Clinical Interventions in Aging (Nov 2022)
Effects of Immersive Virtual Therapy as a Method Supporting Recovery of Depressive Symptoms in Post-Stroke Rehabilitation: Randomized Controlled Trial
Abstract
Pawel Kiper,1 Ewa Przysiężna,2 Błażej Cieślik,1 Katarzyna Broniec-Siekaniec,3 Aleksandra Kucińska,3 Jarosław Szczygieł,4,5 Katarzyna Turek,6 Robert Gajda,7,8 Joanna Szczepańska-Gieracha2 1Healthcare Innovation Technology Lab, IRCCS San Camillo Hospital, Venezia, Italy; 2Faculty of Physiotherapy, University School of Physical Education in Wroclaw, Wroclaw, Poland; 3“REPTY” Upper Silesian Rehabilitation Centre, Tarnowskie Góry, Poland; 4Humanitas University in Sosnowiec, Sosnowiec, Poland; 5Neurorehabilitation Department, District Hospital, Zawiercie, Poland; 6The Karol Lipiński Academy of Music in Wroclaw, Wrocław, Poland; 7Gajda-Med District Hospital in Pultusk, Pułtusk, Poland; 8Department of Kinesiology and Health Prevention, Jan Dlugosz University in Częstochowa, Częstochowa, PolandCorrespondence: Pawel Kiper, IRCCS San Camillo Hospital, Alberoni 70, Venezia, 30126, Italy, Tel +390412207157, Email [email protected]: Depressive symptoms constitute an important group of mental problems that alter the course of post-stroke rehabilitation by reducing quality of life, physical activity, social functioning, and interpersonal relationships. Although several studies have shown the efficacy of virtual reality (VR) in the motor treatment of poststroke patients, there is a lack of studies that would also evaluate the impact of VR on psychological aspects. Thus, we investigated the effectiveness of immersive VR therapy on both functional activity and depressive symptoms in stroke survivors.Patients and Methods: We conducted a single blind, randomized controlled trial comparing VR therapy with Schultz’s Autogenic Training (SAT). Patients randomized to the VR group received treatment in an immersive VR therapeutic garden with elements of psychotherapy and physical activity of the upper extremities, whereas patients in the control group received SAT. Additionally, patients in both groups received standard neurological rehabilitation. The full research cycle lasted six weeks. We used Geriatric Depression Scale, Generalized Self-Efficacy Scale, Acceptance of Illness Scale, Visual Analogue Scale of pain, Hospital Anxiety and Depression Scale, Barthel Index, Lawton Instrumental Activities of Daily Living Scale and Rivermead Motor Assessment for outcome assessment. This trial was registered with ClinicalTrials.gov (NCT03830372).Results: We assessed 60 patients and randomly assigned to the VR or control group. The VR group showed a significant reduction in depressive symptoms (ηp2 = 0.13, p < 0.01) compared to SAT. The applied VR therapy significantly increased the sense of self-efficacy and the level of acceptance of the illness; however, this effect was similar to that obtained with the standard intervention. We did not observe statistically significant changes in the functional parameters of post-stroke patients.Conclusion: The use of VR therapy combined with neurological rehabilitation had a positive effect on improving mood and reducing depressive symptoms in post-stroke patients.Keywords: stroke, depressive symptoms, virtual reality, mental health, neurorehabilitation
