NCT04313777

Brief Summary

This study evaluates the effectiveness of virtual reality (VR) therapy in the treatment of depression and anxiety symptoms in patients undergoing second stage of cardiac rehabilitation. Half of the study group will receive VR therapy (VR group) as an addition to cardiologically monitored physical training. The other half of the group (control group) will receive Schultz Autogenic Training as a standard supplement to cardiological training

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
77

participants targeted

Target at P25-P50 for not_applicable cardiovascular-diseases

Timeline
Completed

Started Jan 2020

Shorter than P25 for not_applicable cardiovascular-diseases

Geographic Reach
1 country

2 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

January 6, 2020

Completed
2 months until next milestone

First Submitted

Initial submission to the registry

March 11, 2020

Completed
2 days until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 13, 2020

Completed
5 days until next milestone

First Posted

Study publicly available on registry

March 18, 2020

Completed
16 days until next milestone

Study Completion

Last participant's last visit for all outcomes

April 3, 2020

Completed
Last Updated

June 23, 2020

Status Verified

June 1, 2020

Enrollment Period

2 months

First QC Date

March 11, 2020

Last Update Submit

June 22, 2020

Conditions

Keywords

virtual realitycardiac rehabilitationpsychotherapycardiac surgerydepressionanxietystress

Outcome Measures

Primary Outcomes (1)

  • Change in depressed mood and anxiety from baseline

    The Hospital Anxiety and Depression Scale (HADS) is a fourteen-item scale scoring from 0 to 3 for each item. The first seven items relate to anxiety (HADS-A), and the remaining seven items relate to depression (HADS-D). The global scoring ranges from 0 to 42 with a cut-off point of 8/21 for anxiety and 8/21 for depression. The higher the score, the greater anxiety or depression symptoms. HADS will be performed at the beginning and after four weeks of treatment.

    At baseline and after 8 sessions of VR therapy (week 3)

Secondary Outcomes (1)

  • Change in perception of stress from baseline

    At baseline and after 8 sessions of VR therapy (week 3)

Study Arms (2)

VR therapy group

EXPERIMENTAL

Cardiac rehabilitation supplemented by VR therapy

Behavioral: Cardiac rehabilitationDevice: Virtual therapeutic support

Control Group

ACTIVE COMPARATOR

Cardiac rehabilitation supplemented by Schultz Autogenic Training

Behavioral: Cardiac rehabilitationBehavioral: Schultz Autogenic Training

Interventions

Four weeks of cardiac rehabilitation conducted in an outpatient care facility. Three times per week (80 minutes per day) cardiologically monitored aerobic training consisting of: 40 minutes of interval training on a cycloergometer and 40 minutes of general fitness exercises.

Control GroupVR therapy group

8 sessions of VR therapy (each of them 20 minutes long). As a virtual reality source, VR Tier One device (Stolgraf®) were used. Thanks to using head mounted display and the phenomenon of total immersion VR therapy provides an intense visual, auditory and kinesthetic stimulation. It can have a calming and mood-improving effect or help the patients recognize their psychological resources and motivate to the rehabilitation process. In the virtual therapeutic garden there are a rich set of symbols and metaphors based on Ericksonian Psychotherapy approach.

VR therapy group

8 sessions of Schultz Autogenic Training (each of them 20 minutes long).

Control Group

Eligibility Criteria

Age40 Years - 85 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Coronary Artery Disease;
  • the second stage of cardiac rehabilitation conducted in outpatient settings;

You may not qualify if:

  • cognitive impairment (MMSE\<24);
  • inability to self-complete the research questionnaires;
  • presence of the following issues at the time of the examination or in the medical data: disturbances of consciousness, psychotic symptoms or other serious psychiatric disorders;
  • initiation of psychiatric treatment during the research project;
  • contraindications for virtual therapy (epilepsy, vertigo, eyesight impairment);
  • the patient's refusal at any stage of the research project.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

University School of Physical Education

Wroclaw, Lower Silesian Voivodeship, 51-612, Poland

Location

Centrum Kardiologiczne Pro Corde Sp. z o.o.

Wroclaw, Lower Silesian Voivodeship, 52-244, Poland

Location

Related Publications (8)

  • Li J, Theng YL, Foo S. Game-based digital interventions for depression therapy: a systematic review and meta-analysis. Cyberpsychol Behav Soc Netw. 2014 Aug;17(8):519-27. doi: 10.1089/cyber.2013.0481. Epub 2014 May 8.

    PMID: 24810933BACKGROUND
  • McCann RA, Armstrong CM, Skopp NA, Edwards-Stewart A, Smolenski DJ, June JD, Metzger-Abamukong M, Reger GM. Virtual reality exposure therapy for the treatment of anxiety disorders: an evaluation of research quality. J Anxiety Disord. 2014 Aug;28(6):625-31. doi: 10.1016/j.janxdis.2014.05.010. Epub 2014 Jun 7.

    PMID: 25093964BACKGROUND
  • Maples-Keller JL, Bunnell BE, Kim SJ, Rothbaum BO. The Use of Virtual Reality Technology in the Treatment of Anxiety and Other Psychiatric Disorders. Harv Rev Psychiatry. 2017 May/Jun;25(3):103-113. doi: 10.1097/HRP.0000000000000138.

    PMID: 28475502BACKGROUND
  • Freeman D, Reeve S, Robinson A, Ehlers A, Clark D, Spanlang B, Slater M. Virtual reality in the assessment, understanding, and treatment of mental health disorders. Psychol Med. 2017 Oct;47(14):2393-2400. doi: 10.1017/S003329171700040X. Epub 2017 Mar 22.

    PMID: 28325167BACKGROUND
  • Valmaggia LR, Latif L, Kempton MJ, Rus-Calafell M. Virtual reality in the psychological treatment for mental health problems: An systematic review of recent evidence. Psychiatry Res. 2016 Feb 28;236:189-195. doi: 10.1016/j.psychres.2016.01.015. Epub 2016 Jan 12.

    PMID: 26795129BACKGROUND
  • Szczepanska-Gieracha J, Morka J, Kowalska J, Kustrzycki W, Rymaszewska J. The role of depressive and anxiety symptoms in the evaluation of cardiac rehabilitation efficacy after coronary artery bypass grafting surgery. Eur J Cardiothorac Surg. 2012 Nov;42(5):e108-14. doi: 10.1093/ejcts/ezs463. Epub 2012 Aug 19.

    PMID: 22906598BACKGROUND
  • Thompson T, Steffert T, Steed A, Gruzelier J. A randomized controlled trial of the effects of hypnosis with 3-D virtual reality animation on tiredness, mood, and salivary cortisol. Int J Clin Exp Hypn. 2011 Jan;59(1):122-42. doi: 10.1080/00207144.2011.522917.

    PMID: 21104488BACKGROUND
  • Dibben G, Faulkner J, Oldridge N, Rees K, Thompson DR, Zwisler AD, Taylor RS. Exercise-based cardiac rehabilitation for coronary heart disease. Cochrane Database Syst Rev. 2021 Nov 6;11(11):CD001800. doi: 10.1002/14651858.CD001800.pub4.

MeSH Terms

Conditions

Cardiovascular DiseasesCoronary Artery DiseaseDepressionMood DisordersAnxiety Disorders

Interventions

Cardiac Rehabilitation

Condition Hierarchy (Ancestors)

Coronary DiseaseMyocardial IschemiaHeart DiseasesArteriosclerosisArterial Occlusive DiseasesVascular DiseasesBehavioral SymptomsBehaviorMental Disorders

Intervention Hierarchy (Ancestors)

RehabilitationAftercareContinuity of Patient CarePatient CareTherapeuticsHealth ServicesHealth Care Facilities Workforce and Services

Study Officials

  • Joanna Szczepańska-Gieracha, Prof.

    University School of Physical Education in Wroclaw, Poland

    PRINCIPAL INVESTIGATOR
  • Sandra Jóźwik, MSc.

    University School of Physical Education in Wroclaw, Poland

    STUDY CHAIR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Professor

Study Record Dates

First Submitted

March 11, 2020

First Posted

March 18, 2020

Study Start

January 6, 2020

Primary Completion

March 13, 2020

Study Completion

April 3, 2020

Last Updated

June 23, 2020

Record last verified: 2020-06

Data Sharing

IPD Sharing
Will not share

Locations