JMIR Publications

ABSTRACT

Background:

Virtual Reality (VR) represents an innovative tool which can facilitate exposure to either stressful or relaxing stimuli, and enables individuals who have difficulties visualizing scenes to be involved in a more realistic sensorimotor experience. It also facilitates multisensory stimulation, a sense of presence, and achievement of relaxation. VR scenarios representing visual and auditory elements of natural relaxing environments can facilitate the learning of relaxation techniques such as Progressive Muscle Relaxation (PMRT). A standardized technique deployed to reduce anxiety symptoms is represented by the integration of PMRT with Guided Imagery (GI). Imagination exposure to a pleasant environment helps to establish an association between a relaxing scenario and the relaxation technique, thus enhancing relaxation. Empirical evidence has shown that VR scenarios can increase the effects of relaxation techniques by enabling people to experience emotional conditions in more vivid settings.

Objective:

The main aim of this pilot study protocol is to investigate the impact on state anxiety of PMRT, associated with a personalized relaxing scenario in VR, and the role of VR scenarios in facilitating the recall of relaxing images and sense of presence. A secondary aim is to understand if relaxing sessions administered online via Zoom are more effective for managing anxiety and stress than a procedural setting based on audio-track guidance.

Methods:

Based on a longitudinal, between-subject design, one hundred and five university students will be randomly exposed to one of three experimental conditions: 1) PMRT via Zoom and GI exposure; 2) PMRT via Zoom and personalized VR exposure; 3) PMRT based on audio-track guidance and personalized VR exposure. Individuals are assessed before and after seven training sessions based on self-report questionnaires investigating anxiety, depression, quality of life, coping strategies, sense of presence, engagement, and side effects related to VR exposure. Heart rate data is also detected by a MiBand 2 sensor.

Results:

The experimental procedure is ongoing. In the present paper, preliminary data on a sample of 40 participants will be illustrated. The experimental phase is expected to conclude in February 2023, and the final results of the research will be presented in April 2023.

Conclusions:

The results of this study will help to shape the experimental design to apply it on a subsequent randomized controlled trial, also considering clinical samples. This work is expected to measure if VR is a more engaging and helpful technique in promoting relaxation and decreasing anxiety levels than GI, by making the visualization process easier and by helping people to face more realistic sensory experiences. Assessing the efficacy of the PMRT in alternative delivery modes may extend its applications, especially in situations where the standard procedure is more challenging to be administered. To our knowledge, no equivalent study has been published so far on this matter. Clinical Trial: This study is registered with the National Institute of Health (NIH) U.S. National Library of Medicine, ClinicalTrials.gov identifier NCT05478941, as of July 28th, 2022.