1
|
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 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.
Collapse
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
| |
Collapse
|
2
|
Micheluzzi V, Burrai F, Casula M, Serra G, Al Omary S, Merella P, Casu G. Effectiveness of virtual reality on pain and anxiety in patients undergoing cardiac procedures: A systematic review and meta-analysis of randomized controlled trials. Curr Probl Cardiol 2024; 49:102532. [PMID: 38503359 DOI: 10.1016/j.cpcardiol.2024.102532] [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: 03/14/2024] [Accepted: 03/15/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND Cardiac procedures often induce pain and anxiety in patients, adversely impacting recovery. Pharmachological approaches have limitations, prompting exploration of innovative digital solutions like virtual reality (VR). Although early evidence suggests a potential favourable benefit with VR, it remains unclear whether the implementation of this technology can improve pain and anxiety. We aimed to assess by a systematic review and meta-analysis the effectiveness of VR in alleviating anxiety and pain on patients undergoing cardiac procedures. METHODS Our study adhered to the PRISMA method and was registered in PROSPERO under the code CRD42024504563. The search was carried out in the PubMed, Web of Science, Scopus, and the Cochrane Library databases in January 2024. Four randomized controlled trials were included (a total of 382 patients). Risk of bias was employed to assess the quality of individual studies, and a random-effects model was utilized to examine the overall effect. RESULTS The results showed that VR, when compared to the standard of care, had a statistically significant impact on anxiety (SMD = -0.51, 95 % CI: -0.86 to -0.16, p = 0.004), with a heterogeneity I2 = 57 %. VR did not show a significant difference in terms of pain when compared to standard care (SMD= -0.34, 95 % CI: -0.75 to -0.07, p = 0.10). The included trials exhibited small sample sizes, substantial heterogeneity, and variations in VR technology types, lengths, and frequencies. CONCLUSIONS VR effectively lowers anxiety levels in patients undergoing cardiac procedures, however, did not show a statistically significant difference on pain.
Collapse
Affiliation(s)
| | - Francesco Burrai
- Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
| | - Marta Casula
- Clinical and interventional cardiology, University Hospital, Sassari, Italy; Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
| | - Giuseppe Serra
- Clinical and interventional cardiology, University Hospital, Sassari, Italy; Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
| | - Shadi Al Omary
- Clinical and interventional cardiology, University Hospital, Sassari, Italy; Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
| | - Pierluigi Merella
- Clinical and interventional cardiology, University Hospital, Sassari, Italy
| | - Gavino Casu
- Clinical and interventional cardiology, University Hospital, Sassari, Italy; Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy.
| |
Collapse
|
3
|
Micheluzzi V, Navarese EP, Merella P, Talanas G, Viola G, Bandino S, Idini C, Burrai F, Casu G. Clinical application of virtual reality in patients with cardiovascular disease: state of the art. Front Cardiovasc Med 2024; 11:1356361. [PMID: 38633842 PMCID: PMC11021579 DOI: 10.3389/fcvm.2024.1356361] [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: 12/15/2023] [Accepted: 03/14/2024] [Indexed: 04/19/2024] Open
Abstract
Virtual reality offers a multisensory experience to patients, allowing them to hear, watch, and interact in a virtual environment. Immersive virtual reality is particularly suitable for the purpose of completely isolating patients from the external environment to transport them away from the suffering related to the disease. On this state of the art, we summarize the available literature on the effectiveness of virtual reality on various physical and psychological outcomes in patients with atherosclerotic cardiovascular disease. Virtual reality has been employed in the cardiovascular field in various settings such as cardiac rehabilitation, interventional cardiology, and cardiac surgery. This technology offers promising opportunities to improve several outcomes related to cardiovascular disease, but further research is needed to entirely capture its benefits and to standardize the intervention.
Collapse
Affiliation(s)
- Valentina Micheluzzi
- Clinical and Experimental Cardiology, Clinical and Interventional Cardiology, University Hospital, Sassari, Italy
- Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
| | - Eliano Pio Navarese
- Clinical and Experimental Cardiology, Clinical and Interventional Cardiology, University Hospital, Sassari, Italy
- Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
| | - Pierluigi Merella
- Clinical and Experimental Cardiology, Clinical and Interventional Cardiology, University Hospital, Sassari, Italy
- Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
| | - Giuseppe Talanas
- Clinical and Experimental Cardiology, Clinical and Interventional Cardiology, University Hospital, Sassari, Italy
| | - Graziana Viola
- Clinical and Experimental Cardiology, Clinical and Interventional Cardiology, University Hospital, Sassari, Italy
| | - Stefano Bandino
- Clinical and Experimental Cardiology, Clinical and Interventional Cardiology, University Hospital, Sassari, Italy
| | - Chiara Idini
- Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
| | - Francesco Burrai
- Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
| | - Gavino Casu
- Clinical and Experimental Cardiology, Clinical and Interventional Cardiology, University Hospital, Sassari, Italy
- Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
| |
Collapse
|
4
|
Bashir ZS, Misquith C, Has P, Bukhari SM. The Effectiveness of Virtual Reality on Anxiety and Pain Management in Patients Undergoing Cardiac Procedures: A Systematic Review and Meta-Analysis. Cureus 2024; 16:e57557. [PMID: 38707015 PMCID: PMC11068510 DOI: 10.7759/cureus.57557] [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] [Accepted: 04/03/2024] [Indexed: 05/07/2024] Open
Abstract
Cardiac procedure-related anxiety and pain can adversely affect outcomes and lead to patient dissatisfaction. Virtual reality (VR) offers a promising alternative to traditional therapies for improving patient experience. Our objective is to synthesize evidence and assess the effectiveness of VR in reducing cardiac procedure-related anxiety and pain compared to standard of care. We conducted a comprehensive search across various online databases, including MEDLINE, EMBASE, CINAHL, Web of Sciences, and COCHRANE, to identify relevant randomized controlled trials (RCTs) focusing on VR, cardiac procedures, anxiety, and pain. We utilized a random-effect model to generate effect estimates reported as standardized mean differences (SMD) with a 95% confidence interval. Our review comprised 10 studies with a total of 621 participants (intervention arm: 301, control arm: 320). Overall, among the seven studies evaluating anxiety outcomes, no significant difference in anxiety reduction was observed between the intervention and control groups (standardized mean difference (SMD) -0.62, 95% CI -1.61, 0.37, p=0.22). However, studies using the same anxiety assessment tool demonstrated a significant improvement in the VR arm (SMD -1.01, 95% CI -1.98, -0.04, p=0.04). Conversely, the narrative synthesis of four studies examining pain revealed mixed results. Our findings suggest no significant difference in anxiety reduction between the VR and control groups. Future studies should employ standardized tools for assessing and reporting anxiety and pain to better understand the potential of VR in enhancing patient experience during cardiac procedures.
Collapse
Affiliation(s)
- Zubair S Bashir
- Department of Medicine, Warren Alpert Medical School, Brown University, Providence, USA
| | | | - Phinnara Has
- Lifespan Biostatistics, Epidemiology and Research Design, Rhode Island Hospital, Brown University, Providence, USA
| | | |
Collapse
|
5
|
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.
Collapse
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
| |
Collapse
|
6
|
Micheluzzi V, Casu G, Sanna GD, Canu A, Iovino P, Caggianelli G, Vellone E. Improving adherence to rehabilitation for heart failure patients through immersive virtual reality (VIRTUAL-HF): A protocol for a randomized controlled trial. Contemp Clin Trials 2024; 138:107463. [PMID: 38302011 DOI: 10.1016/j.cct.2024.107463] [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: 11/04/2023] [Revised: 01/02/2024] [Accepted: 01/24/2024] [Indexed: 02/03/2024]
Abstract
BACKGROUND To improve symptoms and reduce poor outcomes related to heart failure (HF), international guidelines recommend cardiac rehabilitation (CR), particularly for those with a reduced ejection fraction. Unfortunately, patient adherence to rehabilitation programs remains suboptimal, with dropouts ranging from 15.4 to 63.3%. An innovative and promising intervention that could improve adherence to rehabilitation is virtual reality (VR). This study aims to evaluate the effects of VR in patients with HF who undergo CR using this technology in terms of adherence (primary outcome), functional capacity, perceived exertion, angina, quality of life, heart rate, oxygen saturation, blood pressure, maximum oxygen uptake, minute ventilation/carbon dioxide production slope, oxygen pulse, blood values of NT-proBNP and HF related rehospitalization rates (secondary outcomes). METHODS A randomized controlled trial will be conducted in a sample of 80 patients referred to CR. Participants will be enrolled in a cardiological rehabilitation unit of a large university hospital in Italy and randomized (1:1) to the experimental intervention consisting of CR performed with high-quality immersive VR with PICO 4® Head Mounted Display headset and TREADMILL XR® software (Arm 1) or standard CR (Arm 2). Patients, according to guidelines, will perform 30-min of CR sessions with moderate intensity, twice a week for one month. RESULTS Significant improvements in primary and secondary outcomes are expected in patients in the intervention group. CONCLUSIONS If proven to be effective, VR could be an innovative, safe, and easy digital health intervention to improve adherence to CR in patients with HF, as well as important clinical outcomes.
Collapse
Affiliation(s)
- Valentina Micheluzzi
- Clinical and Interventional Cardiology, Sassari University Hospital, Sassari, Italy; Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.
| | - Gavino Casu
- Clinical and Interventional Cardiology, Sassari University Hospital, Sassari, Italy; Department of Medicine, and Pharmacy, University of Sassari, Sassari, Italy
| | | | - Antonella Canu
- Clinical and Interventional Cardiology, Sassari University Hospital, Sassari, Italy
| | - Paolo Iovino
- Health Sciences Department, University of Florence, Florence, Italy
| | | | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy; Department of Nursing and Obstetrics, Wroclaw Medical University, Wrocław, Poland
| |
Collapse
|
7
|
Shrestha AB, Taha AM, Siddiq A, Shrestha S, Thakur P, Chapagain S, Sharma S, Halder A, Rajak K, Shah V. Virtual and augmented reality in cardiovascular care in low and middle income country. Curr Probl Cardiol 2024; 49:102380. [PMID: 38191103 DOI: 10.1016/j.cpcardiol.2024.102380] [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: 12/24/2023] [Accepted: 01/04/2024] [Indexed: 01/10/2024]
Abstract
The global health sector has witnessed an escalating integration of Virtual Reality (VR) and Augmented Reality (AR) technologies, particularly in high-income countries. The application of these cutting-edge technologies is gradually extending to Low- and Middle-Income Countries (LMICs), notably in the domain of cardiovascular care. AR and VR technologies are revolutionizing cardiovascular care by offering solutions for diagnosis, medical training, and surgical planning. AR and VR provide detailed and immersive visualizations of cardiac structures, aiding in diagnosis and intervention planning. In cardiovascular care, VR reduces patient-reported pain, eases anxiety, and accelerates post-procedural recovery. AR and VR are also valuable for life support training, creating immersive and controlled learning environments. AR and VR have the potential to significantly impact healthcare in low- and middle-income countries with enhanced accessibility and affordability. This review outlines the existing spectrum of VR and AR adoption and its burgeoning utility in the cardiovascular domain within LMICs.
Collapse
Affiliation(s)
- Abhigan Babu Shrestha
- Department of Internal medicine, M Abdur Rahim Medical College, Dinajpur, Bangladesh.
| | | | | | | | - Prince Thakur
- Nepalgunj Medical College and Research Institute, Nepalgunj, Nepal
| | | | | | - Anupam Halder
- Department of Internal Medicine, UPMC Harrisburg, PA, United States
| | - Kripa Rajak
- Department of Internal Medicine, UPMC Harrisburg, PA, United States
| | - Vaibhav Shah
- Department of Internal Medicine, Icahn School of Medicine, Mount Sinai- Elmhurst Hospital Centre, New York, United States
| |
Collapse
|
8
|
Larsson CE, Cabassut V, Peretout P, Marliere S, Vautrin E, Piliero N, Salvat M, Riou L, Vanzetto G, Vilotitch A, Bosson JL, Barone-Rochette G. Assessment of the Objective Effect of Virtual Reality for Preoperative Anxiety in Interventional Cardiology. Am J Cardiol 2023; 205:207-213. [PMID: 37611412 DOI: 10.1016/j.amjcard.2023.07.130] [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: 03/29/2023] [Revised: 07/19/2023] [Accepted: 07/26/2023] [Indexed: 08/25/2023]
Abstract
The management of anxiety because of upcoming invasive coronary angiography (ICA) remains suboptimal. Previously published studies investigating the potential of virtual reality (VR) for the reduction of anxiety in ICA procedures used a subjective evaluation method. The purpose of this study was to determine whether the use of a VR program before ICA objectively decreases anxiety as assessed by the SD of normal to normal (SDNN). Lower SDNN is associated with worse anxiety. A total of 156 patients referred for ICA after a positive noninvasive test for coronary disease were included in the present randomized study. The interventional group benefited from the use of a VR mask in the transfer room before ICA, whereas the control group underwent the procedure as usual. In both groups, SDNN was measured before ICA. No statistical difference in SDNN was observed between the VR and control groups (45.5 ± 17.8 vs 50.6 ± 19.5, p = 0.12). The preoperative use of a VR mask for anxiolytic purposes in the setting of ICA did not result in a decrease in anxiety.
Collapse
Affiliation(s)
| | - Verane Cabassut
- Department of Cardiology, University Hospital, Grenoble Alpes, Grenoble, France
| | - Pauline Peretout
- Department of Cardiology, University Hospital, Grenoble Alpes, Grenoble, France
| | - Stéphanie Marliere
- Department of Cardiology, University Hospital, Grenoble Alpes, Grenoble, France
| | - Estelle Vautrin
- Department of Cardiology, University Hospital, Grenoble Alpes, Grenoble, France
| | - Nicolas Piliero
- Department of Cardiology, University Hospital, Grenoble Alpes, Grenoble, France
| | - Muriel Salvat
- Department of Cardiology, University Hospital, Grenoble Alpes, Grenoble, France
| | - Laurent Riou
- Univ. Grenoble Alpes, Institut national de la santé et de la recherche médicale (INSERM), CHU Grenoble Alpes, LRB, 38000 Grenoble, France
| | - Gerald Vanzetto
- Department of Cardiology, University Hospital, Grenoble Alpes, Grenoble, France; Univ. Grenoble Alpes, Institut national de la santé et de la recherche médicale (INSERM), CHU Grenoble Alpes, LRB, 38000 Grenoble, France; French Clinical Research Infrastructure Network, Paris, France
| | | | - Jean Luc Bosson
- TIMC Laboratory Centre national de la recherche scientifique (CNRS)-UMR 5525, University Grenoble Alpes, Grenoble, France; Public Health Department, CHU Grenoble Alpes, 38000, Grenoble, France
| | - Gilles Barone-Rochette
- Department of Cardiology, University Hospital, Grenoble Alpes, Grenoble, France; Univ. Grenoble Alpes, Institut national de la santé et de la recherche médicale (INSERM), CHU Grenoble Alpes, LRB, 38000 Grenoble, France; French Clinical Research Infrastructure Network, Paris, France.
| |
Collapse
|
9
|
Bouraghi H, Mohammadpour A, Khodaveisi T, Ghazisaeedi M, Saeedi S, Familgarosian S. Virtual Reality and Cardiac Diseases: A Systematic Review of Applications and Effects. JOURNAL OF HEALTHCARE ENGINEERING 2023; 2023:8171057. [PMID: 37287540 PMCID: PMC10243949 DOI: 10.1155/2023/8171057] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 01/22/2023] [Accepted: 03/04/2023] [Indexed: 06/09/2023]
Abstract
Introduction Cardiac diseases have grown significantly in recent years, causing many deaths globally. Cardiac diseases can impose a significant economic burden on societies. The development of virtual reality technology has attracted the attention of many researchers in recent years. This study aimed to investigate the applications and effects of virtual reality (VR) technology on cardiac diseases. Methods A comprehensive search was carried out in four databases, including Scopus, Medline (through PubMed), Web of Science, and IEEE Xplore to identify related articles published until May 25, 2022. Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) guideline for systematic reviews was followed. All randomized trials that investigated the effects of virtual reality on cardiac diseases were included in this systematic review. Results Twenty-six studies were included in this systematic review. The results illustrated that virtual reality applications in cardiac diseases can be classified in three categories of physical rehabilitation, psychological rehabilitation, and education/training. This study revealed that the use of virtual reality in psychological and physical rehabilitation can reduce stress, emotional tension, Hospital Anxiety and Depression Scale (HADS) total score, anxiety, depression, pain, systolic blood pressure, and length of hospitalization. Finally, the use of virtual reality in education/training can enhance technical performance, increase the speed of procedures, and improve the user's skills, level of knowledge, and self-confidence as well as facilitate learning. Also, the most limitations mentioned in the studies included small sample size and lack of or short duration of follow-up. Conclusions The results showed that the positive effects of using virtual reality in cardiac diseases are much more than its negative effects. Considering that the most limitations mentioned in the studies were the small sample size and short duration of follow-up, it is necessary to conduct studies with adequate methodological quality to report their effects in the short term and long term.
Collapse
Affiliation(s)
- Hamid Bouraghi
- Department of Health Information Technology, School of Allied Medical Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ali Mohammadpour
- Department of Health Information Technology, School of Allied Medical Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Taleb Khodaveisi
- Department of Health Information Technology, School of Allied Medical Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Marjan Ghazisaeedi
- Department of Health Information Management and Medical Informatics, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheila Saeedi
- Department of Health Information Technology, School of Allied Medical Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
- Clinical Research Development Unit of Farshchian Hospital, Hamadan University of Medical Sciences, Hamadan, Iran
| | | |
Collapse
|
10
|
Bashir Z, Misquith C, Shahab A, Has P, Bukhari S. The impact of Virtual Reality on Anxiety and Functional Capacity in Cardiac Rehabilitation: A Systematic Review and Meta-analysis. Curr Probl Cardiol 2023; 48:101628. [PMID: 36736604 DOI: 10.1016/j.cpcardiol.2023.101628] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 01/23/2023] [Indexed: 02/03/2023]
Abstract
BACKGROUND The overall utilization of cardiac rehabilitation (CR) is low despite its proven benefits in secondary prevention. Virtual reality (VR), a novel method of rehabilitation, may increase overall compliance. The purpose of this systematic review and meta-analysis is to synthesize evidence and report whether the addition of VR leads to an improvement in anxiety and functional capacity (FC) compared to standard CR. METHODS A comprehensive search strategy was used to search the online databases for the randomized controlled trials (RCTs) on VR-CR. Statistical analysis was performed using Stata SE version 17.0 (College Station, TX) and RevMan5. RESULTS A total of 747 study participants were part of 7 studies included in the meta-analysis. Three studies were part of the narrative synthesis. Anxiety showed significant improvement in VR-CR compared to standard CR (SMD -0.32, 95% CI -0.61, -0.03). There was no significant improvement in FC between VR-CR and the standard CR (SMD 0.077, 95% CI -1.24, 1.32). CONCLUSION VR-CR significantly improved CR-related anxiety compared to standard CR. However, no significant improvement in FC was found in VR-CR compared to the standard CR. Further studies are needed to assess the impact of non-immersive and immersive VR on FC.
Collapse
Affiliation(s)
- Zubair Bashir
- Department of Medicine, Alpert Medical School of Brown University, Providence, RI, USA
| | | | - Ahmed Shahab
- Department of Medicine, Alpert Medical School of Brown University, Providence, RI, USA
| | - Phinnara Has
- Lifespan Biostatistics, Epidemiology and Research Design, Rhode Island Hospital, Providence, RI, USA
| | - Syed Bukhari
- Department of Medicine, Temple University, Philadelphia, PA, USA.
| |
Collapse
|
11
|
Shahab A, Misquith C, Bashir Z. Impact of virtual reality on cardiac rehabilitation-related anxiety: a protocol for systematic review and meta-analysis. Open Heart 2022; 9:openhrt-2022-002094. [DOI: 10.1136/openhrt-2022-002094] [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] [Received: 07/20/2022] [Accepted: 10/13/2022] [Indexed: 11/09/2022] Open
Abstract
IntroductionCardiac rehabilitation has proven beneficial in cardiovascular patients and is strongly recommended for secondary prevention after a coronary event. However, overall utilisation of cardiac rehabilitation is often low. The addition of novel methods of rehabilitation may increase overall compliance with cardiac rehabilitation. The use of virtual reality (VR) has been adopted in a variety of therapeutic ways such as physical rehabilitation in neurological diseases, rehabilitation for various psychiatric illnesses and postcancer rehabilitation in breast cancer survivors. In our meta-analysis, we wish to assess whether the addition of VR (fully immersive or non-immersive) leads to an improvement in anxiety and functional capacity compared with standard cardiac rehabilitation at any phase of the rehabilitation process.Method and analysisThis systematic review and meta-analysis protocol was structured according to the published Preferred Reporting for Systematic Review and Meta-analysis—Protocol guidelines. We will devise a search strategy to use online databases to search for the randomised controlled trials. Inclusion criteria and exclusion criteria will be defined. The articles will be reviewed by two independent reviewers and any conflict will be adjudicated through discussion. The bias in the selected studies will be assessed using Cochrane risk-of-bias tool for randomised trials (RoB 2). The outcome of interest will be anxiety and functional capacity. Effect estimates will be reported as standardised mean difference with 95% CI. Fixed effect model will be used if I2<60%, otherwise random effect model will be used to estimate the effect size.Ethics and disseminationThere will be no direct involvement of the patient or the public in the conception, design, data collection and analysis of this systematic review and meta-analysis. Results of this systematic review and meta-analysis will be disseminated via journal articles. In accordance with the guidelines, our systematic review protocol is prospectively registered with the International Prospective Register of Systematic Reviews (PROSPERO) on 07 August 2022.PROSPERO IDCRD 42022342736.
Collapse
|