THE INFLUENCE OF VIRTUAL REALITY ON MOTIVATION AND REHABILITATION IN PATIENTS WITH HEART FAILURE

B.M. Santi¹, S.F. Soares¹, L.T.S. Pereira¹, E.F. Amorim¹, M.M. Regenga¹, M.C. Miura¹

¹Associação Beneficente Síria, São Paulo, Brazil

Background: Cardiovascular rehabilitation (CVR) is one of the main non-pharmacological treatments for patients with heart failure. However, compliance tends to be low because conventional physiotherapy treatments are, in most cases, of long duration, repetitive, and monotonous.

Purpose: Due to this poor compliance, it is necessary to develop new strategies to increase adherence to CVR. Therefore, this study aimed to analyze the impact of a physiotherapy treatment that incorporated the use of virtual reality on motivation, functional capacity, quality of life, and physical activity in patients with heart failure.

Methods: This was a randomized longitudinal study that included male and female patients who were admitted to the ward of Hospital do Coração in São Paulo from July to December 2021, with heart failure as the main diagnosis, regardless of etiology. After the exclusion criteria were applied, 32 individuals were randomized into two groups. The virtual reality group (VRG; n=16) participated in a protocol where conventional motor physical therapy was applied following the institution’s protocol in conjunction with motor physical therapy using an Xbox 360 videogame with Kinect sensor and games that were played on a television, while the conventional group (CG; n=16) received only conventional motor physical therapy. Both groups underwent assessments of functionality through The Morton Mobility Index (DEMMI), quality of life the Minnesota Living with Heart Failure Questionnaire (MLHFQ), and physical activity with the International Physical Activity Questionnaire (IPAQ) at admission, at hospital discharge, and 30 days after discharge. The physiotherapy treatments were administered twice a day during the patients’ hospital stays. Before and after each physiotherapy session, the patients’ motivation was measured using a Motivation Scale that showed seven faces ranging from the saddest to the happiest, on which patients’ selected the face that best represented their degree of motivation.

Results: We observed that both groups remained motivated during their hospitalization in the ward, although, when correlated we didn't get significance: CG (p=0.31) and VRG (p=1). However, compared to the CG, the VRG showed significantly more improvement in functional capacity (p=0.009) and quality of life (p=0.003). There were no significant differences between the scores of the two groups on the initial International Physical Activity Questionnaire (IPAQ); however, 30 days after discharge, the VRG showed higher IPAQ scores, although this difference was not significant (p=0.94).

Conclusions: Non-immersive virtual reality technology can be used in conjunction with conventional physical therapy in hospital settings to help motivate patients and improve functional capacity, which directly impacts their quality of life.

Implications: Due to the positive results of this study and the fact that the VR therapy was well accepted by patients and professional staff, we have continued to implement virtual reality projects in other areas of the hospital, including in the intensive care unit (ICU) and the cardiac rehabilitation outpatient clinic.

Funding acknowledgements: This work is not financed.

Keywords:
cardiac rehabilitation
virtual reality
heart failure

Topics:
Cardiorespiratory
Innovative technology: information management, big data and artificial intelligence
Health promotion & wellbeing/healthy ageing/physical activity

Did this work require ethics approval? Yes

Institution: Associação Beneficente Síria

Committee: Hospital do Coração/Associação Beneficente Síria - HCOR

Ethics number: 47271021.5.0000.0060