Innovations In Clinical Neuroscience

JAN-FEB 2017

A peer-reviewed, evidence-based journal for clinicians in the field of neuroscience

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Innovations in CLINICAL NEUROSCIENCE [ V O L U M E 1 4 , N U M B E R 1 – 2 , J A N U A R Y – F E B R U A R Y 2 0 1 7 ] 14 ABSTRACT Objective: We evaluated the evidence supporting the use of virtual reality among patients in acute inpatient medical settings. Method: We conducted a systematic review of randomized controlled trials conducted that examined virtual reality applications in inpatient medical settings between 2005 and 2015. We used PsycINFO, PubMed, and Medline databases to identify studies using the keywords virtual reality, VR therapy, treatment, and inpatient. Results: We identified 2,024 citations, among which 11 met criteria for inclusion. Studies addressed three general areas: pain management, eating disorders, and cognitive and motor rehabilitation. Studies were small and heterogeneous and utilized different designs and measures. Virtual reality was generally well tolerated by patients, and a majority of studies demonstrated clinical efficacy. Studies varied in quality, as measured by an evaluation metric developed by Reisch, Tyson, and Mize (average quality score=0.87; range=0.78–0.96). Conclusion: Virtual reality is a promising intervention with several potential applications in the inpatient medical setting. Studies to date demonstrate some efficacy, but there is a need for larger, well-controlled studies to show clinical and cost-effectiveness. INTRODUCTION Overview. Since the 1990s, virtual reality (VR) has had promising applications in science and medicine, including intervention delivery. 1 –4 Use of VR interventions has been studied in a wide range of medical conditions, including anxiety, phobias, obesity, chronic pain, and eating disorders. 1,5–10 In recent years, VR technology has become increasingly affordable, immersive, flexible, and portable, enabling its use in a broad range of environments, including the inpatient medical setting. 1 ,7,11 The capacity of VR to modulate subjective experience makes it a compelling intervention in inpatient medical settings, where VR may offer respite from the confining nature of medical wards, or where it may augment or replace analgesics in pain management. To date, no systematic review has been conducted on the use of VR in the inpatient medical setting. Herein, we review controlled studies evaluating the utility and efficacy of VR- based treatments for patients admitted to hospitals or rehabilitation centers. VR and its use in healthcare. VR refers to the interactions between an individual and a computer-generated environment stimulating multiple sensory modalities, including visual, auditory, or haptic experiences. 9 The user's perception of reality is facilitated by the use of head-mounted displays (HMDs, in goggles or headsets), wall by JULIETA DASCAL, BA; MARK REID, PhD; WAGUIH ISHAK, MD, FAPA; BRENNAN SPIEGEL, MD, FACG; JENNIFER RECACHO, MA; BRADLEY ROSEN, MD; and ITAI DANOVITCH, MD, MBA All authors are from Cedars-Sinai Medical Center, Department of Psychiatry and Behavioral Neurosciences in Los Angeles, California. Innov Clin Neurosci. 2017;14(1–2):14–21 FUNDING: No funding was received for the preparation of this article. FINANCIAL DISCLOSURES: The authors have no conflicts of interest relevant to the content of this article. ADDRESS CORRESPONDENCE TO: Itai Danovitch, MD, MBA, Chairman, Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, 8730 Beverly Blvd., Suite E-137, Los Angeles, CA 90048; Phone: (310) 423-2600; Fax: (310) 423-8397; email: Itai.Danovitch@cshs.org KEY WORDS: virtual reality, treatment efficacy, inpatients, pain management, eating disorders, rehabilitation. R E V I E W Virtual Reality and Medical Inpatients: A Systematic Review of Randomized Controlled Trials

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