, Embase, PSYCinfo, and ERIC in May 2022 for studies with participants with social anxiety symptoms receiving stand-alone VRET. Two reviewers independently selected relevant studies in a two-step procedure, and the risk of bias was assessed. Results Of 158 hits, 7 studies were selected for full-text reading, 6 were chosen for evaluation, and 5 were included in meta-analyses. VRET resulted in a significantly lower anxiety score in treated individuals with a standard mean difference of -0.82, 95% confidence interval -1.52 to -0.13, compared to controls. Conclusion Stand-alone VRET may reduce social anxiety symptoms. However, despite promising results, there is still uncertainty as the effect estimate is based on few studies with few participants each and a high risk of bias.
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Affiliation(s)
- Christian Rejbrand
- Faculty of Medicine and Health, School of Medical Sciences, Campus USÖ, Örebro, Sweden
| | - Brynjar Fure
- Faculty of Medicine and Health, School of Medical Sciences, Campus USÖ, Örebro, Sweden
- Centre for Clinical Research, Region Värmland, Karlstad, Sweden
| | - Karin Sonnby
- Centre for Clinical Research, Region Värmland, Karlstad, Sweden
- Centre for Clinical Research, Region Västmanland, Västerås, Sweden
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27
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Lee BM, Kim SW, Lee BJ, Won SH, Park YH, Kang CY, Li L, Rami FZ, Chung YC. Effects and safety of virtual reality-based mindfulness in patients with psychosis: a randomized controlled pilot study. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2023; 9:57. [PMID: 37704650 PMCID: PMC10499950 DOI: 10.1038/s41537-023-00391-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 08/30/2023] [Indexed: 09/15/2023]
Abstract
Virtual reality (VR) technology can be a supporting tool to enhance mindfulness. Recently, many research using VR-based mindfulness (VBM) has been carried out in various psychiatric disorders but not in psychosis. We investigated safety and effects of virtual reality-based mindfulness (VBM) in patients with psychosis as a pilot study. Sixty-four patients were randomly assigned to VBM or to VR control. For VBM, education and meditation videos were provided. For VR control, 3-dimensional natural scenes were shown. Both programs consisted of 8 weekly sessions, each lasting about 30 min. Pre- and post-assessments were performed using the experiences questionnaire (EQ), psychotic symptom rating scales-delusion (PSYRATS-D), PSYRATS-auditory hallucinations (AH), motivation and pleasure scale-self rating (MAP-SR) and etc. The safety questionnaire was also surveyed after 1st and 8th session. Physiological measures such as skin conductance level (SCL), heart rate (HR) and RR interval, were collected during the VR interventions. Limited individuals participated in the safety questionnaire and physiological measures. All the results were presented in mean and standard deviation. We did not observe significant results in group x time interaction and main effects of group and time in the decentering and clinical scales. However, within group comparison showed that patients randomized to VBM showed increased decentering (p = 0.029) and decreased amount (p = 0.032) and duration of preoccupation (p = 0.016) in the PSYRATS-D. For the feelings and motivations about close caring relationships of the MAP-SR, we observed a significant group x time interaction (p = 0.027). The frequency of VR sickness was high but its severity was mild. There were significant differences only in HR over time in the VBM group (p = 0.01). These results suggest that VBM was not more effective in reducing decentering and psychiatric symptoms than VR control but its adversity was modest.
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Affiliation(s)
- Bo Mi Lee
- Department of Psychiatry, Jeonbuk National University Medical School, Jeonju, 54907, Republic of Korea
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, 54907, Republic of Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, 501-746, Republic of Korea
| | - Bong Ju Lee
- Department of Psychiatry, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, 48108, Republic of Korea
| | - Seung-Hee Won
- Department of Psychiatry, Kyungpook National University School of Medicine, Daegu, 41944, Republic of Korea
| | | | - Chae Yeong Kang
- Department of Psychiatry, Jeonbuk National University Medical School, Jeonju, 54907, Republic of Korea
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, 54907, Republic of Korea
| | - Ling Li
- Department of Psychiatry, Jeonbuk National University Medical School, Jeonju, 54907, Republic of Korea
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, 54907, Republic of Korea
| | - Fatima Zahra Rami
- Department of Psychiatry, Jeonbuk National University Medical School, Jeonju, 54907, Republic of Korea
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, 54907, Republic of Korea
| | - Young-Chul Chung
- Department of Psychiatry, Jeonbuk National University Medical School, Jeonju, 54907, Republic of Korea.
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, 54907, Republic of Korea.
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Orr E, Arbel T, Levy M, Sela Y, Weissberger O, Liran O, Lewis J. Virtual reality in the management of patients with low back and neck pain: a retrospective analysis of 82 people treated solely in the metaverse. Arch Physiother 2023; 13:11. [PMID: 37194037 PMCID: PMC10189988 DOI: 10.1186/s40945-023-00163-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 03/31/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND Clinically, neck pain disorders (NPD) and non-specific low back pain (NS-LBP) are respectively the fourth and first most common conditions associated with the greatest number of years lived with disability. Remote delivery of care may benefit healthcare sustainability, reduce environmental pollution, and free up space for those requiring care non-virtual care. METHODS A retrospective analysis was performed on 82 participants with NS-LBP and/or NPD who received exercise therapy delivered solely in the metaverse using virtually reality. The study was to determine if this was achievable, safe, had appropriate outcome measures that could be collected, and if there was any early evidence of beneficial effects. RESULTS The study demonstrated that virtual reality treatment delivered via the metaverse appears to be safe (no adverse events or side effects). Data for more than 40 outcome measures were collected. Disability from NS-LBP was significantly reduced (Modified Oswestry Low Back Pain Disability Index) by 17.8% (p < 0.001) and from NPD (Neck Disability Index) by 23.2% (p = 0.02). CONCLUSIONS The data suggest that this method of providing exercise therapy was feasible, and safe (no adverse events reported), that complete reports were obtained from a large selection of patients, and that software acquired outcomes were obtainable over a range of time points. Further prospective research is necessary to better understand our clinical findings.
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Affiliation(s)
| | | | | | - Yaron Sela
- School of Psychology, Reichman University, Herzliya, Israel
| | | | - Omer Liran
- Cedars-Sinai, Division of Health Services Research, Department of Medicine, Los Angeles, CA, USA
- Department of Psychiatry and Behavioral Sciences, Cedars-Sinai, Los Angeles, CA, USA
| | - Jeremy Lewis
- Therapy Department, Central London Community Healthcare National Health Service Trust, Finchley Memorial Hospital, London, N12 0JE, UK.
- Clinical Therapies, University of Limerick, Limerick, Ireland.
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Schmidt V, König SU, Dilawar R, Sánchez Pacheco T, König P. Improved Spatial Knowledge Acquisition through Sensory Augmentation. Brain Sci 2023; 13:brainsci13050720. [PMID: 37239192 DOI: 10.3390/brainsci13050720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/13/2023] [Accepted: 04/20/2023] [Indexed: 05/28/2023] Open
Abstract
Sensory augmentation provides novel opportunities to broaden our knowledge of human perception through external sensors that record and transmit information beyond natural perception. To assess whether such augmented senses affect the acquisition of spatial knowledge during navigation, we trained a group of 27 participants for six weeks with an augmented sense for cardinal directions called the feelSpace belt. Then, we recruited a control group that did not receive the augmented sense and the corresponding training. All 53 participants first explored the Westbrook virtual reality environment for two and a half hours spread over five sessions before assessing their spatial knowledge in four immersive virtual reality tasks measuring cardinal, route, and survey knowledge. We found that the belt group acquired significantly more accurate cardinal and survey knowledge, which was measured in pointing accuracy, distance, and rotation estimates. Interestingly, the augmented sense also positively affected route knowledge, although to a lesser degree. Finally, the belt group reported a significant increase in the use of spatial strategies after training, while the groups' ratings were comparable at baseline. The results suggest that six weeks of training with the feelSpace belt led to improved survey and route knowledge acquisition. Moreover, the findings of our study could inform the development of assistive technologies for individuals with visual or navigational impairments, which may lead to enhanced navigation skills and quality of life.
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Affiliation(s)
- Vincent Schmidt
- Neurobiopsychology Group, Institute of Cognitive Science, University of Osnabrück, Wachsbleiche 27, 49090 Osnabrück, Germany
| | - Sabine U König
- Neurobiopsychology Group, Institute of Cognitive Science, University of Osnabrück, Wachsbleiche 27, 49090 Osnabrück, Germany
| | - Rabia Dilawar
- Neurobiopsychology Group, Institute of Cognitive Science, University of Osnabrück, Wachsbleiche 27, 49090 Osnabrück, Germany
| | - Tracy Sánchez Pacheco
- Neurobiopsychology Group, Institute of Cognitive Science, University of Osnabrück, Wachsbleiche 27, 49090 Osnabrück, Germany
| | - Peter König
- Neurobiopsychology Group, Institute of Cognitive Science, University of Osnabrück, Wachsbleiche 27, 49090 Osnabrück, Germany
- Department of Neurophysiology and Pathophysiology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
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Hawajri O, Lindberg J, Suominen S. Virtual Reality Exposure Therapy as a Treatment Method Against Anxiety Disorders and Depression-A Structured Literature Review. Issues Ment Health Nurs 2023; 44:245-269. [PMID: 37075308 DOI: 10.1080/01612840.2023.2190051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
Mental illness is a growing global health problem affecting individuals and society. In Sweden, the number of people suffering from mental health illnesses, such as anxiety and depression, is increasing and is expected to be one of the largest public health challenges in 2030. As mental illness increases, the area also needs effective forms of treatment. This study aims to investigate if Virtual Reality Exposure Therapy (VRET) works as a treatment method for adults suffering from anxiety disorders and depression. A structured literature review based on 24 articles found in the databases PubMed, MEDLINE, CINAHL and PsycInfo. Two reviewers independently reviewed and collectively extracted data from the included articles. The articles have been analyzed by using thematic analysis. The results suggest that Virtual reality exposure therapy can work as an effective treatment method for adults with anxiety disorders. It also indicates that VRET may act as a health-promoting intervention to reduce anxiety disorders, phobias, and depression symptoms. Virtual reality exposure therapy can be an effective treatment method and health-promoting effort against anxiety disorders in adults. An essential factor for the patients who accept VRET as a treatment is the initial information therapists give.
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Affiliation(s)
- Omar Hawajri
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden
| | | | - Sakari Suominen
- School of Health Sciences, University of Skövde, Skövde, Sweden
- Department of Public Health, University of Turku, Turku, Finland
- Turku University Hospital, Turku, Finland
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Wong KP, Lai CYY, Qin J. Systematic review and meta-analysis of randomised controlled trials for evaluating the effectiveness of virtual reality therapy for social anxiety disorder. J Affect Disord 2023; 333:353-364. [PMID: 37084968 DOI: 10.1016/j.jad.2023.04.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 03/28/2023] [Accepted: 04/14/2023] [Indexed: 04/23/2023]
Abstract
OBJECTIVE To evaluate the effectiveness of VR therapy (VRT) for symptoms related to social anxiety disorder (SAD), namely fear and avoidance of social interactions and performance situations (FASIP), fear of negative evaluation (FNE), anxiety and depression, a systematic review and meta-analysis were performed. METHODS Medline, PubMed, Science Direct, Web of Science, CINAHL, PsychINFO and Scopus were searched to include randomised controlled trials of VRT for SAD that met the criteria. A total of 15 RCTs with 720 participants published between 1998 and 2022 were included. Hedge's g with a 95 % confidence interval (CI) was adopted to compute the effect sizes. RESULTS Results showed no difference between the effect of VRT and CBT on FASIP, FNE, anxiety and depression and a large effect size for VRT versus the waitlist control group on FASIP (g = -1.170, 95 % CI: -2.056-0.283; p < 0.010). The moderator analysis demonstrated that VRT was superior to the controlled group in addressing FASIP, FNE and anxiety when the sample size was smaller than 50 and the number of sessions was five or fewer. LIMITATIONS Differences in hardware, software and intervention duration for VRT across studies. CONCLUSION This study confirmed the feasibility of VRT in alleviating the FASIP in patients with SAD, with the waitlist control group as a comparison. However, the effectiveness of VRT was not significant in FASIP, FNE, anxiety and depression compared to cognitive behavioural therapy (CBT). Additional social interaction scenarios should be developed in VRT, standardised hardware should be used and the proper length of exposure time to VR should be determined to enhance the efficacy of VRT.
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Affiliation(s)
- Ka Po Wong
- Centre for Smart Health, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China; Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China.
| | - Cynthia Yuen Yi Lai
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
| | - Jing Qin
- Centre for Smart Health, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
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32
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Lohse L, Jelinek L, Moritz S, Blömer J, Bücker L, Miegel F. Efficacy of exposure and response prevention therapy in mixed reality for patients with obsessive-compulsive disorder: study protocol for a randomized controlled trial. BMC Psychol 2023; 11:113. [PMID: 37055854 PMCID: PMC10100604 DOI: 10.1186/s40359-023-01116-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 03/07/2023] [Indexed: 04/15/2023] Open
Abstract
Many patients with obsessive-compulsive disorder (OCD) do not receive cognitive behavioral therapy with exposure and response prevention (first line treatment for OCD), for example, due to patients' fear of the exposure and reservations of the therapists. Technology-supported exposure (e.g., exposure therapy with response prevention in mixed reality [MERP]) for patients with OCD may help to overcome this obstacle. Building upon findings of our pilot study objectives of this study are to evaluate the efficacy, expectations of treatment success, feasibility, and acceptance of MERP as well as to identify possible limitations. In total, 64 outpatients with contamination-related OCD will be recruited and randomized to one of two conditions: MERP (six sessions in six weeks) and self-guided exposure therapy (six exercises in six weeks). Participants will be assessed before (baseline), after the six-week intervention period (post), as well as three months after post assessment (follow-up) regarding symptomatology (Yale-Brown Obsessive Compulsive Scale; Y-BOCS), their subjective evaluation of MERP (acceptance) and sense of presence. The planned study is the first to investigate MERP in patients with OCD.
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Affiliation(s)
- Luzie Lohse
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
| | - Lena Jelinek
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Jannik Blömer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Lara Bücker
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Franziska Miegel
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
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Monferrer M, García AS, Ricarte JJ, Montes MJ, Fernández-Caballero A, Fernández-Sotos P. Facial emotion recognition in patients with depression compared to healthy controls when using human avatars. Sci Rep 2023; 13:6007. [PMID: 37045889 PMCID: PMC10097677 DOI: 10.1038/s41598-023-31277-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 03/09/2023] [Indexed: 04/14/2023] Open
Abstract
The negative, mood-congruent cognitive bias described in depression, as well as excessive rumination, have been found to interfere with emotional processing. This study focuses on the assessment of facial recognition of emotions in patients with depression through a new set of dynamic virtual faces (DVFs). The sample consisted of 54 stable patients compared to 54 healthy controls. The experiment consisted in an emotion recognition task using non-immersive virtual reality (VR) with DVFs of six basic emotions and neutral expression. Patients with depression showed a worst performance in facial affect recognition compared to healthy controls. Age of onset was negatively correlated with emotion recognition and no correlation was observed for duration of illness or number of lifetime hospitalizations. There was no correlation for the depression group between emotion recognition and degree of psychopathology, excessive rumination, degree of functioning, or quality of life. Hence, it is important to improve and validate VR tools for emotion recognition to achieve greater methodological homogeneity of studies and to be able to establish more conclusive results.
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Affiliation(s)
- Marta Monferrer
- Servicio de Salud de Castilla-La Mancha, Complejo Hospitalario Universitario de Albacete, Servicio de Salud Mental, 02004, Albacete, Spain
| | - Arturo S García
- Departmento de Sistemas Informáticos, Universidad de Castilla-La Mancha, 02071, Albacete, Spain
- Neurocognition and Emotion Unit, Instituto de Investigación en Informática de Albacete, 02071, Albacete, Spain
| | - Jorge J Ricarte
- Departmento de Psicología, Universidad de Castilla-La Mancha, 02071, Albacete, Spain
| | - María J Montes
- Servicio de Salud de Castilla-La Mancha, Complejo Hospitalario Universitario de Albacete, Servicio de Salud Mental, 02004, Albacete, Spain
| | - Antonio Fernández-Caballero
- Departmento de Sistemas Informáticos, Universidad de Castilla-La Mancha, 02071, Albacete, Spain
- Neurocognition and Emotion Unit, Instituto de Investigación en Informática de Albacete, 02071, Albacete, Spain
- CIBERSAM-ISCIII (Biomedical Research Networking Centre in Mental Health, Instituto de Salud Carlos III), 28016, Madrid, Spain
| | - Patricia Fernández-Sotos
- Servicio de Salud de Castilla-La Mancha, Complejo Hospitalario Universitario de Albacete, Servicio de Salud Mental, 02004, Albacete, Spain.
- CIBERSAM-ISCIII (Biomedical Research Networking Centre in Mental Health, Instituto de Salud Carlos III), 28016, Madrid, Spain.
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34
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Gillouin PA, Mattatia D, Bouvet C. Virtual reality for clinical evaluation and treatment in schizophrenia: a systematic review. PSYCHOSIS 2023. [DOI: 10.1080/17522439.2023.2197030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Affiliation(s)
- Pierre-Antoine Gillouin
- Laboratoire de psychologique clinique UR CLIPSYD EA4430, Department of Psychology, Université Paris-Nanterre, Nanterre, France
| | - David Mattatia
- Laboratoire de psychologique clinique UR CLIPSYD EA4430, Department of Psychology, Université Paris-Nanterre, Nanterre, France
| | - Cyrille Bouvet
- Laboratoire de psychologique clinique UR CLIPSYD EA4430, Department of Psychology, Université Paris-Nanterre, Nanterre, France
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35
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Fan L, Wang J, Li Q, Song Z, Dong J, Bao F, Wang X. Eye movement characteristics and visual fatigue assessment of virtual reality games with different interaction modes. Front Neurosci 2023; 17:1173127. [PMID: 37065908 PMCID: PMC10102480 DOI: 10.3389/fnins.2023.1173127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 03/13/2023] [Indexed: 04/03/2023] Open
Abstract
This study aimed to investigate the eye movement characteristics and visual fatigue of virtual reality games with different interaction modes. Eye movement data were recorded using the built-in eye tracker of the VR device and eye movement parameters were calculated from the recorded raw data. The Visual Fatigue Scales and Simulator Sickness Questionnaire were used to subjectively assess visual fatigue and overall discomfort of the VR experience. Sixteen male and 17 female students were recruited for this study. Results showed that both the primary and 360 mode of VR could cause visual fatigue after 30 min of gameplay, with significant differences observed in eye movement behavior between the two modes. The primary mode was more likely to cause visual fatigue, as shown by objective measurements of blinking and pupil diameter. Fixation and saccade parameters also showed significant differences between the two modes, possibly due to the different interaction modes employed in the 360 mode. Further research is required to examine the effects of different content and interactive modes of VR on visual fatigue, as well as to develop more objective measures for assessing it.
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Affiliation(s)
- Lei Fan
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- School of Ophthalmology and Optometry and School of Biomedical Engineering, Wenzhou Medical University, Wenzhou, China
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Junjie Wang
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- School of Ophthalmology and Optometry and School of Biomedical Engineering, Wenzhou Medical University, Wenzhou, China
| | - Qi Li
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Zhenhao Song
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Jinhui Dong
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Fangjun Bao
- National Engineering Research Center of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, China
- School of Ophthalmology and Optometry and School of Biomedical Engineering, Wenzhou Medical University, Wenzhou, China
- *Correspondence: Fangjun Bao,
| | - Xiaofei Wang
- School of Ophthalmology and Optometry and School of Biomedical Engineering, Wenzhou Medical University, Wenzhou, China
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
- Xiaofei Wang,
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36
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Klowait N. On the Multimodal Resolution of a Search Sequence in Virtual Reality. HUMAN BEHAVIOR AND EMERGING TECHNOLOGIES 2023. [DOI: 10.1155/2023/8417012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
In virtual reality (VR), participants may not always have hands, bodies, eyes, or even voices—using VR helmets and two controllers, participants control an avatar through virtual worlds that do not necessarily obey familiar laws of physics; moreover, the avatar’s bodily characteristics may not neatly match our bodies in the physical world. Despite these limitations and specificities, humans get things done through collaboration and the creative use of the environment. While multiuser interactive VR is attracting greater numbers of participants, there are currently few attempts to analyze the in situ interaction systematically. This paper proposes a video-analytic detail-oriented methodological framework for studying virtual reality interaction. Using multimodal conversation analysis, the paper investigates a nonverbal, embodied, two-person interaction: two players in a survival game strive to gesturally resolve a misunderstanding regarding an in-game mechanic—however, both of their microphones are turned off for the duration of play. The players’ inability to resort to complex language to resolve this issue results in a dense sequence of back-and-forth activity involving gestures, object manipulation, gaze, and body work. Most crucially, timing and modified repetitions of previously produced actions turn out to be the key to overcome both technical and communicative challenges. The paper analyzes these action sequences, demonstrates how they generate intended outcomes, and proposes a vocabulary to speak about these types of interaction more generally. The findings demonstrate the viability of multimodal analysis of VR interaction, shed light on unique challenges of analyzing interaction in virtual reality, and generate broader methodological insights about the study of nonverbal action.
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King AL, Acquaye-Mallory AA, Vera E, Mendoza T, Reyes J, Stockdill ML, Gilbert MR, Armstrong TS. Feasibility and preliminary efficacy of a virtual reality intervention targeting distress and anxiety in primary brain tumor patients at the time of clinical evaluation: Study protocol for a phase 2 clinical trial. BMC Cancer 2023; 23:262. [PMID: 36944930 PMCID: PMC10030076 DOI: 10.1186/s12885-023-10671-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 02/22/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Primary brain tumor (PBT) patients experience higher levels of distress and anxiety than other solid tumor patients, particularly at the time of clinical evaluation when uncertainty about disease status is high ("scanxiety"). There is promising evidence supporting use of virtual reality (VR) to target psychological symptoms in other solid tumor patients, though PBT patients have not been studied extensively in this context. The primary aim of this phase 2 clinical trial is to establish the feasibility of a remote VR-based relaxation intervention for a PBT population, with secondary aims designed to determine preliminary efficacy of improving distress and anxiety symptoms. METHODS PBT patients (N = 120) with upcoming MRI scans and clinical appointments who meet eligibility will be recruited to participate in a single arm trial conducted remotely through the NIH. Following completion of baseline assessments, participants will complete a 5-min VR intervention via telehealth using a head-mounted immersive device while under supervision of the research team. Following the intervention, over the course of 1 month patients can use VR at their discretion with follow-up assessments done immediately post-VR intervention, as well as 1 week and 4 weeks later. Additionally, a qualitative phone interview will be conducted to assess patient satisfaction with the intervention. DISCUSSION Use of immersive VR is an innovative interventional approach to target distress and scanxiety symptoms in PBT patients who are at high risk for experiencing these symptoms leading into their clinical appointments. Findings from this study may inform design of a future multicenter randomized VR trial for PBT patients and may aid in development of similar interventions for other oncology populations. TRIAL REGISTRATION Clinicaltrials.gov (NCT04301089), registered 9 March 2020.
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Affiliation(s)
- Amanda L King
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892, USA.
| | - Alvina A Acquaye-Mallory
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Elizabeth Vera
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Tito Mendoza
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Jennifer Reyes
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Macy L Stockdill
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Mark R Gilbert
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Terri S Armstrong
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892, USA
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Perra A, Galetti A, Zaccheddu R, Locci A, Piludu F, Preti A, Primavera D, Di Natale L, Nardi AE, Kurotshka PK, Cossu G, Sancassiani F, Stella G, De Lorenzo V, Zreik T, Carta MG. A Recovery-Oriented Program for People with Bipolar Disorder through Virtual Reality-Based Cognitive Remediation: Results of a Feasibility Randomized Clinical Trial. J Clin Med 2023; 12:jcm12062142. [PMID: 36983145 PMCID: PMC10056011 DOI: 10.3390/jcm12062142] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/02/2023] [Accepted: 03/07/2023] [Indexed: 03/11/2023] Open
Abstract
Background: Cognitive impairment is a frequent consequence of bipolar disorder (BD) that is difficult to prevent and treat. In addition, the quality of the preliminary evidence on the treatment of BD through Cognitive Remediation (CR) with traditional methods is poor. This study aims to evaluate the feasibility of a CR intervention with fully immersive Virtual Reality (VR) as an additional treatment for BD and offers preliminary data on its efficacy. Methods: Feasibility randomized controlled cross-over clinical study, with experimental condition lasting three months, crossed between two groups. Experimental condition: CR fully immersive VR recovery-oriented program plus conventional care; Control condition: conventional care. The control group began the experimental condition after a three months period of conventional care (waiting list). After the randomization of 50 people with BD diagnosis, the final sample consists of 39 participants in the experimental condition and 25 in the control condition because of dropouts. Results: Acceptability and tolerability of the intervention were good. Compared to the waitlist group, the experimental group reported a significant improvement regarding cognitive functions (memory: p = 0.003; attention: p = 0.002, verbal fluency: p = 0.010, executive function: p = 0.003), depressive symptoms (p = 0.030), emotional awareness (p = 0.007) and biological rhythms (p = 0.029). Conclusions: The results are preliminary and cannot be considered exhaustive due to the small sample size. However, the evidence of efficacy, together with the good acceptability of the intervention, is of interest. These results suggest the need to conduct studies with larger samples that can confirm this data. Trial registration: ClinicalTrialsgov NCT05070065, registered in September 2021
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Affiliation(s)
- Alessandra Perra
- International PhD in Innovation Sciences and Technologies, University of Cagliari, 09124 Cagliari, Italy
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
- Correspondence:
| | - Alessia Galetti
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Rosanna Zaccheddu
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Aurora Locci
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Federica Piludu
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Antonio Preti
- Department of Neuroscience, University of Turin, 10125 Turin, Italy
| | - Diego Primavera
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | | | - Antonio Egidio Nardi
- Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro 21941-901, Brazil
| | | | - Giulia Cossu
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Federica Sancassiani
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Giusy Stella
- Department of Mental Health and Pathological Addiction, ASL 5, 00034 Rome, Italy
| | | | - Thurayya Zreik
- Mental Health Service User Association, 11072070 Beirut, Lebanon
| | - Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
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King AL, Roche KN, Leeper HE, Vera E, Mendoza T, Mentges K, Acquaye-Mallory AA, Adegbesan KA, Boris L, Burton E, Choi A, Grajkowska E, Kunst T, Levine J, Lollo N, Miller H, Panzer M, Penas-Prado M, Pillai V, Polskin L, Reyes J, Sahebjam S, Stockdill ML, Theeler BJ, Wu J, Gilbert MR, Armstrong TS. Feasibility of a virtual reality intervention targeting distress and anxiety symptoms in patients with primary brain tumors: Interim analysis of a phase 2 clinical trial. J Neurooncol 2023; 162:137-145. [PMID: 36884201 PMCID: PMC9993385 DOI: 10.1007/s11060-023-04271-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 02/15/2023] [Indexed: 03/09/2023]
Abstract
PURPOSE Cancer patients experience distress and anxiety when undergoing imaging studies to monitor disease status, yet these symptoms are not always appropriately identified or well-managed. This interim analysis of a phase 2 clinical trial explored feasibility and acceptability of a virtual reality relaxation (VR) intervention for primary brain tumor (PBT) patients at the time of clinical evaluation. METHODS English speaking, adult PBT patients with previous reports of distress and upcoming neuroimaging were recruited between March of 2021 and March 2022. A brief VR session was done within 2 weeks prior to neuroimaging with patient-reported outcomes (PROs) collected before and immediately post-intervention. Self-directed VR use over the next 1 month was encouraged with additional PROs assessments at 1 and 4 weeks. Feasibility metrics included enrollment, eligibility, attrition, and device-related adverse effects with satisfaction measured with qualitative phone interviews. RESULTS Fifty-five patients were approached via email, 40 (73%) responded and 20 (50%) enrolled (9 declines, 11 screen fails). 65% of participants were ≤ 50 years, 50% were male, 90% were White/non-Hispanic, 85% had good KPS (≥ 90), and most were on active treatment. All patients completed the VR intervention, PROs questionnaires, weekly check-ins, and qualitative interview. Most (90%) reported frequent VR use and high satisfaction and only 7 mild AEs were recorded (headache, dizziness, nausea, neck pain). CONCLUSION This interim analysis supports feasibility and acceptability of a novel VR intervention to target psychological symptoms for PBT patients. Trial enrollment will continue to assess for intervention efficacy. TRIAL REGISTRATION NCT04301089 registered on 3/9/2020.
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Affiliation(s)
- Amanda L King
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, USA. .,Office of Patient-Centered Outcomes Research, National Cancer Institute, National Institutes of Health, 9030 Old Georgetown Road, Bethesda, MD, 20892, USA.
| | - Kayla N Roche
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, USA
| | - Heather E Leeper
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, USA
| | - Elizabeth Vera
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, USA.,Office of Patient-Centered Outcomes Research, National Cancer Institute, National Institutes of Health, 9030 Old Georgetown Road, Bethesda, MD, 20892, USA
| | - Tito Mendoza
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, USA.,Office of Patient-Centered Outcomes Research, National Cancer Institute, National Institutes of Health, 9030 Old Georgetown Road, Bethesda, MD, 20892, USA
| | - Kelly Mentges
- Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Inc., Frederick, USA
| | | | - Kendra A Adegbesan
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, USA
| | - Lisa Boris
- Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Inc., Frederick, USA
| | - Eric Burton
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, USA
| | - Anna Choi
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, USA
| | - Ewa Grajkowska
- Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Inc., Frederick, USA
| | - Tricia Kunst
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, USA
| | - Jason Levine
- Center for Cancer Research Office of Information Technology, National Cancer Institute, National Institutes of Health, Bethesda, USA
| | - Nicole Lollo
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, USA
| | - Hope Miller
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, USA
| | - Marissa Panzer
- Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Inc., Frederick, USA
| | - Marta Penas-Prado
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, USA
| | - Valentina Pillai
- Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Inc., Frederick, USA
| | - Lily Polskin
- Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Inc., Frederick, USA
| | - Jennifer Reyes
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, USA
| | - Solmaz Sahebjam
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, USA
| | - Macy L Stockdill
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, USA
| | - Brett J Theeler
- Uniformed Services University of the Health Sciences, Bethesda, USA
| | - Jing Wu
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, USA
| | - Mark R Gilbert
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, USA
| | - Terri S Armstrong
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, USA
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Lopes K, Dessieux T, Rousseau C, Beloeil H. Virtual Reality as a Hypnotic Tool in the Management of Anxiety During the Performance of the Axillary Block. J Med Syst 2023; 47:31. [PMID: 36856907 DOI: 10.1007/s10916-023-01923-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 02/08/2023] [Indexed: 03/02/2023]
Abstract
Regional anaesthesia is a gold standard in upper limb orthopaedic surgery. Carried out on an awake patient, it can be a source of anxiety. In recent years, hypnotic techniques have been proposed in the management of perioperative anxiety. Among them, virtual reality is increasingly used as a distraction tool during anxious or painful actions despite the scarcity of proof of its benefit in the literature. Before implementing the systematic use of virtual reality when performing regional anaesthesia in our institution, we designed a study hypothesizing that the use of a virtual reality headset when performing an axillary block would reduce patient's anxiety. The study is an investigator-initiated, prospective monocentric and observational trial comparing anxiety scores of patients who underwent upper limb surgery under an axillary block with or without virtual reality headset. The perioperative anxiety was assessed by a numerical range scale before and after the peripheral nerve block performance. Between June 2021 and June 2022, 99 patients were included: 53 wearing the virtual reality headset and 46 not. The difference in numerical range scale for anxiety before and after the axillary block performance did not differ in the virtual reality group compared to the group without headset (mean = -1.9 ± 2.5 vs -1.5 ± 2.0, (p = 0.2520)). Technical difficulties reported by the operators were similar in both groups. Despite the large number of patients included, the virtual reality headset did not reduce patient's anxiety during a peripheral nerve block. Perioperative anxiety was low in all patients.
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Affiliation(s)
- Kelly Lopes
- CHU Rennes, Anesthesia and Intensive Care Department, Univ Rennes, Rennes, F-35000, France
| | - Thierry Dessieux
- CHU Rennes, Anesthesia and Intensive Care Department, Univ Rennes, Rennes, F-35000, France
| | - Chloe Rousseau
- Univ Rennes, CHU Rennes, Inserm, CIC-1414, Biostatistics, Rennes, F-35000, France
| | - Helene Beloeil
- Anesthesia and Intensive Care Department, Univ Rennes, CHU Rennes, Inserm, CIC-1414, COSS-1242, Rennes, F-35000, France.
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Sorribes De Ramón LA, Ferrández Martínez AF, García Carricondo AR, Espín Gálvez F, Alarcón Rodríguez R. Effect of virtual reality and music therapy on anxiety and perioperative pain in surgical extraction of impacted third molars. J Am Dent Assoc 2023; 154:206-214. [PMID: 36707274 DOI: 10.1016/j.adaj.2022.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 11/11/2022] [Accepted: 11/12/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND The objective of this study was to evaluate the effect of virtual reality (VR) and music therapy on anxiety and perioperative pain in patients undergoing extraction of impacted third molars. METHODS A total of 275 patients who had to undergo surgery for third-molar extraction participated in a randomized controlled trial and were divided into 3 parallel groups: music therapy intervention (n = 91), VR intervention (n = 93), and control (n = 91). The Spielberger State-Trait Anxiety Inventory and the visual analog scale of pain intensity were used as measurements in this study. RESULTS Patients in the music therapy and VR groups showed a greater reduction in anxiety level scores after third-molar extraction surgery (reduction in total anxiety in music group: 15.12; 95% CI, 13.16 to 17.08; Rosenthal r, 1.61; P < .001; reduction in total anxiety in VR group: 9.80; 95% CI, 7.66 to 11.95; Rosenthal r, 0.97; P < .001; reduction in total anxiety in control group: 9.80; 95% CI, 7.66 to 11.95; Rosenthal r, 0.97; P < .001). The intensity of pain after the intervention was lower in patients in the music therapy group than patients in the control group (P = .04). After the intervention, the music therapy and VR groups presented a significant decrease in systolic blood pressure (P < .05), diastolic blood pressure (P < .05), and heart rate (P < .05) compared with the control group. CONCLUSIONS These findings suggest that the use of music therapy and VR during third-molar extraction surgery reduces anxiety and improves the patient's physiological parameters. PRACTICAL IMPLICATIONS Implementation of these interventions (noninvasive, nonpharmacologic, economic) in the field of oral and maxillofacial surgery and dentistry could improve procedures performed under local anesthesia, improving the clinical experience of patients. This clinical trial was registered with the Australian New Zealand Clinical Trials Registry. The registration number is ACTRN12622000384752.
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King AL, Acquaye AA, Mendoza T, Reyes J, Stockdill M, Gilbert MR, Armstrong TS, Vera E. Feasibility and preliminary efficacy of a virtual reality intervention targeting distress and anxiety in primary brain tumor patients at the time of clinical evaluation: Study protocol for a phase 2 clinical trial. RESEARCH SQUARE 2023:rs.3.rs-2521990. [PMID: 36865245 PMCID: PMC9980195 DOI: 10.21203/rs.3.rs-2521990/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
Background: Primary brain tumor (PBT) patients experience higher levels of distress and anxiety than other solid tumor patients, particularly at the time of clinical evaluation when uncertainty about disease status is high ("scanxiety"). There is promising evidence supporting use of virtual reality (VR) to target psychological symptoms in other solid tumor patients, though PBT patients have not been studied extensively in this context. The primary aim of this phase 2 clinical trial is to establish the feasibility of a remote VR-based relaxation intervention for a PBT population, with secondary aims designed to determine preliminary efficacy of improving distress and anxiety symptoms. Methods: PBT patients (N=120) with upcoming MRI scans and clinical appointments who meet eligibility will be recruited to participate in a single arm trial conducted remotely through the NIH. Following completion of baseline assessments, participants will complete a 5-minute VR intervention via telehealth using a head-mounted immersive device while under supervision of the research team. Following the intervention, over the course of 1 month patients can use VR at their discretion with follow-up assessments done immediately post-VR intervention, as well as 1 week and 4 weeks later. Additionally, a qualitative phone interview will be conducted to assess patient satisfaction with the intervention. Discussion: Use of immersive VR is an innovative interventional approach to target distress and scanxiety symptoms in PBT patients who are at high risk for experiencing these symptoms leading into their clinical appointments. Findings from this study may inform design of a future multicenter randomized VR trial for PBT patients and may aid in development of similar interventions for other oncology populations. Trial Registration: clinicaltrials.gov (NCT04301089), registered 9 March 2020.
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Affiliation(s)
- Amanda L. King
- National Cancer Institute, National Institutes of Health
| | | | - Tito Mendoza
- National Cancer Institute, National Institutes of Health
| | - Jennifer Reyes
- National Cancer Institute, National Institutes of Health
| | - Macy Stockdill
- National Cancer Institute, National Institutes of Health
| | | | | | - Elizabeth Vera
- National Cancer Institute, National Institutes of Health
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Restout J, Bernache-Assollant I, Morizio C, Boujut A, Angelini L, Tchalla A, Perrochon A. Fully Immersive Virtual Reality Using 360° Videos to Manage Well-Being in Older Adults: A Scoping Review. J Am Med Dir Assoc 2023; 24:564-572. [PMID: 36758621 DOI: 10.1016/j.jamda.2022.12.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 12/20/2022] [Accepted: 12/31/2022] [Indexed: 02/08/2023]
Abstract
OBJECTIVE The development of negative behavioral and psychosocial factors (depression, anxiety, apathy, etc) is associated with poor well-being, which can contribute to health issues in ageing, especially in the context of COVID-19. Despite its relative novelty, fully immersive virtual reality (VR) interventions through 360° immersive videos are becoming more accessible and flexible and constitute an emerging method to potentially enhance well-being. The aim of this scoping review is to assess the effectiveness of 360° interventions on well-being in older adults with or without cognitive impairment, as well as cybersickness and attitudes toward this technology. DESIGN Scoping review. SETTING AND PARTICIPANTS Older adults with or without cognitive impairment. METHODS The PRISMA-SR guideline was followed. Four databases were used, and we selected articles published until April 2022. We have analyzed the effect of 360° videos on the well-being of older adults with respect to the study design, the population, the contents, the duration of intervention, and the outcomes. RESULTS A total of 2262 articles were screened, of which 10 articles were finally included in this review. Most of them are pilot studies and used mixed methods including scales and interviews. The material and content of VR are diversified. Many behavioral and psychological outcomes were assessed, including anxiety, apathy, loneliness, depression, social engagement, quality of life, and emotions. The results were positive or mixed, according to the outcomes. We recorded few adverse events, and the interviews show contrasting results concerning the participants' feelings (ie, degree of immersion, familiarity with technology, and VR content). CONCLUSIONS AND IMPLICATIONS The use of VR 360° videos seems feasible in community-dwelling older adults or residential aged care facilities, as they are safe and provide enjoyment. It constitutes an emerging and promising therapeutic tool to manage psychosocial disorders. This review provides key considerations for the design and implementation of interventions using VR 360° video in clinical practice.
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Affiliation(s)
- J Restout
- Université de Limoges, HAVAE, UR20217, Limoges, France
| | | | - C Morizio
- Université de Limoges, HAVAE, UR20217, Limoges, France
| | - A Boujut
- Université de Limoges, HAVAE, UR20217, Limoges, France; 3iL Groupe, Limoges, France
| | - L Angelini
- School of Management Fribourg, HES-SO, Fribourg, Switzerland; Humantech Institute, HES-SO, Fribourg, Switzerland
| | - A Tchalla
- CHU de Limoges, Pôle HU gérontologie clinique, Limoges, France; Laboratoire VieSanté, UR 24134 (Vieillissement, Fragilité, Prévention, e-Santé), IFR OMEGA HEALTH, Université de Limoges, Limoges, France
| | - A Perrochon
- Université de Limoges, HAVAE, UR20217, Limoges, France.
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Sánchez-Nieto D, Castaño-Castaño S, Navarro-Martos R, Obrero-Gaitán E, Cortés-Pérez I, Nieto-Escamez F. An Intervention on Anxiety Symptoms in Moderate Alzheimer's Disease through Virtual Reality: A Feasibility Study and Lessons Learned. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20032727. [PMID: 36768091 PMCID: PMC9915234 DOI: 10.3390/ijerph20032727] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 05/28/2023]
Abstract
(1) Background: Although cognitive impairment is considered the core deficit of dementia, anxiety disorders also have a negative influence on the social and daily life of the affected population. We have explored the exposure of relaxing scenarios in immersive Virtual Reality (iVR) as an intervention strategy for people with moderate Alzheimer's disease. (2) Methods: Three participants were recruited from a day center to participate in a five-week study, which included a Pre- and Post-evaluation with the Montreal Cognitive Assessment (MoCA), Neuropsychiatric Inventory-Questionnaire (NPI-Q), Clinical Dementia Rating Scale (CDR), Global Deterioration Scale (GDS), Hamilton Anxiety Rating Scale (HARS), State-Trait Anxiety Inventory (STAI), and the anxiety subdomain of the Neuropsychiatric Inventory (NPI). Participants' heart rate, oxygen saturation, arterial pressure, and respiratory rate were also monitored during intervention sessions. Three virtual scenarios from Nature Treks VR were used as the intervention over three weeks (a total of nine sessions). (3) Results: Post-intervention anxiety assessment showed a light reduction in psychological anxiety in the HARS questionnaire. A light reduction in heart rate was also observed during the exposure to iVR. (4) Discussion: The use of virtual scenarios was a satisfactory experience for all the participants. Preliminary data point to a relaxing effect of iVR scenarios and a potential reduction in psychological anxiety, but further research is required to confirm the efficacy of the intervention.
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Affiliation(s)
- Desirée Sánchez-Nieto
- VIVALDI Day Stay Unit, Avda. Reino de España 184, Roquetas de Mar, 04740 Almería, Spain
| | | | - Remedios Navarro-Martos
- Department Psychology, University of Almería, Carretera del Sacramento S/N, 04120 Almería, Spain
| | - Esteban Obrero-Gaitán
- Department Health Sciences, University of Jaén, Campus Las Lagunillas S/N, 23071 Jaén, Spain
| | - Irene Cortés-Pérez
- Department Health Sciences, University of Jaén, Campus Las Lagunillas S/N, 23071 Jaén, Spain
| | - Francisco Nieto-Escamez
- Department Psychology, University of Almería, Carretera del Sacramento S/N, 04120 Almería, Spain
- Center for Neuropsychological Assessment and Rehabilitation (CERNEP), University of Almería, Carretera del Sacramento S/N, 04120 Almería, Spain
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From virtual to prosocial reality: The effects of prosocial virtual reality games on preschool Children's prosocial tendencies in real life environments. COMPUTERS IN HUMAN BEHAVIOR 2023. [DOI: 10.1016/j.chb.2022.107546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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King AL, Roche KN, Leeper HE, Vera E, Mendoza T, Mentges K, Acquaye AA, Adegbesan K, Boris L, Burton E, Choi A, Grajkowska E, Kunst T, Levine J, Lollo N, Miller H, Panzer M, Penas-Prado M, Pillai V, Polskin L, Reyes J, Sahebjam S, Stockdill M, Theeler BJ, Wu J, Gilbert MR, Armstrong TS. Feasibility of a virtual reality intervention targeting distress and anxiety symptoms in patients with primary brain tumors: Interim analysis of a phase 2 clinical trial. RESEARCH SQUARE 2023:rs.3.rs-2522094. [PMID: 36789426 PMCID: PMC9928043 DOI: 10.21203/rs.3.rs-2522094/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Purpose: Cancer patients experience distress and anxiety when undergoing imaging studies to monitor disease status, yet these symptoms are not always appropriately identified or well-managed. This interim analysis of a phase 2 clinical trial explored feasibility and acceptability of a virtual reality relaxation (VR) intervention for primary brain tumor (PBT) patients at the time of clinical evaluation. Methods: English speaking, adult PBT patients with previous reports of distress and upcoming neuroimaging were recruited between March of 2021 and March 2022. A brief VR session was done within 2 weeks prior to neuroimaging with patient-reported outcomes (PROs) collected before and immediately post-intervention. Self-directed VR use over the next 1 month was encouraged with additional PROs assessments at 1 and 4 weeks. Feasibility metrics included enrollment, eligibility, attrition, and device-related adverse effects with satisfaction measured with qualitative phone interviews. Results: 55 patients were approached via email, 40 (73%) responded and 20 (50%) enrolled (9 declines, 11 screen fails). 65% of participants were ≤ 50 years, 50% were male, 90% were White/non-Hispanic, 85% had good KPS (≥ 90), and most were on active treatment. All patients completed the VR intervention, PROs questionnaires, weekly check-ins, and qualitative interview. Most (90%) reported frequent VR use and high satisfaction and only 7 mild AEs were recorded (headache, dizziness, nausea, neck pain). Conclusion: This interim analysis confirmed feasibility and acceptability of a novel VR intervention to target psychological symptoms for PBT patients. Trial enrollment will continue to assess for intervention efficacy. Trial Registration: NCT04301089 registered on 3/9/2020.
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Affiliation(s)
- Amanda L King
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health
| | - Kayla N Roche
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health
| | - Heather E Leeper
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health
| | - Elizabeth Vera
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health
| | - Tito Mendoza
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health
| | - Kelly Mentges
- Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Inc
| | - Alvina A Acquaye
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health
| | - Kendra Adegbesan
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health
| | - Lisa Boris
- Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Inc
| | - Eric Burton
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health
| | - Anna Choi
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health
| | - Ewa Grajkowska
- Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Inc
| | - Tricia Kunst
- Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Inc
| | - Jason Levine
- Center for Cancer Research Office of Information Technology, National Cancer Institute, National Institutes of Health
| | - Nicole Lollo
- Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Inc
| | - Hope Miller
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health
| | - Marissa Panzer
- Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Inc
| | - Marta Penas-Prado
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health
| | - Valentina Pillai
- Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Inc
| | - Lily Polskin
- Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Inc
| | - Jennifer Reyes
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health
| | - Solmaz Sahebjam
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health
| | - Macy Stockdill
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health
| | | | - Jing Wu
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health
| | - Mark R Gilbert
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health
| | - Terri S Armstrong
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health
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Mavragani A, Tchao D, Lewis-Fung S, Pardini S, Harris LR, Appel L. Virtual Reality Therapy for People With Epilepsy and Related Anxiety: Protocol for a 3-Phase Pilot Clinical Trial. JMIR Res Protoc 2023; 12:e41523. [PMID: 36692939 PMCID: PMC9906303 DOI: 10.2196/41523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Anxiety is one of the most common psychiatric comorbidities in people with epilepsy and often involves fears specifically related to the condition, such as anxiety related to the fear of having another seizure. These epilepsy- or seizure-related fears have been reported as being more disabling than the seizures themselves and significantly impact quality of life. Although research has suggested that exposure therapy (ET) is helpful in decreasing anxiety in people with epilepsy, no research to our knowledge has been conducted on ET in people with epilepsy using virtual reality (VR). The use of novel technologies such as an immersive VR head-mounted display for ET in this population offers several benefits. Indeed, using VR can increase accessibility for people with epilepsy with transportation barriers (eg, those who live outside urban centers or who have a suspended driver's license owing to their condition), among other advantages. In the present research protocol, we describe the design of an innovative VR-ET program administered in the home that focuses on decreasing anxiety in people with epilepsy, specifically anxiety related to their epilepsy or seizures. OBJECTIVE Our primary objective is to examine the feasibility of the study protocol and proposed treatment as well as identify suggestions for improvement when designing subsequent larger clinical trials. Our secondary objective is to evaluate whether VR-ET is effective in decreasing anxiety in a pilot study. We hypothesize that levels of anxiety in people with epilepsy will decrease from using VR-ET. METHODS This mixed methods study comprises 3 phases. Phase 1 involves engaging with those with lived experience through a web-based questionnaire to validate assumptions about anxiety in people with epilepsy. Phase 2 involves filming videos using a 360° camera for the VR-ET intervention (likely consisting of 3 sets of scenes, each with 3 intensity levels) based on the epilepsy- and seizure-related fears most commonly reported in the phase 1 questionnaire. Finally, phase 3 involves evaluating the at-home VR-ET intervention and study methods using a series of validated scales, as well as semistructured interviews. RESULTS This pilot study was funded in November 2021. Data collection for phase 1 was completed as of August 7, 2022, and had a final sample of 18 participants. CONCLUSIONS Our findings will add to the limited body of knowledge on anxiety in people with epilepsy and the use of VR in this population. We anticipate that the insights gained from this study will lay the foundation for a novel and accessible VR intervention for this underrecognized and undertreated comorbidity in people with epilepsy. TRIAL REGISTRATION ClinicalTrials.gov NCT05296057; https://clinicaltrials.gov/ct2/show/NCT05296057. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/41523.
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Affiliation(s)
| | | | | | - Susanna Pardini
- OpenLab, University Health Network, Toronto, ON, Canada.,Department of General Psychology, University of Padova, Padova, Italy.,Digital Health Lab, Centre for Health and Wellbeing, Bruno Kessler Foundation, Trento, Italy
| | | | - Lora Appel
- OpenLab, University Health Network, Toronto, ON, Canada.,School of Health Policy & Management, York University, Toronto, ON, Canada.,Michael Garron Hospital, Toronto, ON, Canada
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Gendia A, Rehman M, Cota A, Gilbert J, Clark J. Can virtual reality technology be considered as a part of the surgical care pathway? Ann R Coll Surg Engl 2023; 105:2-6. [PMID: 36374265 PMCID: PMC9773243 DOI: 10.1308/rcsann.2022.0125] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2022] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Virtual reality (VR) is emerging as a new technology in the healthcare sector. It has been shown to enhance the patient's experience and satisfaction in various settings. This review aims to give a brief description of the use of VR and establish validity of its applications to improve the patient's pathway through surgery. METHODS A literature search was conducted using the PubMed and Embase™ databases to identify fields in which VR technology has been trialled in relation to surgery. The search terms 'virtual reality' and 'surgery' were employed. RESULTS Although benefits relating to VR use have been identified in mental health, obesity management, and physical and cognitive rehabilitation, those in surgery have been less well documented. There are, however, some important but limited benefits reported in managing surgery related stress and improving preoperative patient education as well as VR being an adjunct to some level of postoperative analgesia. CONCLUSIONS The current applications of VR in relation to surgical care fall into four main categories: preoperative education, supporting mental health, postoperative pain management, and pre and postoperative patient optimisation. Future studies and validation of VR applications should be carried out so the technology can be utilised throughout the entire patient pathway as VR surgical care bundles.
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Affiliation(s)
- A Gendia
- Royal Cornwall Hospitals NHS Trust, UK
| | - M Rehman
- Northampton General Hospital NHS Trust, UK
| | - A Cota
- Royal Cornwall Hospitals NHS Trust, UK
| | - J Gilbert
- Royal Cornwall Hospitals NHS Trust, UK
| | - J Clark
- Royal Cornwall Hospitals NHS Trust, UK
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Maples-Keller JL, Sherrill A, Reddi P, Norrholm SD, Rothbaum BO. Extinction-Based Exposure Therapies Using Virtual Reality. Curr Top Behav Neurosci 2023; 64:335-352. [PMID: 37566312 DOI: 10.1007/7854_2023_437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2023]
Abstract
The focus of this chapter is an overview of integrating virtual reality (VR) technology within the context of exposure therapy for anxiety disorders, a gold standard treatment, with a focus on how VR can help facilitate extinction learning processes integral to these interventions. The chapter will include an overview of advantages of incorporating VR within exposure therapy, and benefits specifically within an inhibitory learning approach for extinction training. A review of the empirical literature on the effectiveness of VR exposure therapy for specific phobia and PTSD will be provided, as well as practical overview of how to effectively incorporate VR within exposure therapy.
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Affiliation(s)
- Jessica L Maples-Keller
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA.
| | - Andrew Sherrill
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Preethi Reddi
- Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Seth D Norrholm
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Barbara O Rothbaum
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
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Krittanawong C, Isath A, Katz CL, Kaplin S, Wang Z, Ma M, Storch EA, Torous J, Ellis SR, Lavie CJ. Public perception of metaverse and mental health on Twitter: A sentiment analysis. Prog Cardiovasc Dis 2023; 76:99-101. [PMID: 36442668 DOI: 10.1016/j.pcad.2022.11.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | - Ameesh Isath
- Department of Cardiology, Westchester Medical Centre, New York Medical College, Valhalla, NY, USA
| | - Craig L Katz
- Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Health System Design & Global Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Scott Kaplin
- Department of Cardiovascular Medicine, NYU Langone - Long Island, Mineola, NY, USA
| | - Zhen Wang
- Mayo Clinic Evidence-based Practice Center, Rochester, MN, USA; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA; Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Minhua Ma
- Falmouth University, Falmouth, England, UK
| | - Eric A Storch
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Boston, MA, USA
| | - John Torous
- Division of Digital Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, USA; Massachusetts Mental Health Center, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | | | - Carl J Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA, USA
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