Virtual Reality for ICU Patients

(GAMERS Trial)

Overseen By Anna E Mall, MSN

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Duke University

Disqualifiers: Pregnancy, Blindness, Seizures, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

30 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial examines whether Virtual Reality (VR) can aid patients in the cardiothoracic ICU (a hospital unit for heart and lung issues) in increasing mobility and improving well-being. Participants will use a VR device to play games involving arm and hand movements, potentially alleviating anxiety, depression, and loneliness. This VR-assisted mobility trial is ideal for adults who have been in the ICU for at least three days and experience difficulty moving. As an unphased trial, it presents a unique opportunity to explore innovative technology that could enhance recovery and improve well-being.

Do I need to stop my current medications for the trial?

The trial information does not specify whether you need to stop taking your current medications. It is best to discuss this with the study team or your doctor.

What prior data suggests that this VR device is safe for ICU patients?

Research has shown that using virtual reality (VR) for movement exercises in ICU patients is generally safe and well-received. One study found that VR aids movement and balance in very sick patients. Another study demonstrated that VR for arm exercises in the ICU is both feasible and safe, with patients responding positively. Additionally, VR exercises proved enjoyable and effective, enhancing patient participation and accelerating physical recovery. Overall, VR in ICU settings appears to improve patient experiences without major safety concerns. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about using virtual reality (VR) for ICU patients because it offers a unique way to enhance mobility and potentially improve recovery. Unlike traditional physical therapy, which can be challenging for ICU patients due to their limited mobility and comfort, VR provides an engaging, immersive environment that can motivate and assist patients in moving more effectively. This method could make it easier for patients to participate in mobility exercises, possibly leading to faster recovery times and a better overall ICU experience. By integrating VR, there's hope to improve patient outcomes and make rehabilitation in the ICU more accessible and enjoyable.

What evidence suggests that this VR intervention is effective for ICU patients?

Research has shown that virtual reality (VR) can help very sick patients move more easily and feel less stressed. In this trial, participants will receive a VR intervention to observe its effects on ICU mobility. Studies have found that using VR for exercises keeps patients more engaged and helps them improve movement more quickly. VR also appears to reduce stress, pain, and anxiety, and it can even enhance sleep quality. Evidence suggests that using VR in intensive care units (ICUs) might reduce the time patients need machines like ventilators. Overall, VR is a promising tool for aiding patient recovery in the ICU. ^{1 3 4 6 7}

Who Is on the Research Team?

Anna E Mall, MSN

Principal Investigator

Duke University

Are You a Good Fit for This Trial?

This trial is for patients in the cardiothoracic ICU who are able to participate in activities that involve upper body movement. They should be willing to use a VR device and play games designed to encourage mobility, as well as complete surveys about their mental health.

Inclusion Criteria

I was in the ICU for 3 or more days and couldn't move much.

English speaking

I am 18 years old or older.

Exclusion Criteria

I have had seizures in the past.

Pregnancy

History of special enteric contact isolation

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants engage in a Virtual Reality intervention to improve mobility and psychological health in the ICU

up to 6 months

Daily sessions

Follow-up

Participants are monitored for safety and effectiveness after the intervention

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• VR assisted mobility

Trial Overview The study is testing whether using Virtual Reality (VR) applications can help improve physical activity and psychological well-being of patients recovering in the intensive care unit after cardiac surgery.

How Is the Trial Designed?

Group I: Virtual Reality (VR) intervention Experimental Treatment 1 Intervention

Cohort for observing the effects of the VR intervention on ICU mobility.

Who Is Running the Clinical Trial?

Duke University

Lead Sponsor

Trials

2,495

Recruited

5,912,000+

Published Research Related to This Trial

Virtual reality (VR) has the potential to reduce anxiety, stress, and pain in critically ill patients, while also aiding in their rehabilitation and improving communication among care providers.

Augmented reality (AR) can enhance the education of healthcare providers in critical care settings, helping them acquire essential skills, but both technologies face challenges such as 'cybersickness' and ethical concerns regarding their use in vulnerable patient populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Virtual and augmented reality in critical care medicine: the patient's, clinician's, and researcher's perspective. Bruno, RR., Wolff, G., Wernly, B., et al.[2022]

The study demonstrated that immersive virtual reality (iVR) is feasible for use in critically ill patients in the ICU, including those on mechanical ventilation, with 80% of sessions completed without serious side effects.

iVR significantly reduced anxiety levels in patients after each session, indicating that digital therapies like iVR can effectively improve emotional well-being during ICU stays.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Usage of immersive virtual reality as a relaxation method in an intensive care unit. Martí-Hereu, L., Navarra-Ventura, G., Navas-Pérez, AM., et al.[2023]

A study involving 33 critically ill cardiac surgery patients showed that using virtual reality (VR) technology during their ICU stay significantly decreased their respiratory rate, indicating a relaxing effect, while heart rate and blood pressure remained stable.

Patients reported high acceptance and recollection of the VR experience, with 84.8% recalling the VR sessions compared to only 30.3% recalling their ICU stay, suggesting that VR can provide effective cognitive stimulation and comfort during critical illness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Perception and Performance on a Virtual Reality Cognitive Stimulation for Use in the Intensive Care Unit: A Non-randomized Trial in Critically Ill Patients. Gerber, SM., Jeitziner, MM., Knobel, SEJ., et al.[2020]

A proof-of-concept study involving 37 healthy participants in an ICU showed that virtual reality (VR) stimulation with natural scene videos significantly reduced heart rate and blood pressure, indicating a calming effect.

The VR setup also improved visual processing, as evidenced by an increased fixation/saccade ratio, suggesting that VR can enhance cognitive engagement and potentially aid in recovery for critically ill patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Visuo-acoustic stimulation that helps you to relax: A virtual reality setup for patients in the intensive care unit. Gerber, SM., Jeitziner, MM., Wyss, P., et al.[2019]

A systematic review of 59 studies highlights that virtual reality (VR) and augmented reality (AR) can enhance training for healthcare providers in intensive care units (ICUs) by simulating complex procedures like CPR and intubation.

VR and AR technologies may also benefit patients in ICUs by reducing stress and pain during invasive procedures, facilitating communication with relatives, and supporting rehabilitation efforts.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Virtual and augmented reality in intensive care medicine: a systematic review. Kanschik, D., Bruno, RR., Wolff, G., et al.[2023]

A pilot study in the PICU involving children aged 3 to 17 showed that 100% of participants enjoyed using virtual reality, indicating high satisfaction with this intervention.

Parents reported that 82% of children felt calmer after using virtual reality, suggesting it may be an effective tool for improving emotional well-being in critically ill patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An Innovative Virtual Reality Experience in the PICU: A Pilot Study. Badke, CM., Essner, BS., O'Connell, M., et al.[2020]

In a pilot study involving 12 critically ill children in a Pediatric Critical Care Unit, virtual reality exercise using Nintendo Wii™ Boxing was found to be safe, with no adverse events reported during the intervention.

While the VR exercise increased upper limb activity compared to daily activity, challenges in feasibility were noted, as only 8 participants completed the study, indicating potential barriers to implementation in this patient population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

"Wii-Hab" in critically ill children: a pilot trial. Abdulsatar, F., Walker, RG., Timmons, BW., et al.[2022]

The Visual Patient Avatar ICU technology enhances patient monitoring by dynamically displaying vital signs and device information, which ICU professionals found to improve information retention and problem identification.

While most users had a positive perception of the tool's simplicity and intuitiveness, some expressed concerns about potential information overload and the lack of exact numerical values, indicating areas for further development before clinical use.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

User Perceptions of Avatar-Based Patient Monitoring for Intensive Care Units: An International Exploratory Sequential Mixed-Methods Study. Lunkiewicz, J., Gasciauskaite, G., Roche, TR., et al.[2023]

A multidisciplinary team has created a virtual reality system designed to promote early mobilization for critically ill patients in the ICU, addressing the low utilization rates of such practices.

The system includes features like varied mobilization exercises, cognitive training integration, visualization of exercises, and tracking of progress, which may enhance patient rehabilitation outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Development of a Virtual Reality System for Early Mobilization of Critically Ill Patients. Wang, J., Zhang, C., Jia, Y., et al.[2019]

A survey of 233 clinicians and 50 patients at Mayo Clinic revealed that both groups generally support the use of video recognition (VR) technology in the ICU, particularly for enhancing patient safety and aiding in diagnostics.

Concerns about VR include potential privacy breaches and the impact on the patient-clinician relationship, with 81% of clinicians worried about VR being used in lawsuits and 59% of patients expressing privacy concerns.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Are We Ready for Video Recognition and Computer Vision in the Intensive Care Unit? A Survey. Glancova, A., Do, QT., Sanghavi, DK., et al.[2022]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11837775/

Effects of virtual reality technology on early mobility in ... Virtual reality technology has a better overall effect in improving motor rehabilitation in critically ill patients and enhancing balance, functional walking,

2. medicaljournalssweden.se medicaljournalssweden.se/jrm/article/view/28399/50471

Effectiveness of virtual reality assisted active limb ... The study found that virtual reality-based exercises were more engaging and effective, leading to higher patient compliance and faster improvements in physical ...

3. aacnjournals.org aacnjournals.org/aacnacconline/article/35/3/238/32541/Virtual-Reality-Strategies-for-Promoting-Mobility

Virtual Reality Strategies for Promoting Mobility in the ... A growing body of evidence supports the use of VR in critical care settings to alleviate patients' stress, pain, and anxiety; improve sleep ...

4. annalsofintensivecare.springeropen.com annalsofintensivecare.springeropen.com/articles/10.1186/s13613-023-01176-z

Virtual and augmented reality in intensive care medicine The aim of this systematic review was to provide a detailed summary of how VR and AR are currently being used in various areas of intensive care medicine.

5. neurorehabvr.com neurorehabvr.com/blog/using-vr-icu

Reclaiming Life: VR Sparks Healing in the ICU Discover how virtual reality is transforming ICU care by improving early mobilization, reducing ventilator days, and supporting faster ...

6. sciencedirect.com sciencedirect.com/science/article/abs/pii/S1036731424001176

Feasibility & Safety: VR Upper Limb Rehab for Critical Illness Interactive upper limb VRR is a feasible, safe, and appreciated tool to use in rehabilitation of critically ill patients during their prolonged ICU stay.

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9490570/

ICU-VR to Improve Psychological Well-being in ICU Survivors An ICU-specific virtual reality intervention (ICU-VR) for post-ICU patients is feasible and safe, improves satisfaction with ICU aftercare, and might improve ...