Virtual Therapy Complementary Prehabilitation of Women Diagnosed with Breast Cancer-A Pilot Study

Oliver Czech, Katarzyna Siewierska, Aleksandra Krzywińska, Jakub Skórniak, Adam Maciejczyk, Rafał Matkowski, Joanna Szczepańska-Gieracha, Iwona Malicka, Oliver Czech, Katarzyna Siewierska, Aleksandra Krzywińska, Jakub Skórniak, Adam Maciejczyk, Rafał Matkowski, Joanna Szczepańska-Gieracha, Iwona Malicka

Abstract

Breast cancer is becoming an important issue due to its various consequences and epidemiology. Studies are showing that it extremely impacts the mental health as well as the physical activity of the patients. In addition to the most common symptom, which is fatigue, patients also have problems with the quality of sleep. Therefore, this study aimed to evaluate the effectiveness of virtual reality (VR) therapy in improving the mental state and quality of sleep, as well as increasing the physical activity (PA) of patients diagnosed with breast cancer. The study was conducted in a hospital's Breast Unit and included patients at the time of diagnosis of malignant breast cancer. A total of 16 subjects randomly divided into experimental (n = 9), and control (n = 7) groups were measured with the Beck Depression Scale, Mental Adjustment to Cancer Scale, International Physical Activity Questionnaire, and Pittsburgh Sleep Quality Index at two timepoints. The experimental intervention consisted of a 2-week (8 sessions) Virtual Therapeutic Garden (VRTierOne) procedure performed daily for about 15 min. Significant differences were identified between groups in the interactions between the main factors seen in the destructive style of the Mini-Mac scale: F(1.14) = 4.82, p = 0.04, and between multiple experiments: F(1.14)= 5.54, p = 0.03 showing a significant reduction in the destructive style of coping with the disease in the study group after therapy (32.44 vs. 28.33, p = 0.003). The level of main effects [study] for the constructive style is F(1.14) = 3.93, p = 0.06 with a significant increase in constructive style in the study group (43.33 vs. 45.33, p = 0.044). Significant differences in levels of depression between multiple experiments: F(1.14) = 5.04, p = 0.04, show a significant reduction in the severity of depressive symptoms was found in the experimental group after therapy (13.33 vs. 8.11, p = 0.02). However, the analysis did not show significant differences between group analyses (p = 0.25). It seems that VR reduces the severity of depressive symptoms and reduces the destructive style and can be an effective option in improving the mental state of patients diagnosed with breast cancer.

Keywords: physical activity; physical health; psychotherapy; quality of sleep; virtual reality.

Conflict of interest statement

Authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Study flow.

References

    1. Mattiuzzi C., Lippi G. Current cancer epidemiology. J. Epidemiol. Glob. Health. 2019;9:217–222. doi: 10.2991/jegh.k.191008.001.
    1. Block K.I., Gyllenhaal C., Lowe L., Amedei A., Amin A.R., Aquilano K., Arbiser J., Arreola A., Arzumanyan A., Ashraf S.S., et al. Designing a broad-spectrum integrative approach for cancer prevention and treatment. Semin. Cancer Biol. 2015;35:S276–S304. doi: 10.1016/j.semcancer.2015.09.007.
    1. Poort H., Jacobs J.M., Pirl W.F., Temel J.S., Greer J.A. Fatigue in patients on oral targeted or chemotherapy for cancer and associations with anxiety, depression, and quality of life. Palliat. Support. Care. 2020;18:141–147. doi: 10.1017/S147895151900066X.
    1. Poort H., van der Graaf W.T., Tielen R., Vlenterie M., Custers J.A., Prins J.B., Verhagen C.A., Gielissen M.F., Knoop H. Prevalence, Impact, and Correlates of Severe Fatigue in Patients With Gastrointestinal Stromal Tumors. J. Pain Symptom Manag. 2016;52:265–271. doi: 10.1016/j.jpainsymman.2016.02.019.
    1. Butt Z., Rosenbloom S.K., Abernethy A.P., Beaumont J.L., Paul D., Hampton D., Jacobsen P.B., Syrjala K.L., Von Roenn J.H., Cella D. Fatigue is the most important symptom for advanced cancer patients who have had chemotherapy. J. Natl. Compr. Cancer Netw. 2008;6:448–455. doi: 10.6004/jnccn.2008.0036.
    1. O’Regan P., McCarthy G., O’Reilly S., Power D., Bird B.H., Murphy C.G., Hegarty J. Cancer-related fatigue and self-care agency: A multicentre survey of patients receiving chemotherapy. J. Clin. Nurs. 2019;28:4424–4433. doi: 10.1111/jocn.15026.
    1. Hofman M., Ryan J.L., Figueroa-Moseley C.D., Jean-Pierre P., Morrow G.R. Cancer-related fatigue: The scale of the problem. Oncologist. 2007;12:4–10. doi: 10.1634/theoncologist.12-S1-4.
    1. Batalik L., Winnige P., Dosbaba F., Vlazna D., Janikova A. Home-Based Aerobic and Resistance Exercise Interventions in Cancer Patients and Survivors: A Systematic Review. Cancers. 2021;13:1915. doi: 10.3390/cancers13081915.
    1. Wu F., Laza-Cagigas R., Pagarkar A., Olaoke A., El Gammal M., Rampal T. The Feasibility of Prehabilitation as Part of the Breast Cancer Treatment Pathway. PM&R. 2021;13:1237–1246.
    1. Chirico A., Maiorano P., Indovina P., Milanese C., Giordano G.G., Alivernini F., Iodice G., Gallo L., De Pietro G., Lucidi F., et al. Virtual reality and music therapy as distraction interventions to alleviate anxiety and improve mood states in breast cancer patients during chemotherapy. J. Cell. Physiol. 2020;235:5353–5362. doi: 10.1002/jcp.29422.
    1. Kareliotis G., Tremi I., Kaitatzi M., Drakaki E., Serafetinides A.A., Makropoulou M., Georgakilas A.G. Combined radiation strategies for novel and enhanced cancer treatment. Int. J. Radiat. Biol. 2020;96:1087–1103. doi: 10.1080/09553002.2020.1787544.
    1. van Vulpen J.K., Peeters P.H., Velthuis M.J., van der Wall E., May A.M. Effects of physical exercise during adjuvant breast cancer treatment on physical and psychosocial dimensions of cancer-related fatigue: A meta-analysis. Maturitas. 2016;85:104–111. doi: 10.1016/j.maturitas.2015.12.007.
    1. Kirk D., Kabdebo I., Whitehead L. Prevalence of distress, its associated factors and referral to support services in people with cancer. J. Clin. Nurs. 2021;30:2873–2885. doi: 10.1111/jocn.15794.
    1. van Waart H., van Dongen J.M., van Harten W.H., Stuiver M.M., Huijsmans R., Vreeswijk J.A.J.H.H.-v., Sonke G.S., Aaronson N.K. Cost-utility and cost-effectiveness of physical exercise during adjuvant chemotherapy. Eur. J. Health Econ. 2018;19:893–904. doi: 10.1007/s10198-017-0936-0.
    1. Brahmbhatt P., Sabiston C.M., Lopez C., Chang E., Goodman J., Jones J., McCready D., Randall I., Rotstein S., Mina D.S. Feasibility of Prehabilitation Prior to Breast Cancer Surgery: A Mixed-Methods Study. Front. Oncol. 2020;10:571091. doi: 10.3389/fonc.2020.571091.
    1. Toohey K., Hunter M., McKinnon K., Casey T., Turner M., Taylor S., Paterson C. A systematic review of multimodal prehabilitation in breast cancer. Breast Cancer Res. Treat. 2022 doi: 10.1007/s10549-022-06759-1.
    1. Jóźwik S., Cieślik B., Gajda R., Szczepańska-Gieracha J. Evaluation of the Impact of Virtual Reality-Enhanced Cardiac Rehabilitation on Depressive and Anxiety Symptoms in Patients with Coronary Artery Disease: A Randomised Controlled Trial. J. Clin. Med. 2021;10:2148. doi: 10.3390/jcm10102148.
    1. Beck A.T., Ward C.H., Mendelson M., Mock J., Erbaugh J. An inventory for measuring depression. Arch. Gen. Psychiatry. 1961;4:561–571. doi: 10.1001/archpsyc.1961.01710120031004.
    1. Watson M., Greer S., Young J., Inayat Q., Burgess C., Robertson B. Development of a questionnaire measure of adjustment to cancer: The MAC scale. Psychol. Med. 1988;18:203–209. doi: 10.1017/S0033291700002026.
    1. Hallal P.C., Victora C.G. Reliability and validity of the International Physical Activity Questionnaire (IPAQ) Med. Sci. Sports Exerc. 2004;36:556. doi: 10.1249/01.MSS.0000117161.66394.07.
    1. Mollayeva T., Thurairajah P., Burton K., Mollayeva S., Shapiro C.M., Colantonio A. The Pittsburgh sleep quality index as a screening tool for sleep dysfunction in clinical and non-clinical samples: A systematic review and meta-analysis. Sleep Med. Rev. 2016;25:52–73. doi: 10.1016/j.smrv.2015.01.009.
    1. Rutkowski S., Czech O., Wrzeciono A., Kiper P., Szczepańska-Gieracha J., Malicka I. Virtual reality as a chemotherapy support in treatment of anxiety and fatigue in patients with cancer: A systematic review and meta-analysis and future research directions. Complement. Ther. Med. 2021;61:102767. doi: 10.1016/j.ctim.2021.102767.
    1. Rutkowski S., Szczegielniak J., Szczepańska-Gieracha J. Evaluation of the Efficacy of Immersive Virtual Reality Therapy as a Method Supporting Pulmonary Rehabilitation: A Randomized Controlled Trial. J. Clin. Med. 2021;10:352. doi: 10.3390/jcm10020352.
    1. Szczepańska-Gieracha J., Cieślik B., Serweta A., Klajs K. Virtual Therapeutic Garden: A Promising Method Supporting the Treatment of Depressive Symptoms in Late-Life: A Randomized Pilot Study. J. Clin. Med. 2021;10:1942. doi: 10.3390/jcm10091942.
    1. Jóźwik S., Cieślik B., Gajda R., Szczepańska-Gieracha J. The Use of Virtual Therapy in Cardiac Rehabilitation of Female Patients with Heart Disease. Medicina. 2021;57:768. doi: 10.3390/medicina57080768.
    1. Riva G., Bernardelli L., Castelnuovo G., Clementi A., Lernia D.D., Pedroli E., Malighetti C., Sforza F., Wiederhold B.K., Serino S. A Free Weekly Self-Administered at-Home Virtual Reality Based Protocol for Overcoming the Psychological Burden of Coronavirus: A Pragmatic Waitlist-Controlled Trial Conducted During COVID-19 Lockdown in Italy with 2-Week Follow-Up. arXiv. 2021 doi: 10.31234/.
    1. Horesh D., Kohavi S., Shilony-Nalaboff L., Rudich N., Greenman D., Feuerstein J.S., Abbasi M.R. Virtual Reality Combined with Artificial Intelligence (VR-AI) Reduces Hot Flashes and Improves Psychological Well-Being in Women with Breast and Ovarian Cancer: A Pilot Study. Healthcare. 2022;10:2261. doi: 10.3390/healthcare10112261.
    1. Chang L.-C., Wang C.-Y., Yu P. Virtual reality improves sleep quality amongst older adults with disabilities. Int. J. Geriatr. Psychiatry. 2014;29:1312–1313. doi: 10.1002/gps.4172.
    1. Evans E., Naugle K.E., Kaleth A.S., Arnold B., Naugle K.M. Physical Activity Intensity, Perceived Exertion, and Enjoyment During Head-Mounted Display Virtual Reality Games. Games Health J. 2021;10:314–320. doi: 10.1089/g4h.2021.0036.
    1. Qian J., McDonough D.J., Gao Z. The Effectiveness of Virtual Reality Exercise on Individual’s Physiological, Psychological and Rehabilitative Outcomes: A Systematic Review. Int. J. Environ. Res. Public Health. 2020;17:4133. doi: 10.3390/ijerph17114133.
    1. Baños R.M., Espinoza M., García-Palacios A., Cervera J.M., Esquerdo G., Barrajón E., Botella C. A positive psychological intervention using virtual reality for patients with advanced cancer in a hospital setting: A pilot study to assess feasibility. Support. Care Cancer. 2013;21:263–270. doi: 10.1007/s00520-012-1520-x.

Source: PubMed

3
订阅