Exercises using virtual reality to relieve COVID breathlessness – News-Medical.Net

Patients recovering from severe coronavirus disease 2019 (COVID-19) pneumonia often suffer from refractory breathlessness.

A recent study published on the preprint server medRxiv* conducted at the University Hospital of Geneva in Switzerland evaluates an immersive virtual reality (iVR)-based digital intervention to alleviate refractory breathlessness in patients recovering from COVID-19 pneumonia.

Study: Virtual reality exercise to help COVID patients with refractory breathlessness. Image Credit: Photographee.eu / Shutterstock.com

Refractory breathlessness

Chronic breathlessness syndrome causes a disabling sensation of difficult breathing. It occurs even when the patient undergoes optimized treatment for the diagnosed medical condition.

Refractory breathlessness is a stubborn and unmanageable condition that can be observed in acute disease. This condition often leads to a negative impact on the patients’ quality of life and autonomy.

Since refractory breathlessness accompanies acute conditions, the identification of the underlying condition is essential for pathophysiological treatment. Currently, refractory breathlessness is an underrecognized respiratory condition; thus, there remains a need for developing evidence-based interventions to alleviate breathlessness.

Digital therapeutics

The perception of breathlessness happens through neural pathways similar to pain processing and bodily self-consciousness, as evidenced by neuroimaging. Digiceuticals or iVR-based Digital Therapeutics (DTx) have been used as interventions for alleviating chronic pain in patients with complex regional pain syndrome or spinal cord injury.

In patients with respiratory discomfort, based on visual-respiratory feedback, visual-respiratory stimulation can provide an increased feeling of breathing control and changes in physiological measures of breathing. This approach is also associated with a reduced negative emotional state related to experimentally-induced shortness of breath.

Long COVID

Long COVID is a complex condition where symptoms occur beyond the infection and recovery period of COVID-19. Long COVID symptoms include general weakness, malaise, fatigue, concentration impairments, and breathlessness. Around 25% of long COVID patients complain of breathlessness.

Breathlessness is poorly associated with pulmonary function tests or lung imaging in long COVID. Therefore, current treatments are focused on lung rehabilitation; however, a neuro-rehabilitation approach could be tested to understand and alleviate breathlessness.

COVID-19 Virtual Reality (COVVR) clinical study

The COVVR study is a controlled, randomized, single-blind, cross-over clinical study that is aimed at determining the effects of iVR-based DTx on breathing comfort in patients recovering from severe COVID-19 pneumonia. This is a single-site study that was conducted at the University Hospital of Geneva in Switzerland and is registered with ClinicalTrials.gov (NCT04844567).

Thirty-one patients were included, all of whom were recovering from severe COVID-19 pneumonia and had refractory breathlessness with a self-rated intensity of five or higher on a ten-point visual analogic dyspnea scale. All patients who participated in this study provided consent and spoke French or English.

Patient exclusion criteria included unstable respiratory, neurological, or cardiac conditions, or psychiatric illness and a score of below 25 on the Montreal Cognitive Assessment (MoCA). Five patients were excluded due to a MoCA score of less than 25. The cross-over groups were randomly assigned and concealed from the referring clinician.

Experimental setup

Patients were in a semi-seated position in their hospital bed and wore a respiration belt fitted on the abdomen that recorded respiratory movements. They also wore a head-mounted display that held a VR-compatible smartphone.

The smartphone ran the VR simulation and was connected via Bluetooth® to the respiration belt. The scientists developed software in collaboration with MindMaze to collect …….

Source: https://www.news-medical.net/news/20211031/Exercises-using-virtual-reality-to-relieve-COVID-breathlessness.aspx

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