Evaluation of the Efficacy of Immersive Virtual Reality Therapy as a Method Supporting Pulmonary Rehabilitation: A Randomized Controlled Trial.

Sebastian Rutkowski,Joanna Szczepańska-Gieracha,Jan Szczegielniak

doi:10.3390/jcm10020352

Abstract

Anxiety has been estimated to occur in 21–96% and depression in 27–79% of patients with chronic obstructive pulmonary disorder (COPD). We found a scarcity of literature providing evidence on how virtual reality (VR) therapy affects the intensity of depressive and anxiety symptoms and stress levels in COPD patients undergoing in-hospital pulmonary rehabilitation (PR). This study enrolled 50 COPD patients with symptoms of stress, depression, and anxiety, randomly assigned to one of two groups. The two groups participated in the traditional PR programme additionally: the VR-group performed 10 sessions of immersive VR-therapy and the control group performed 10 sessions of Schultz autogenic training. Comparison of the changes in stress levels and depressive and anxiety symptoms was the primary outcome. Analysis of the results showed a reduction in stress levels only in the VR-group (p < 0.0069), with a medium effect size (d = 0.353). The symptoms of depression (p < 0.001, d = 0.836) and anxiety (p < 0.0009, d = 0.631) were statistically significantly reduced only in the VR-group, with a strong effect size. The enrichment of pulmonary rehabilitation with immersive VR therapy brings benefits in terms of mood improvement and reduction in anxiety and stress in patients with COPD.

Highlights

Chronic obstructive pulmonary disease (COPD) is a major threat to public health and is recognized as one of the most impactful of the common chronic diseases, making it the second most common cause of disability and the third leading cause of death globally [1]
The study adhered to the Declaration of Helsinki guidance, ethical approval was obtained from the Research Ethics Committee of the University School of Physical Education in Wrocław, Poland (Resolution No 18/2020) and the study was registered in ClinicalTrials.gov (NCT04601545)
In the first model, which considered stress levels, 6MWT and FEV1 were independently associated with an improvement in the Perception of Stress Questionnaire (PSQ) total score (Table 3)

Summary

Introduction

Chronic obstructive pulmonary disease (COPD) is a major threat to public health and is recognized as one of the most impactful of the common chronic diseases, making it the second most common cause of disability and the third leading cause of death globally [1]. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) defines COPD as a disease state characterized by airflow limitation, causing shortness of breath, significant systemic effects involving the lung and extrapulmonary adverse reactions, with a high disease rate, high disability rate, high mortality rate and a long course of disease [2]. Prevalence studies indicated that patients with COPD are four times more likely to develop depression than those without COPD. Such patients rarely receive the appropriate comprehensive treatment [5]. Anxiety has been estimated to occur in 21–96% and depression in 27–79% of patients with COPD, values that are higher than for the general population or other chronic diseases [9]

Methods

Results

Conclusion