Virtual Therapy as a Method Supporting the Cardiac Rehabilitation
Condition: Cardiovascular Diseases; Coronary Artery Disease; Depressive Symptoms; Mood Disorders; Anxiety State; Stress
MeSH terms: Cardiovascular Diseases; Coronary Artery Disease; Myocardial Ischemia; Coronary Disease; Depression; Mood Disorders
Study type: Interventional

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.
    

Detailed description: 
      Cardiologically monitored physical training in second stage of cardiac rehabilitation leads
      to the improvement in the physical capacity and overall fitness of the patients with Coronary
      Artery Disease, allowing restoration of independence in daily functioning. Psychological
      support is required in order to reduce the negative psychological symptoms related to both
      the heart disease itself and the cardiac surgery performed. In this study the investigators
      want to assess the effectiveness of the virtual reality (VR) therapy compared to standard
      psychological support (Schultz Autogenic Training).

      Thanks to using head mounted display and the phenomenon of total immersion VR therapy allows
      to completely separate the patient from the hospital environment, provides an intense visual,
      auditory and kinesthetic stimulation. Depending on the stage of therapy it can have a calming
      and mood-improving effect or, in another part of the therapy, it can motivate the patient to
      the rehabilitation process. The additional aim of the VR therapy is to help the patients
      regain their emotional balance, let them recognize their psychological resources and trigger
      the natural recovery mechanisms.

      The goals of the project:

        1. The evaluation of the influence of VR therapy on the depressive symptoms and the anxiety
           level of the patients undergoing second stage of cardiac rehabilitation.

        2. The evaluation of the influence of VR therapy on the stress level of the patients
           undergoing second stage of cardiac rehabilitation.
    

Intervention name(s): Cardiac rehabilitation; Virtual therapeutic support; Standard therapeutic support
Intervention type(s): Behavioral; Device; Behavioral
Intervention description(s): 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.; 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. The most important is the Garden of Revival which symbolizes the patient's health. It used to be full of life and energy, now it is neglected, requires work to be revived. In the therapeutic process day by day, the therapist tells the patient a symbolic story about his/her situation. By performing tasks in the virtual garden, the patient becomes an active participant of the therapeutic process and sees the effects his/her work.; 8 sessions of Schultz Autogenic Training (each of them 20 minutes long).
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: virtual reality; cardiac rehabilitation; psychotherapy; cardiac surgery; depression; anxiety; stress; elderly; Coronary Artery Disease; Ischemic Heart Disease