BackgroundPeople with social anxiety disorder (SAD) fear social interactions and may be reluctant to seek treatments involving exposure to social situations. Social exposure conducted in virtual reality (VR), embedded in individual cognitive–behavioural therapy (CBT), could be an answer.AimsTo show that conducting VR exposure in CBT for SAD is effective and is more practical for therapists than conducting exposurein vivo.MethodParticipants were randomly assigned to either VR exposure (n= 17),in vivoexposure (n= 22) or waiting list (n= 20). Participants in the active arms received individual CBT for 14 weekly sessions and outcome was assessed with questionnaires and a behaviour avoidance test. (Trial registration number ISRCTN99747069.)ResultsImprovements were found on the primary (Liebowitz Social Anxiety Scale) and all five secondary outcome measures in both CBT groups compared with the waiting list. Conducting exposure in VR was more effective at post-treatment thanin vivoon the primary outcome measure and on one secondary measure. Improvements were maintained at the 6-month follow-up. VR was significantly more practical for therapists thanin vivoexposure.ConclusionsUsing VR can be advantageous over standard CBT as a potential solution for treatment avoidance and as an efficient, cost-effective and practical medium of exposure.

Social phobia is one of the most frequent mental disorders and is accessible to two forms of scientifically validated treatments: anti-depressant drugs and cognitive behavior therapies (CBT). In this last case, graded exposure to feared social situations is one of the fundamental therapeutic ingredients. Virtual reality technologies are an interesting alternative to the standard exposure in social phobia, especially since studies have shown its usefulness for the fear of public speaking. This paper reports a preliminary study in which a virtual reality therapy (VRT), based on exposure to virtual environments, was used to treat social phobia. The sample consisted of 36 participants diagnosed with social phobia assigned to either VRT or a group-CBT (control condition). The virtual environments used in the treatment recreate four situations dealing with social anxiety: performance, intimacy, scrutiny, and assertiveness. With the help of the therapist, the patient learns adapted cognitions and behaviors in order to reduce anxiety in the corresponding real situations. Both treatments lasted 12 weeks, and sessions were delivered according to a treatment manual. Results showed statistically and clinically significant improvement in both conditions. The effect-sizes comparing the efficacy of VRT to the control traditional group-CBT revealed that the differences between the two treatments are trivial. 76

For patients with cLBP, adherence to home-based exercise programs could be facilitated by increasing the attractiveness of the programs, improving patient performance and favoring a feeling of being supported. New technologies meet these challenges and seem attractive to patients but are not a substitute for the human relationship between patients and care providers.

Background: Although executive functioning (EF) was found to be associated with cognitive deterioration, the majority of the tests for assessing EF lack ecological validity. Aims: To examine the feasibility and the validity of the virtual action planning supermarket (VAP-S) for the diagnosis of patients with mild cognitive impairment (MCI). Methods: Thirty MCI patients (mean age = 69.5 years) were compared to 30 healthy elderly persons (mean age = 69.2 years) in their performance of the VAP-S. Results: Significant differences were found between the groups in the majority of the measures of the VAP-S. The combination of the MMSE and the trajectory duration provided the best predictive classification for the groups. Conclusion: MCI patients have EF deficits, and the VAP-S is a viable tool to assess EF deficits in patients with MCI and healthy elderly.

Unlike pencil-and-paper tests, virtual reality is useful to assess large-scale navigation strategies in patients with brain injury or schizophrenia, or in the context of ageing and dementia. Better knowledge about both the impact of the different aids and the cognitive processes involved is essential for the use of aids in neurorehabilitation.

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Cognitive planning deficits affect patients with Parkinson's disease (PD) and traditional psychometric tests meet difficulties to evaluate their impact on daily life activities. Virtual reality (VR) may provide a new means of assessment. The objective of this study was firstly to develop a virtual environment (VE) useful to explore planning and secondly to examine the effectiveness of using VR in the assessment of cognitive planning for patients with PD. A virtual supermarket (VS) was designed in which participants carried out a task close to daily activities: a test of shopping list. There were two preliminary sessions to familiarize the participants with the software and the supermarket's layout. Then, during the assessment session, participants completed the task, without any time limitation. Global intellectual efficiency was assessed in order to exclude patients with dementia. Data related to the performance in the VS were recorded. Five patients with PD and five age-matched healthy volunteers, meeting inclusion criteria, constituted our convenience sample. The patients did not perform as well as the control group. In particular, the session's duration and the distance covered were longer. The patients' path is specific with numerous stops, turning around, and hesitancies. Finally, their motivation for further training sessions is aroused. The results underline the potential of using VR in the assessment of cognitive planning in PD. A larger analysis is currently being carried out to confirm and to explore all the outcome measures.