Effectiveness of an Inpatient Virtual Reality-Based Pulmonary Rehabilitation Program among COVID-19 Patients on Symptoms of Anxiety, Depression and Quality of Life: Preliminary Results from a Randomized Controlled Trial

Sebastian Rutkowski; Katarzyna Bogacz; Oliver Czech; Anna Rutkowska; Jan Szczegielniak

doi:10.3390/ijerph192416980

Effectiveness of an Inpatient Virtual Reality-Based Pulmonary Rehabilitation Program among COVID-19 Patients on Symptoms of Anxiety, Depression and Quality of Life: Preliminary Results from a Randomized Controlled Trial

Int J Environ Res Public Health. 2022 Dec 17;19(24):16980. doi: 10.3390/ijerph192416980.

Authors

Sebastian Rutkowski¹, Katarzyna Bogacz^{1

2}, Oliver Czech³, Anna Rutkowska¹, Jan Szczegielniak^{1

2}

Affiliations

¹ Faculty of Physical Education and Physiotherapy, Opole University of Technology, 45-758 Opole, Poland.
² Specialist Hospital of the Ministry of the Interior and Administration in Głuchołazy, 48-340 Głuchołazy, Poland.
³ Department of Physiotherapy, Wroclaw University of Health and Sport Sciences, 51-612 Wroclaw, Poland.

Abstract

Forms of rehabilitation for patients after COVID-19 are gaining interest. The purpose of this study was to investigate and compare an innovative in-hospital pulmonary rehabilitation programs augmented with training elements performed in virtual reality. This randomized controlled study included 32 patients enrolled in post-COVID-19 rehabilitation at a Public Hospital in Poland. The rehabilitation models included exercise capacity training on a cycle ergometer, breathing and general fitness workout, resistance training, and relaxation. The forms of training and relaxation differed between the groups: the experimental group employed virtual reality, and the control group used a traditional form of therapy. Exercise tolerance was assessed using a 6 min walk test (6 MWT), while psychological parameters were evaluated using the Hospital Anxiety and Depression Scale (HADS) and the brief World Health Organization Quality of Life Scale (WHOQOL-BRIEF). The analysis of the post-rehabilitation results showed a statistically significant improvement in both groups regarding depression (VR: 6.9 (3.9) vs. 4.7 (3.5), p = 0.008; CG: 7.64 (4.5) vs. 6.6 (4.8), p = 0.017) and anxiety (VR: 8.6 (4.6) vs. 5.6 (3.3), p < 0.001; CG: 9.57 (6.0) vs. 8 (4.8), p = 0.003). No statistically significant improvements in quality of life were noted in both groups. Moreover, the analysis showed a statistically significant improvement in the exercise capacity in both groups after completion of the rehabilitation program, expressed as a distance in the 6 MWT, as well as a statistically significant improvement in dyspnea in the VR group. To conclude, the analysis of the preliminary data revealed that a 3-week hospital-based pulmonary rehabilitation program for COVID-19 patients led to an improvement in exercise tolerance as well as a reduction in the symptoms of anxiety and depression. The virtual reality-based form of training delivery, despite its attractiveness, did not significantly affect patients' performance.

Trial registration: ClinicalTrials.gov NCT05244135.

Keywords: COVID-19; anxiety; pulmonary rehabilitation; stress; virtual reality.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Anxiety
COVID-19*
Depression
Humans
Inpatients
Quality of Life
Virtual Reality*

Associated data

ClinicalTrials.gov/NCT05244135

Grants and funding

This project was funded by The Polish National Agency for Academic Exchange Narodowa Agencja Wymiany Akademickiej (NAWA), under the NAWA Urgency Grants; grant number PPN/GIN/2020/1/00054.