Designing Virtual Reality Assisted Psychotherapy for Anxiety in Older Adults Living with Parkinson’s Disease: Integrating Literature for Scoping

ABSTRACT

Objective: This review integrates literature to discuss the potential use of virtual reality (VR) in treatment of anxiety in Parkinson’s disease (PD) and inform next steps.

Methods: A systematic search was performed to identify studies of VR use in PD, using four databases. Data were reported in accordance to the Preferred Reporting Items for Systematic reviews and Meta-Analyzes extension for Scoping Reviews (PRISMA-ScR).

Results: Thirty-two studies met the inclusion criteria with four VR studies from the same study group directly assessing the effects of anxiety on motor symptoms in PD. Primary studies implementing a VR protocol in PD identified focus areas of understanding and alleviating freezing of gait (FOG), balance training, and cognitive and motor rehabilitation, and informed design considerations.

Conclusion: VR in PD studies suggested established feasibility. With appropriate design considerations, a VR based protocol could improve anxiety outcomes in PD.

Clinical implications: VR in PD provides control of a patient’s field of view, which can be exploited to induce specific responses, provide visual feedback, analysis of patient actions, and introduce safe challenges in the context of training. VR assisted Cognitive Behavioral Therapy (CBT) tailored to suit subtypes of anxiety disorders in PD have the potential to improve the efficacy and effectiveness of psychotherapy in PD.

KEYWORDS:

• Parkinson’s disease
• anxiety
• virtual reality
• psychotherapy
• cognitive behavior therapy

Clinical implications

• Promising outcomes of VR assisted anxiety treatment, and VR use in PD for cognitive and motor rehabilitation, provide a strong grounding for novel VR assisted anxiety treatment in PD.

• Design considerations include addressing PD-specific anxiety symptoms, limiting complexity, safety considerations, and engaging patients with real-time feedback.

• VR assisted psychotherapy has the potential to advance clinical practise in PD with long-term benefits, and inform a novel psychotherapeutic guidelines for older adults.

Acknowledgments

We acknowledge the Lions Medical Research Foundation, and National Health, and Medical Research Council for supporting Dr Nadeeka Dissanayaka’s salary. Royal Brisbane & Woman’s Hospital Foundation and Brain & Behaviour Foundation competitive grant schemes for funding VR studies in PD.

Disclosure statement

No potential conflict of interest was reported by the authors.

Supplemental Material

Supplemental data for this article can be accessed on the publisher’s website.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This work was supported by the Brain and Behavior Research Foundation; National Health and Medical Research Council; Lions Medical Research Foundation; Royal Brisbane and Women’s Hospital Foundation.