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

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.

Evaluation of the Impact of Virtual Reality-Enhanced Cardiac Rehabilitation on Depressive and Anxiety Symptoms in Patients with Coronary Artery Disease: A Randomised Controlled Trial.

The aim of this study was to assess the efficacy of virtual reality (VR)-enhanced cardiac rehabilitation (CR) in reducing the intensity of depression and anxiety symptoms in patients undergoing phase II of CR in ambulatory conditions. One hundred participants (mean age 65.7 years) were divided randomly into two groups. Both groups took part in eight sessions of standard CR (three times per week). The experimental group was additionally supported by eight sessions of VR therapy using the VR TierOne device and the control group by eight sessions of Schultz Autogenic Training. The Hospital Anxiety and Depression Scale (HADS) was used as the primary outcome measure. The Perception of Stress Questionnaire was used as the secondary outcome measure. The data from 77 participants were subject to analysis. Post-intervention, in the experimental group, the overall HADS score was statistically significantly reduced by 13.5%, HADS-Depression by 20.8%, and the general stress level by 12.8% (p < 0.05). In the control group, the scores of the HADS, HADS-Anxiety and the general stress level were statistically significantly higher, by 4.8%, 6.5%, and 4.9%, respectively. VR-enhanced CR for individuals with cardiovascular disease reduced the level of anxiety and depression symptoms compared to standard CR.

Immersive Virtual Reality Therapy as a Support for Cardiac Rehabilitation: A Pilot Randomized-Controlled Trial.

Depression and anxiety can significantly reduce the effectiveness of cardiac rehabilitation (CR). Several studies have assessed the effectiveness of virtual reality (VR)-based interventions for symptoms of anxiety and depression; however, they do not relate to patients with heart disease. The aim of this study was to assess the effects of VR therapy on the mental state of patients with coronary artery disease (CAD). Thirty-four CAD patients with elevated anxiety or depression symptoms were recruited. After randomization, 17 participants were assigned to the intervention group, and 17 to the control group. Both groups underwent standard CR for outpatients. In the intervention group, eight VR therapy sessions were applied. In the control group, eight sessions of Schultz' Autogenic Training were applied. To assess patient mental states, Hospital Anxiety and Depression Scale (HADS) and Perception of Stress Questionnaire (PSQ) were used, before and after 4 weeks of CR. In the intervention group, a significant decrease in HADS score was observed (19.46 pretreatment vs. 15.73 post-treatment, p = 0.003), HADS-Anxiety subscale decreased by 16.0 percent (p = 0.01) and HADS-Depression by 23.0 percent (p = 0.003). Similarly, a significant decrease in PSQ was recorded at 12.8 percent (64.73 vs. 56.47, p = 0.03). In the control group, HADS and PSQ data did not change. VR therapy significantly reduced the severity of depressive symptoms, anxiety, and stress levels in CAD patients undergoing CR. Immersive VR therapy effectively supports the CR of individuals with anxiety-depressive symptoms. ClinicalTrials.gov (NCT04045977).