Investigating the role of auditory and visual sensory inputs for inducing relaxation during virtual reality stimulation

Naef, Aileen C.; Jeitziner, Marie‐Madlen; Knobel, Samuel E. J.; Exl, Matthias Thomas; Müri, René M.; Jakob, Stephan M.; Nef, Tobias; Gerber, Stephan M.

doi:10.1038/s41598-022-21575-9

Cited by 16 publications

(24 citation statements)

References 45 publications

(50 reference statements)

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“…Only one session was initially performed to assess the feasibility of repeated VR stimulation in the ICU and patients’ willingness to participate in a second session. The VR sessions lasted up to 30 min in line with previous work that has shown a relaxation effect in sessions lasting 30 min ( 17 ). The intended goal of 30 min was always communicated to the participants.…”

Section: Methodssupporting

confidence: 62%

“…Therefore, combining a technique to block external sensory stimuli while providing a calmer and controlled sensory input virtually could be a valuable technique for addressing sensory overload and sensory deprivation within the ICU. This is supported by work in healthy individuals that found the greatest relaxation effect was induced when participants were provided with combined audiovisual inputs, thereby effectively blocking the real-world sensory inputs ( 17 ).…”

Section: Introductionmentioning

confidence: 84%

“…To our knowledge, limited studies have investigated the effect and acceptability of repetitive virtual reality (VR) sessions in a randomly selected sample of critically ill patients. Past studies have used a variety of methods to determine the usability of such technology, the acceptance among staff and patients, the required setup, and any negative outcomes ( 17–20 ). Specifically, Gerber et al showed the feasibility of using immersive VR in the ICU as well as providing initial work in patients; however, the VR exposure was short, and all participants were patients pre-scheduled to undergo heart surgery and thus shown the VR videos prior to their ICU stay ( 18 ).…”

Section: Introductionmentioning

confidence: 99%

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Effects of immersive virtual reality on sensory overload in a random sample of critically ill patients

Naef,

Gerber,

Single

et al. 2023

Front. Med.

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BackgroundSensory overload and sensory deprivation have both been associated with negative health outcomes in critically ill patients. While there is a lack of any clear treatment or prevention strategies, immersive virtual reality is a promising tool for addressing such problems, but which has not been repetitively tested in random samples. Therefore, this study aimed to determine how critically ill patients react to repeated sessions of immersive virtual reality.MethodsThis exploratory study was conducted in the mixed medical–surgical intermediate care unit of the University Hospital of Bern (Inselspital). Participants (N = 45; 20 women, 25 men; age = 57.73 ± 15.92 years) received two immersive virtual reality sessions via a head-mounted display and noise-canceling headphones within 24 h during their stay in the unit. Each session lasted 30-min and showed a 360-degree nature landscape. Physiological data were collected as part of the participants’ standard care, while environmental awareness, cybersickness, and general acceptance were assessed using a questionnaire designed by our team (1 = not at all, 10 = extremely).ResultsDuring both virtual reality sessions, there was a significant negative linear relationship found between the heart rate and stimulation duration [first session: r(43) = −0.78, p < 0.001; second session: r(38) = −0.81, p < 0.001] and between the blood pressure and stimulation duration [first session: r(39) = −0.78, p < 0.001; second session: r(30) = −0.78, p < 0.001]. The participants had a high comfort score [median (interquartile range {IQR}) = 8 (7, 10); mean = 8.06 ± 2.31], did not report being unwell [median (IQR) = 1 (1, 1); mean = 1.11 ± 0.62], and were not aware of their real-world surroundings [median (IQR) = 1 (1, 5); mean = 2.99 ± 3.22].ConclusionThe subjectively reported decrease in environmental awareness as well as the decrease in the heart rate and blood pressure over time highlights the ability of immersive virtual reality to help critically ill patients overcome sensory overload and sensory deprivation. Immersive virtual reality can successfully and repetitively be provided to a randomly selected sample of critically ill patients over a prolonged duration.

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Section: Methodssupporting

confidence: 62%

Section: Introductionmentioning

confidence: 84%

Section: Introductionmentioning

confidence: 99%

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Effects of immersive virtual reality on sensory overload in a random sample of critically ill patients

Naef,

Gerber,

Single

et al. 2023

Front. Med.

Self Cite

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“…VR headsets are likely to have stronger associated health benefits than flat screens because of their high levels of immersion 12 . Audiovisual combinations promote greater psychological benefits than audio or visual sensory inputs alone 13 . Correspondingly, researchers are increasingly studying simulated nature in VR headsets rather than other media 11 .…”

Section: Introductionmentioning

confidence: 99%

Daily exposure to virtual nature reduces symptoms of anxiety in college students

Browning

Shin

Drong

et al. 2023

Sci Rep

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Exposure to natural environments offers an array of mental health benefits. Virtual reality provides simulated experiences of being in nature when outdoor access is limited. Previous studies on virtual nature have focused mainly on single "doses" of virtual nature. The effects of repeated exposure remain poorly understood. Motivated by this gap, we studied the influence of a daily virtual nature intervention on symptoms of anxiety, depression, and an underlying cause of poor mental health: rumination. Forty college students (58% non-Hispanic White, median age = 19) were recruited from two U.S. universities and randomly assigned to the intervention or control group. Over several weeks, anxious arousal (panic) and anxious apprehension (worry) decreased with virtual nature exposure. Participants identifying as women, past VR users, experienced with the outdoors, and engaged with the beauty in nature benefited particularly strongly from virtual nature. Virtual nature did not help symptoms of anhedonic depression or rumination. Further research is necessary to distinguish when and for whom virtual nature interventions impact mental health outcomes.

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“…This relaxation component may have an incremental value regarding pain relief and may contribute to a change in perceptions. Also, by immersing a virtual environment, VR may block peripheral stimuli by reducing the brain’s processing pain signals 13. The tolerability of a VR headset was associated with fewer side effects in comparison to pharmacological analgesics and was perceived by patients as pleasant and fun.…”

Section: Introductionmentioning

confidence: 99%

Use of virtual reality in port implantation to reduce perioperative anxiety and pain: protocol for a randomised controlled pilot trial at a single German university hospital (VIP-trial; DRKS00028508)

Graf,

Feldmann,

Hunold

et al. 2023

BMJ Open

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IntroductionIntravenous access port implantation is commonly performed under local anaesthesia, which offers advantages such as increased patient satisfaction and resource savings compared with general anaesthesia. However, patients may experience increased perioperative stress and anxiety in the operating room setting without general anaesthesia. Virtual reality (VR) distraction or hypnosis during surgery under local anaesthesia may help patients to auditorily and visually separate from their real environment and engage with a virtual environment through hypnorelaxing guidance. Previous studies suggested that VR hypnosedation may reduce the use of sedatives or general anaesthesia, and may offer additional benefits such as reducing postoperative pain and nausea, and promoting faster patient discharge.Methods and analysisThe VIP trial is a randomised controlled pilot trial comparing the usage of VR during port implantation with the current standard of care (local anaesthesia and analgosedation if needed). A total of 120 adult patients are included after screening for eligibility and obtaining informed consent. Patients are randomised preoperatively in a 1:1 ratio to the trial groups. The main outcomes are change of perioperative anxiety and pain. Further outcomes include patient satisfaction and tolerability, perioperative analgesia and sedation, occurrence of postoperative nausea, vomiting and VR sickness symptoms, surgeon’s satisfaction, procedure duration, postoperative complications until postoperative day 30 and patient willingness to hypothetically undergo port implantation again under the same conditions.Ethics and disseminationThe VIP trial has been approved by the Ethics Committee of the Medical Faculty of Ulm University (reference number 03/22). If the intervention demonstrates that VR can effectively reduce perioperative anxiety and pain, it may become a novel standard of care to minimise the need for analgosedation or general anaesthesia in port implantation procedures and improve patient outcomes. The results will be submitted to a peer-reviewed journal in the field and will be presented at applicable conferences to ensure rigorous evaluation and access for the academic community.Trial registration numberGerman Clinical Trials Register: DRKS00028508; registration date 15 March 2022; Universal Trial Number: U1111-1275-4995.

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Investigating the role of auditory and visual sensory inputs for inducing relaxation during virtual reality stimulation

Cited by 16 publications

References 45 publications

Effects of immersive virtual reality on sensory overload in a random sample of critically ill patients

Effects of immersive virtual reality on sensory overload in a random sample of critically ill patients

Daily exposure to virtual nature reduces symptoms of anxiety in college students

Use of virtual reality in port implantation to reduce perioperative anxiety and pain: protocol for a randomised controlled pilot trial at a single German university hospital (VIP-trial; DRKS00028508)

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