A Randomized, Controlled, Crossover Trial of Virtual Reality in Maintenance Cardiovascular Rehabilitation in a Low-Resource Setting: Impact on Adherence, Motivation, and Engagement

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MetadadosDescriçãoIdioma
Autor(es): dc.contributorUniversidade Estadual Paulista (Unesp)-
Autor(es): dc.contributorUniversity of Brasilia-
Autor(es): dc.contributorYork University-
Autor(es): dc.creatorda Cruz, Mayara Moura Alves [UNESP]-
Autor(es): dc.creatorRicci-Vitor, Ana Laura [UNESP]-
Autor(es): dc.creatorBorges, Giovanna Lombardi Bonini [UNESP]-
Autor(es): dc.creatorda Silva, Paula Fernanda [UNESP]-
Autor(es): dc.creatorTurri-Silva, Natália-
Autor(es): dc.creatorTakahashi, Carolina [UNESP]-
Autor(es): dc.creatorGrace, Sherry L.-
Autor(es): dc.creatorVanderlei, Luiz Carlos Marques [UNESP]-
Data de aceite: dc.date.accessioned2022-02-22T00:54:17Z-
Data de disponibilização: dc.date.available2022-02-22T00:54:17Z-
Data de envio: dc.date.issued2021-06-25-
Data de envio: dc.date.issued2021-06-25-
Data de envio: dc.date.issued2021-05-04-
Fonte completa do material: dc.identifierhttp://dx.doi.org/10.1093/ptj/pzab071-
Fonte completa do material: dc.identifierhttp://hdl.handle.net/11449/208739-
Fonte: dc.identifier.urihttp://educapes.capes.gov.br/handle/11449/208739-
Descrição: dc.descriptionOBJECTIVE: The purpose of this study was to investigate the effects of adding virtual reality (VR) to maintenance cardiac rehabilitation (CR); it was hypothesized VR would increase adherence, motivation, and engagement. METHODS: This study was a randomized, 1:1 concealed-allocation, single-blinded, 2 parallel-arm, crossover trial. Blinded assessments were undertaken at baseline (midprogram), 12 weeks, and 24 weeks after baseline. The setting was a single CR program of unlimited duration in Brazil. Participants were patients with cardiovascular diseases or risk factors who had been in the program for 3 months or longer. The CR program consisted of 3 supervised exercise sessions per week. In the VR arm, participants had 1 VR session of the 3 per week during the initial 12 weeks of the trial; this was withdrawn the subsequent 12 weeks. Measures were program adherence (% of 3 sessions/week over 12 weeks, ascertained in all participants), motivation (Behavioral Regulation in Exercise Questionnaire 3), and engagement (User Engagement Scale, adapted; vigor, dedication, and absorption subscales); all 3 were primary outcomes. RESULTS: Sixty-one (83.6%) patients were randomly assigned (n = 30 to CR + VR); 54 (88.5%) were retained at 12 and 24 weeks. At baseline, participants had been in CR on average 7 years and had high engagement and motivation. CR + VR resulted in a significant increase in adherence at 12 weeks (baseline = 72.87%; 12 weeks = 82.80%), with significant reductions at 24 weeks when VR was withdrawn (65.48%); in the usual CR care arm, there were no changes over time. There was a significant effect for arm, with significantly higher adherence in the CR + VR arm than usual CR at 12 weeks (73.51%). Motivation decreased significantly from baseline to 12 weeks (4.32 [SD = 0.37] vs 4.02 [SD = 0.76]) and significantly increased from 12 to 24 weeks in the CR + VR arm (4.37 [SD = 0.36]). Absorption was significantly lower at 12 weeks in the CR + VR arm (6.79 [SD = 0.37] vs 6.20 [SD = 1.01]). CONCLUSION: Although VR increased program adherence, interspersing it with usual CR sessions actually decreased patient motivation and absorption. IMPACT: Supplementing a maintenance CR program with VR using exergames resulted in significantly greater adherence (8% increase or 3 of 36 sessions), and this was quite a robust effect given it was extinguished with the removal of VR. However, contrary to the hypotheses, offering 1 session of VR per week and 2 of usual CR exercise was related to lower motivation and absorption, which has implications for how clinicians design programs for this patient population.-
Descrição: dc.descriptionDepartment of Physiotherapy São Paulo State University (UNESP) School of Technology and Sciences-
Descrição: dc.descriptionDepartment of Physiotherapy University of Brasilia-
Descrição: dc.descriptionDepartment of Physiotherapy Faculty of Health York University-
Descrição: dc.descriptionDepartment of Physiotherapy São Paulo State University (UNESP) School of Technology and Sciences-
Idioma: dc.languageen-
Relação: dc.relationPhysical therapy-
???dc.source???: dc.sourceScopus-
Palavras-chave: dc.subjectCardiac Rehabilitation-
Palavras-chave: dc.subjectCardiovascular Diseases-
Palavras-chave: dc.subjectExercise-
Palavras-chave: dc.subjectTreatment Adherence and Compliance-
Palavras-chave: dc.subjectUser Engagement Virtual Reality Exposure Therapy-
Título: dc.titleA Randomized, Controlled, Crossover Trial of Virtual Reality in Maintenance Cardiovascular Rehabilitation in a Low-Resource Setting: Impact on Adherence, Motivation, and Engagement-
Tipo de arquivo: dc.typelivro digital-
Aparece nas coleções:Repositório Institucional - Unesp

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