Virtual Reality Based-therapy Applied to Physical Therapy in Cardiology.
2 augustus 2019 bijgewerkt door: Ana Laura Ricci-Vitor, Universidade Estadual Paulista Júlio de Mesquita Filho
The aim of this study is to investigate engagement, motivation, and the barriers to adherence of virtual reality based therapy (VRBT) in patients with cardiac diseases and risk factors to the development of cardiac diseases.
In addition, to investigate autonomic and hemodynamic responses of VRBT in comparison with conventional therapy (CT).
To do this, patients with cardiac diseases or risk factors will be invited to perform CT or VRBT+CT.
They will be submitted to an initial evaluation, and then will be random allocated to 12 weeks of intervention and to a final evaluation.
The primary outcomes includes engagement, motivation, barriers and adherence in the 12 previous weeks using questionnaire, after 12 weeks of the intervention and after 12 weeks of the final intervention program.
Hemodynamic and autonomic responses will be considered the secondary outcomes being evaluated before, during and after a session at the first, sixth and twelfth week.
Studie Overzicht
Toestand
Voltooid
Conditie
Interventie / Behandeling
Gedetailleerde beschrijving
Introduction: cardiovascular rehabilitation programs (CR) can promote several benefits in patients with cardiac diseases.
However, there are problems related to the patient adherence in CR.
Some of these problems can be caused to factors like motivation.
Alternative therapies can improve motivation and increase adherence to CR.
In this context, virtual reality based therapy (VRBT), have shown benefits in cardiac patients to pain relief, functional capacity and increasing physical activity levels, but there is no answer whether it can increase engagement and adherence to CR.
In addition, it is important to investigate hemodynamic responses of VRBT.
Objective: investigate engagement, motivation, and the barriers to adherence of VRBT in patients with cardiac diseases and risk factors to the development of cardiac diseases.
In addition, to investigate autonomic and hemodynamic responses of VRBT in comparison with conventional therapy (CT).
Methods: patients with cardiac diseases or risk factors will be invited to perform CT or VRBT+CT.
They will be submitted to an initial evaluation, the intervention and to a final evaluation.
The initial evaluation include eligibility investigation, and after they will be random allocated to the interventions.
The interventions will be performed with a frequency of three times a week, for 12 weeks, and the intensity will be prescribed individually.
The primary outcomes includes engagement, motivation, barriers and adherence in the 12 previous weeks according to a recall questionnaire, after 12 weeks of the intervention and after 12 weeks of the final intervention program.
The engagement will be evaluated using the User Engagement Scale (modified).
Motivation will be evaluated using the intrinsic motivation questionnaire.
The barriers will be evaluated using the Barriers Scale of Cardiac Rehabilitation.
Adherence will be evaluated using the presence in the patient's records.
Hemodynamic responses will be evaluated before, during and after a session at the first, sixth and twelfth week using blood pressure, heart rate, respiratory rate, oxygen saturation and rating of perceived exertion.
Autonomic responses will be evaluated using heart rate variability.
Statistical analysis: the data analysis will be evaluated using the two way ANOVA with Bonferroni posttest with significance to p < 0.05.
Studietype
Ingrijpend
Inschrijving (Werkelijk)
68
Fase
- Niet toepasbaar
Contacten en locaties
In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.
Studie Locaties
-
-
São Paulo
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Presidente Prudente, São Paulo, Brazilië, 19060900
- Laboratório de Fisiologia do Estresse
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Deelname Criteria
Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
14 jaar en ouder (Volwassen, Oudere volwassene)
Accepteert gezonde vrijwilligers
Nee
Geslachten die in aanmerking komen voor studie
Allemaal
Beschrijving
Inclusion Criteria:
- Patients with cardiovascular diseases
- Patients with risk factors to develop cardiovascular diseases
Exclusion Criteria:
- Patients who disagree to participate of any protocol interventions
Studie plan
Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Preventie
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Dubbele
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
|
Actieve vergelijker: Conventional therapy
Exercise-based cardiac rehabilitation
|
Both interventions uses exercises
|
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Experimenteel: Virtual reality based therapy
Exercise-based virtual reality
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Both interventions uses exercises
|
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Engagement
Tijdsspanne: Change from baseline at 12 weeks
|
Measured using the Utrecht engagement scale modified There is 17 items scored from 1 to 7, according to the Likert Scale.
Then, each item is summed and divided for the number of items.
Higher values represent a better engagement.
|
Change from baseline at 12 weeks
|
|
Motivation
Tijdsspanne: Change from baseline at 12 weeks
|
Measured using the Intrinsic motivation inventory There is 18 items scored from 1 to 5, according to the Likert Scale.
Then, each item is summed and divided for the number of items.
Higher values represent a better motivation.
|
Change from baseline at 12 weeks
|
|
Barriers to Cardiac Rehabilitation
Tijdsspanne: Change from baseline at 12 weeks
|
Measured using Cardiac Rehabilitation Barriers Scale There is 21 items score from 1 to 5, according to the Likert Scale.
Then, each item is summed and divided for the number of items.
Higher values represent a worse outcome.
In addition, there is four subscales: 1) Perceived need/health care factors, 2) Logistical factors, 3) Work/time conflicts, and 4) Comorbidities/functional status.
The subscales are scored in the same way of the total, it means, from 1 to 5 and them dividing from the total number of the items included in the subscale.
|
Change from baseline at 12 weeks
|
|
Adherence to Cardiac Rehabilitation
Tijdsspanne: Change from baseline at 12 weeks
|
Measured using the number of cardiac rehabilitation sessions attended
|
Change from baseline at 12 weeks
|
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Autonomic responses
Tijdsspanne: Up to 12 weeks
|
Measured using heart rate variability The heart rate variability will be measured through the following linear indices (SDNN: the standard deviation of normal-to-normal intervals, ms; rMSSD: the root mean square of successive difference between normal intervals,ms; RRtri: triangular index, based on RR intervals,ms; TINN: triangular interpolation of the normal to normal interval between consecutive heart beats, ms; LF: low frequency, nu; HF: high frequency and nonlinear indices,nu.).
In addition the nonlinear indices will be measured (SD1: standard deviation of instant variability beat to beat; SD2: standard deviation of long-term interval between consecutive heart beats).
In general higher values represent a better autonomic response.
|
Up to 12 weeks
|
|
Blood pressure
Tijdsspanne: Up to 12 weeks
|
Measured using both systolic blood pressure and diastolic blood pressure
|
Up to 12 weeks
|
|
Heart rate
Tijdsspanne: Up to 12 weeks
|
Measured using an equipment validated for recording heart rate beat to beat
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Up to 12 weeks
|
|
Respiratory rate
Tijdsspanne: Up to 12 weeks
|
Measured using the number of respiratory incursions in one minute
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Up to 12 weeks
|
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Oxygen Saturation
Tijdsspanne: Up to 12 weeks
|
Measured using an oximeter
|
Up to 12 weeks
|
|
Perceived exertion
Tijdsspanne: Up to 12 weeks
|
Measured using Borg Scale.
This scale varies from 6 to 20.
|
Up to 12 weeks
|
Medewerkers en onderzoekers
Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.
Onderzoekers
- Hoofdonderzoeker: Ana Laura Ricci-Vitor, PhD, Universidade Estadual Paulista Julio de Mesquita Filho
Publicaties en nuttige links
De persoon die verantwoordelijk is voor het invoeren van informatie over het onderzoek stelt deze publicaties vrijwillig ter beschikking. Dit kan gaan over alles wat met het onderzoek te maken heeft.
Algemene publicaties
- da Cruz MMA, Ricci-Vitor AL, Borges GLB, da Silva PF, Turri-Silva N, Takahashi C, Grace SL, Vanderlei LCM. A Randomized, Controlled, Crossover Trial of Virtual Reality in Maintenance Cardiovascular Rehabilitation in a Low-Resource Setting: Impact on Adherence, Motivation, and Engagement. Phys Ther. 2021 May 4;101(5). pii: pzab071. doi: 10.1093/ptj/pzab071.
- Alves da Cruz MM, Ricci-Vitor AL, Bonini Borges GL, Fernanda da Silva P, Ribeiro F, Marques Vanderlei LC. Acute Hemodynamic Effects of Virtual Reality-Based Therapy in Patients of Cardiovascular Rehabilitation: A Cluster Randomized Crossover Trial. Arch Phys Med Rehabil. 2020 Apr;101(4):642-649. doi: 10.1016/j.apmr.2019.12.006. Epub 2020 Jan 8.
Studie record data
Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.
Bestudeer belangrijke data
Studie start (Werkelijk)
19 december 2017
Primaire voltooiing (Werkelijk)
1 december 2018
Studie voltooiing (Werkelijk)
3 juni 2019
Studieregistratiedata
Eerst ingediend
6 november 2017
Eerst ingediend dat voldeed aan de QC-criteria
13 december 2017
Eerst geplaatst (Werkelijk)
19 december 2017
Updates van studierecords
Laatste update geplaatst (Werkelijk)
5 augustus 2019
Laatste update ingediend die voldeed aan QC-criteria
2 augustus 2019
Laatst geverifieerd
1 augustus 2019
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- NCT400579/2017-0
Plan Individuele Deelnemersgegevens (IPD)
Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?
Nee
Beschrijving IPD-plan
After published results,
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Nee
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
Nee
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