Virtual Reality Training in Occupational Rehabilitation

Work-related Attention Bias Modification Training and Virtual Reality Training in Occupational Rehabilitation: A Multisite Pilot Study

Work-related attention bias modification training and virtual reality training in occupational rehabilitation is a multisite pilot study.

The quantitative aim of this pilot study is to compared virtual reality (VR) training and attention bias modication (ABM) training to investigate whether the different training forms result in different results measured with work-related outcomes and cognitive outcomes. The qualitative aim of this pilot study is to investigate the patients' experiences with the usage of VR.

Three rehabilitation insitutions will be recruiting patients participating in occupational rehabilitation, and the study will compare the outcomes of work-related interventions with and without the addition of ABM or VR training.

The study seeks to determine if these interventions can improve work ability, reduce symptoms of depression and anxiety, and change attentional bias from negative to positive stimuli.

Study Overview

• Status: Active, not recruiting
• Conditions: Depression; Musculoskeletal Diseases; Anxiety Disorders; Mental Health Disorder; Back Pain, Low
• Intervention / Treatment: Device: Virtual Reality with Beat Saber

• Study Type: Interventional
• Enrollment (Estimated): 100
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Norway
  • Rauland, Norway, 3864
    • Norwegian National Advisory Unit on Occupational Rehabilitation

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Age between 18 - 67 years
• Must be on sick leave, work assessment allowance or on disability pension
• Receiving work-related rehabilitation or treatment at clinics with either an International Classification of Primary Care, Second edition (ICPC-2) within the musculoskeletal (L), psychiatric (P) or unspecific disorders (A) categories or International Classification Disorders-10 diagnosis within the mental and behavioral disorders (F), Diseases of the musculoskeletal system and connective tissue (M) or other diagnoses.

Exclusion Criteria:

• Applying for a full disability pension;
• Unable to complete the measures and receive instructions in Norwegian.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Non-Randomized
• Interventional Model: Sequential Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Comparing VR training and ABM training; The objective of this study is to investigate whether VR and ABM training increases work ability, work-related self-efficacy, attention and reduces symptoms of depression and anxiety and consequently change an attentional bias from negative to positive stimuli. We will compare patients receiving work-related interventions + VR, work-related interventions + ABM training and work-related interventions only. We will also investigate whether positive changes in attentional bias are associated with increased work participation. Self-reported work ability, self-efficacy, depression, anxiety and objective computerised cognitive and emotional testing will be assessed at baseline (start rehabilitation/treatment) and at posttest (end rehabilitation/treatment).	Device: Virtual Reality with Beat Saber; The VR activity used in the intervention was an add-on activity that did not replace any other activities in the programme. The off-the-shelf product Beat Saber (Beat Games, Prague, The Czech Republic) is the VR game of choice in our study. In collaboration with the participating clinics a systematic VR activity plan will be developed. This includes the selection of games and designing a plan that is interesting and motivating both for patients and clinicians.
No Intervention: Patients' experiences with the usage of VR.; The objective of this part is to investigate the experiences in using VR. R&D personell will make individual interviews with five patients at each of the three clinics involved in piloting VR. The aim of the interviews will be to capture how the patients experienced the VR activity, the demands of the VR activity, how VR has influenced different aspects of health and whether VR has influenced the abilities to return to work.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Increase work ability	Self-reported questionnaire measures, (Work Ability Scale). Work ability: Self-rated work ability was assessed using a single-item question to determine the WAS; this question was published by Gould et al. as part of the full work ability index (WAI). The question used by this study to measure WAS ("current work ability compared with your lifetime best") used a scale of 0 to 10 (0 = "completely unable to work" and 10 = "work ability at its best"). The following measurement classification from Gould et al. [46] was used: poor (0 to 5), moderate (6 to 7), good (8 to 9) and excellent (10).	Baseline and discharge (four weeks), and 6 and 12 months after discharge
Reduced depression and anxiety	Self-reported questionnaire measure, (The Hospital Anxiety And Depression Scale).	Baseline and discharge (four weeks)
Increase expectations to return to work	Self-reported questionnaire measures, (Return-to-Work Expectation)	Baseline and discharge (four weeks), and 6 and 12 months after discharge

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Increased cognitive performance and attention	Computerized cognitive measures. - Rapid Visual Information Processing (Cambridge Cognition, 2020). The mean response latency on trials where the subject responded correctly. Calculated across all assessed trials.	Baseline and discharge (four weeks)
Increased cognitive performance and memory	Computerized cognitive measures. - Spatial Working Memory (Cambridge Cognition, 2020). The number of times the subject incorrectly revisits a box in which a token has previously been found.	Baseline and discharge (four weeks)
Increased cognitive performance	Computerized cognitive measures. - Stop Signal Task (Cambridge Cognition, 2020). The estimate of time when an individual can successfully inhibit their responses 50% of the time.	Baseline and discharge (four weeks)
Patients's experiences in using VR	Interview guide based on the participants experience.	From discharge up to 5 month after discharge.

Collaborators and Investigators

• Sponsor: Molde University College
• Collaborators: Norwegian National Advisory Unit on Occupational Rehabilitation
• Investigators: Study Director: Chris Jensen, PhD, Norwegian National Advisory Unit on Occupational Rehabilitation

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2022
• Primary Completion (Estimated): January 1, 2026
• Study Completion (Estimated): January 1, 2026

Study Registration Dates

• First Submitted: April 23, 2024
• First Submitted That Met QC Criteria: May 7, 2024
• First Posted (Actual): May 13, 2024

Study Record Updates

• Last Update Posted (Actual): May 13, 2024
• Last Update Submitted That Met QC Criteria: May 7, 2024
• Last Verified: May 1, 2024

More Information

Terms related to this study

• Keywords: Virtual reality; qualitative study; patient experience; gaming; occupational rehabilitation; quanitative study
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Back Pain; Low Back Pain; Anxiety Disorders; Mental Disorders; Musculoskeletal Diseases
• Other Study ID Numbers: 254368

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No