The Use of Virtual Therapy in Cardiac Rehabilitation of Female Patients with Heart Disease

Abstract

Background and Objectives: Cardiovascular disease (CVD) has become increasingly prevalent in women, and it is also in this group that the risk of developing depression is the highest. The most commonly applied therapeutic intervention in cardiac rehabilitation is Schultz’s autogenic training, which has proven to be of little efficacy in reducing depression and anxiety disorders. At the same time, a growing number of scientific reports have been looking at the use of virtual reality (VR) to treat mental health problems. This study aimed at assessing the efficacy of virtual therapy in reducing levels of depression, anxiety, and stress in female CVD patients. Materials and Methods: The study included 43 women who were randomly divided into two groups: experimental group (N = 17), where eight-week cardiac rehabilitation was enhanced with VR-based therapeutic sessions, and control group (N = 26), where the VR therapy was replaced with Schultz’s autogenic training. Mental state parameters were measured using the Perception of Stress Questionnaire and Hospital Anxiety and Depression Scale (HADS). Results: In the experimental group, the sole parameter which failed to improve was HADS-Anxiety, which remained at the baseline level. In the control group, there was a deterioration in nearly all tested parameters except for HADS-Depression. Statistically significant differences in the efficacy of rehabilitation were recorded in relation to the level of stress in the sub-scales: emotional tension (p = 0.005), external stress (p = 0.012), intrapsychic stress (p = 0.023) and the generalized stress scale (p = 0.004). Conclusions: VR therapy is an efficient and interesting complement to cardiac rehabilitation, with proven efficacy in reducing stress levels.

Effectiveness of virtual reality interventions on physiological and psychological outcomes of adults with cardiovascular disease: A systematic review and meta‐analysis

“…The mean age range of participants was 48.70–69.47 years. The included studies were conducted in eight countries: four studies were conducted in Poland (Jóźwik et al, 2021a; Jóźwik et al, 2021b; Maciołek et al, 2020; Szczepańska‐Gieracha et al, 2021), two in the USA (Groninger et al, 2021; Gulick et al, 2021), two in Iran (Hessabi et al, 2020; Keshvari et al, 2021), two in Brazil (Lima et al, 2020; Silva et al, 2018) one in Taiwan (Chuang et al, 2005), one in Spain (García‐Bravo et al, 2020), one in the United Kingdom (Morgan et al, 2021), and one in Portugal (Vieira et al, 2018) (Table 1).…”

“…In bias due to deviations from intended interventions, the section was evaluated with six signaling questions including participant and personnel awareness, deviations from the intended intervention, and appropriate analysis method. This criterion was judged as low risk in eight studies (Chuang et al, 2005; García‐Bravo et al, 2020; Groninger et al, 2021; Keshvari et al, 2021; Lima et al, 2020; Maciołek et al, 2020; Silva et al, 2018; Szczepańska‐Gieracha et al, 2021), high risk in one study (Hessabi et al, 2020), and some concerns in five studies (Gulick et al, 2021; Jóźwik et al, 2021a; Jóźwik et al, 2021b; Vieira et al, 2018). Given the nature of the interventions, none of the included studies were blinded to participants or personnel.…”

“…Given the nature of the interventions, none of the included studies were blinded to participants or personnel. Although there were missing participants, an intention to treat analysis was not made (Gulick et al, 2021; Jóźwik et al, 2021a, 2021b; Morgan et al, 2021; Vieira et al, 2018). One study did not give the consort flow diagram and did not give dropout information, and it was not reported whether an intention to treat analysis information was reported (Hessabi et al, 2020).…”

“…One study did not give the consort flow diagram and did not give dropout information, and it was not reported whether an intention to treat analysis information was reported (Hessabi et al, 2020). In risk of bias due to missing outcome data, five studies (Chuang et al, 2005; Gulick et al, 2021; Jóźwik et al, 2021a; Jóźwik et al, 2021b; Vieira et al, 2018) were evaluated as high risk because of missing data and no appropriate analysis, and nine studies were evaluated as low risk (García‐Bravo et al, 2020; Groninger et al, 2021; Hessabi et al, 2020; Keshvari et al, 2021; Lima et al, 2020; Maciołek et al, 2020; Morgan et al, 2021; Silva et al, 2018; Szczepańska‐Gieracha et al, 2021). In risk of bias in measurement of the outcome and risk of bias in selection of the reported result, all studies were decided as being low risk.…”

“…In this systematic review and meta-analysis, the type and procedure of the VR intervention and procedure of the control group, the evaluated parameters and measurement outcomes are also included in Table 1. VR intervention was applied to patients in the cardiac rehabilitation process in eight studies (García-Bravo et al, 2020;Gulick et al, 2021;Jóźwik et al, 2021aJóźwik et al, , 2021bMaciołek et al, 2020;Silva et al, 2018;Szczepańska-Gieracha et al, 2021;Vieira et al, 2018) and in an invasive intervention process was applied in four studies (Chuang et al, 2005;Keshvari et al, 2021;Lima et al, 2020;Morgan et al, 2021). Two studies (Groninger et al, 2021;Hessabi et al, 2020) were with patients hospitalized in a cardiac care unit.…”