The Potential of Personalized Virtual Reality in Palliative Care: A Feasibility Trial

BACKGROUND: Virtual Reality can help alleviate symptoms in a non-palliative care population. Personalized therapy can further alleviate these symptoms. There is little evidence in a palliative care population. AIM: To understand the feasibility of repeated personalized virtual reality sessions in a palliative care population. DESIGN: A feasibility randomized control trial. Intervention: personalized virtual reality, Control: non-personalized virtual reality. All participants completed a 4-minute virtual reality session for 4 weeks. At each point, the Edmonton Symptom Assessment System-Revised (scored 0 = none up to 100 = worst) was completed pre- and post- each session. A time-series regression analysis was completed for the overall effect. SETTING/PARTICIPANTS: The research took place in one hospice. The main inclusion criteria was: (1) under the care of the hospice (2) advanced disease (3) over 18 years (4) physically able to use virtual reality set (5) capacity (6) proficient English. RESULTS: Twenty-six participants enrolled, of which 20 (77%) completed all sessions. At baseline, the intervention group had a mean pre- score of 26.3 (SD 15.1) which reduced to 11.5 (SD 12.6) after the first session. At the same time point, the control group had a mean pre- score of 37.9 (SD 21.6) which reduced to 25.5 (SD 17.4) post-session. The mean scores dropped following each session, however this was not significant (mean difference = -1.3, 95% CI: -6.4 to 3.7, p = 0.601). CONCLUSIONS: It is feasible to complete repeated virtual reality sessions within a palliative care population. Future research should explore the structure and effectiveness of virtual reality in a fully powered trial

Personalized Virtual Reality Environments for Intervention with People with Disability

[Abstract] Background: Virtual reality (VR) is a technological resource that allows the generation of an environment of great realism while achieving user immersion. The purpose of this project is to use VR as a complementary tool in the rehabilitation process of people with physical and cognitive disabilities. An approach based on performing activities of daily living is proposed. Methods: Through joint work between health and IT professionals, the VR scenarios and skills to be trained are defined. We organized discussion groups in which health professionals and users with spinal injury, stroke, or cognitive impairment participated. A testing phase was carried out, followed by a qualitative perspective. As materials, Unity was used as a development platform, HTC VIVE as a VR system, and Leap Motion as a hand tracking device and as a means of interacting with the scenarios. Results: A VR application was developed, consisting of four scenarios that allow for practicing different activities of daily living. Three scenarios are focused on hand mobility rehabilitation, while the remaining scenario is intended to work on a cognitive skill related to the identification of elements to perform a task. Conclusions: Performing activities of daily living using VR environments provides an enjoyable, motivating, and safe means of rehabilitation in the daily living process of people with disabilities and is a valuable source of information for healthcare professionals to assess a patient’s evolution.The APC was funded by the National Program of R + D+i oriented to the Challenges of Society 2019 (coordinated research) Grant number: PID2019-104323RB-C33. Ministry of science and innovation.The APC was funded by the National Program of R + D+i oriented to the Challenges of Society 2019 (coordinated research) Grant number: PID2019-104323RB-C33. Ministry of science and innovation. The research was done in the Center CITIC, which is a Research Center accredited by Galician University System (Xunta de Galicia). CITIC is partly supported by “Consellería de Cultura, Educación e Universidades from Xunta de Galicia”, which provided 80% of funds through ERDF Funds, ERDF Operational Programme Galicia 2014-2020, and the remaining 20% was provided by “Secretaría Xeral de Universidades [Grant ED431G 2019/01]Xunta de Galicia; ED431G 2019/0

The use of relaxation techniques in a personalized virtual environment

This bibliographic research addresses the innovative approach to relaxation that introduces the use of personalized virtual reality in the relaxing process. It is conceptualized as a critical integration of literature that considers the subject. Research is divided into three chapters. First of all, it defines virtual reality and its properties, with particular attention being given to the “sense of presence” as it is one of the key characteristics of virtual reality that make it a special form of human experience. Furthermore, this chapter takes perspective on virtual reality showing to be a successful technology in different areas of research, with the accent on its usefulness in clinical psychology. In the second chapter, research defines the concept of relaxation and continues with discussing relaxation techniques with particular attention being given to progressive muscle relaxation and body scan’s use in medical, and more specifically, psychological settings. Final chapter introduces the concept of personalization. In the end, it finally integrates literature that highlights the importance of the personalized virtual reality in relaxation practice, but also criticizes current studies defining possible directions for the future advances of the concept

Virtual Reality for Cognitive Stimulation in the Elderly and Individuals with Disability

Cursos e Congresos, C-155[Abstract] The recent advances in virtual reality enable the creation of highly realistic and immersive environments. The purpose of this project is to develop a virtual reality tool for cognitive stimulation in the elderly and people with disabilities through gamification. This tool will feature a range of activities, with adjustable difficulty levels and accessibility options. These activities can be combined with a 360º video to create a gymkhana or a circuit, providing users with an engaging and customized experience to enhance cognitive abilities and mental AgilityXunta de Galicia; ED431B 2022/39ADCOR Foundation CITIC is financed by the Xunta de Galicia through the collaboration agreement between the Consellería de Cultura, Educación, Formación Profesional e Universidades and the Galician universities for the reinforcement of the research centres of the Galician University System (CIGUS). The research carried out by TALIONIS group is financed by the Xunta de Galicia (Aidfrom the Consellería de Cultura, Educación, Formación Profesional e Universidades for the consolidation and structuring of competitive research units) ED431B 2022/3

Blended Approach to Occupational Performance (BAOP): Guidelines Enabling Children with Autism

The performance of daily activities is impacted by motor impairments in children with autism spectrum disorders (ASD). Research has recently demonstrated the prevalence and specificity of motor impairments in people with ASD. The motor learning of individuals with ASD is partially intact, and evidence suggests that a method to alter skill learning and repeated practice of motor sequences might be beneficial. Aiming to use this knowledge to guide occupational therapy interventions, initial guidelines for children with ASD blended Cognitive Orientation to daily Occupational Performance (CO-OP) with virtual reality (VR) were created. An expert panel reviewed the initial guidelines. The results from the semi-structured expert panel discussion were to (a) increase the number of sessions, (b) provide more visuals to children, and (c) use VR as a reinforcer. Guidelines were revised accordingly. The revised guidelines, called Blended Approach to Occupational Performance (BAOP), are ready for further testing

How effective is virtual reality technology in palliative care? A systematic review and meta-analysis

BACKGROUND: The efficacy of virtual reality for people living with a terminal illness is unclear. AIM: To determine the feasibility and effectiveness of virtual reality use within a palliative care setting. DESIGN: Systematic review and meta-analysis. PROSPERO (CRD42021240395). DATA SOURCES: Medline, Embase, AMED, PsycINFO, CINAHL, Cochrane Central Register of Controlled Trials and Web of Science were searched from inception to March 2021. Search terms included 'virtual reality' and 'palliative care'. Eligibility: (1) adult (>18 years old) with a terminal illness (2) at least one virtual reality session and (3) feasibility data and/or at least one patient outcome reported. The ROB-2 and ROBINS tools assessed risk of bias. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) tool assessed the quality of the evidence. Standardised mean differences (Hedges's g) were calculated from the pre- and post-data. A DerSimonian-Laird random effects model meta-analysis was conducted. RESULTS: Eight studies were included, of which five were in the meta-analysis. All studies had at least some concern for risk of bias. Virtual reality statistically significantly improved pain (p = 0.0363), tiredness (p = 0.0030), drowsiness (p = 0.0051), shortness of breath (p = 0.0284), depression (p = 0.0091) and psychological well-being (p = 0.0201). The quality of the evidence was graded as very low due to small sample sizes, non-randomisation methods and a lack of a comparator arm. CONCLUSIONS: Virtual reality in palliative care is feasible and acceptable. However, limited sample sizes and very low-quality studies mean that the efficacy of virtual reality needs further research

Personalized, Naturalistic Virtual Reality Scenarios Coupled With Web-Based Progressive Muscle Relaxation Training for the General Population: Protocol for a Proof-of-Principle Randomized Controlled Trial

Background: Virtual reality (VR) is an innovative tool that can facilitate exposure to either stressful or relaxing stimuli and enables individuals who have difficulties visualizing scenes to be involved in a more realistic sensorimotor experience. It also facilitates multisensory stimulation, a sense of presence, and achievement of relaxation. VR scenarios representing visual and auditory elements of natural relaxing environments can facilitate the learning of relaxation techniques such as the progressive muscle relaxation technique (PMRT). A complementary standardized technique deployed to reduce anxiety symptoms is the integration of PMRT and guided imagery (GI). Exposure to a pleasant imaginary environment helps the establishment of an association between a relaxing scenario and the relaxation technique, consequently promoting relaxation. Empirical evidence has shown that VR scenarios can increase the effects of relaxation techniques by enabling people to experience emotional conditions in more vivid settings. Objective: The main aim of this pilot study protocol is to investigate the impact on state anxiety of PMRT, associated with a personalized relaxing scenario in VR, and the role of VR scenarios in facilitating the recall of relaxing images and a sense of presence. A secondary aim is to understand if relaxing sessions administered via Zoom are more effective for managing anxiety and stress than a procedural setting based on audio-track guidance. Methods: Based on a longitudinal, between-subject design, 108 university students will be randomly exposed to one of three experimental conditions: (1) PMRT via Zoom and GI exposure, (2) PMRT via Zoom and personalized VR exposure, and (3) PMRT based on audio-track guidance and personalized VR exposure. Individuals are assessed before and after 7 training sessions based on self-report questionnaires investigating anxiety, depression, quality of life, coping strategies, sense of presence, engagement, and side effects related to VR exposure. Heart rate data are also detected by an Mi Band 2 sensor. Results: The experimental procedure is ongoing. In this paper, preliminary data from a sample of 40 participants will be illustrated. The experimental phase is expected to conclude in May 2023, and the final results of the research will be presented in June 2023. Conclusions: The results of this study will help shape the experimental design to apply it on a subsequent randomized controlled trial, also considering clinical samples. This work is expected to measure whether VR is a more engaging and helpful technique in promoting relaxation and decreasing anxiety levels than GI, by making the visualization process easier and by helping people to face more realistic sensory experiences. Assessing the efficacy of the PMRT in alternative delivery modes may extend its applications, especially in situations where the standard procedure is more challenging to be administered. To our knowledge, no equivalent study has been published so far on this matter. Trial registration: ClinicalTrials.gov NCT05478941; https://clinicaltrials.gov/ct2/show/NCT05478941. International registered report identifier (irrid): DERR1-10.2196/44183