Authors (including presenting author) :
Cheung HL (1), Chow YT (1), Chiang KH (1)
Affiliation :
(1) Physiotherapy department, Shatin Hospital
Introduction :
Anxiety and dyspnoea are prevalent symptoms for patients in palliative care (PC) units. Both of these symptoms are inter-related and mutually affected with each other. Breathing exercise is one of the strategy to alleviate anxiety and dyspnoea.
However, most of the patients cannot manifest breathing rhythm properly though practice conventional breathing retraining (BR). Immersive Virtual Reality (VR) training is a novel mean to provide immersive visual and auditory cues on BR.
Objectives :
To evaluate feasibility of using immersive VR training for relaxation training via BR for patients with anxiety or dyspnoea symptoms in PC unit
Methodology :
Patients were recruited from PC in-patient unit in Shatin Hospital and Bradbury Hospice. Inclusion criteria including patients could follow VR training, medically stable and patients with anxiety or dyspnoea symptoms.
Training protocol included 1 minute of trial use of immersive VR training. Patients were excluded if they had motion sickness or head and neck discomfort. 1 session of 5 minutes BR using VR training headset was delivered. Setting of respiratory rate (RR) was 12 per minute, and breath-in and breath-out rhythm was 2:3 seconds. Immersive visual & auditory clues and peaceful scene were provided.
Outcome measures included self-rated symptoms score (0-10 numeral rating scale, NRS), physiological parameters and questionnaire for patients’ feedback.
Result & Outcome :
14 patients were recruited and completed VR training program in January 2025. No patients were excluded.
Their mean age was 77.9 years old. 12 (85.7%) of them were cancer patients. 5 (35.7%) of them required oxygen supplement (1-3 liter).
Compare with outcomes before and after VR BR, both dyspnoea score at rest (from 0.93 to 0.70, p=0.1894) and anxiety score at rest (from 0.43 to 0.36, p=0.3356) demonstrated improvement but they were statistically insignificant. However, confidence score on managing dyspnoea demonstrated statistically significant improvement (from 4.86 to 5.36, p=0.013).
In addition, RR demonstrated mark and statistically significant improvement at 1 minute after VR training (from 21.43 to 18.50, p=0.0016) and upon completion of training (from 21.43 to 15.64, p=0.0008). Pulse rate was stable and no significant changes during training. Patients’ feedback showed that 35.7% and 57 % of them agreed that this VR training could help to alleviate anxiety and dyspnoea symptoms respectively.
In conclusion, this pilot study of immersive VR training for relaxation via BR was feasible to implement in PC unit, and it could probably enhance relaxation via VR breathing retraining. Further study with larger sample size was planned to conduct to evaluate the program’s effectiveness.
