Virtual Therapeutic Garden for Depressive Symptoms
Condition: Depressive Symptoms; Depression; Anxiety
MeSH terms: Depression
Study type: Interventional

Summary: 
      This study evaluates the addition of virtual therapy intervention in the treatment of
      depression in the elderly. Half of the participants will receive virtual reality treatment as
      an addition to physical exercises and psychoeducation, while the other half will receive
      physical exercises and psychoeducation alone.
    

Detailed description: 
      Depressive disorders are frequent and can either first be manifested at a younger age and
      recurrent during later life or have an onset beyond 60 years (late-life depression). The
      multifactorial genesis of depression in old age includes psychosocial, vascular and metabolic
      factors and requires multimodal and multi-professional therapy including physical activity
      and psychosocial interventions. However, there is still a percentage of older people who do
      not show improvement in depressive symptoms.

      In recent years, various types of virtual reality are gaining in popularity, primarily
      because of the availability and ease of use. A systematic review from 2018 concluded that VR
      treatment had moderate to large effects in anxiety and depression, compared to controls and
      it could be another effective choice available to clinicians and patients.

      Therefore, the aim of this project was to evaluate the effectiveness of virtual therapy in
      the elderly, in whom the previous multimodal therapeutic program has not brought the expected
      results.
    

Intervention name(s): Group general fitness training; Group relaxation and psychoeduaction; VRTierOne
Intervention type(s): Behavioral; Behavioral; Device
Intervention description(s): A single session of general fitness training will be composed of low-intensity, general-fitness exercises. Most of the exercises will be carried out in a sitting position and standing positon. The session will contain aerobic (general warm-up), musculo-articular (strengthening muscles and joints range of motion) and stabilizing exercises (improve spatio-visual coordination). Conducted by a physiotherapist in group form.; A single session of relaxation (10 minutes) psychoeducation (10 minutes) will contain minilectures about mental well-being and psychohygiene. In summary 20 minutes.; As a virtual reality source, VRTierOne device (Stolgraf®) were used. Thanks to using head mounted display and the phenomenon of total immersion "VRTierOne" Stolgraf® 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 lector (therapist) tells the patient a symbolic story about his/her situation. By performing tasks in the virtual garden, the patient influences the course of this story, becomes an active participant of the therapeutic process and sees the effects his work.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: virtual reality; depression; anxiety; mental health; elderly; rehabilitation; virtual garden