UKRAINIAN BULLETIN OF PSYCHONEUROLOGY

The Scientific and Practical Journal of Medicine
ISSN 2079-0325
DOI 10.36927/2079-0325

USING VIRTUAL REALITY TECHNOLOGIES IN COMPREHENSIVE PSYCHOREHABILITATION OF ARMED CONFLICT VETERANS: A REVIEW OF CLINICAL TARGETS AND THERAPEUTIC POTENTIAL

Abstract

The psychological consequences of armed conflict include not only post-traumatic stress disorder but also a wide range of comorbid conditions: anxiety, depression, cognitive deficits after traumatic brain injuries, chronic pain after amputations, vestibular dysfunctions, and sleep disorders. Virtual reality (VR) technology is a multifunctional rehabilitation tool that allows addressing each of these targets within a single technological format.

The aim of this review is to organize the evidence on the effectiveness of VR in four dimensions of comprehensive psycho-rehabilitation for veterans: psychiatric, neurocognitive, physicalpsychological, and sleep-psychophysiological. Peer-reviewed publications were selected based on a search in the PubMed database. The summarized data confirm the wide range of effective VR applications: from reducing anxiety and depression in patients with somatic illnesses to cognitive recovery after traumatic brain injury, managing phantom pain, correcting vestibular disorders, and normalizing sleep in chronic insomnia. The complex nature of veterans’ rehabilitation needs makes VR a particularly relevant tool in an interdisciplinary protocol.

Pages

References

  1. Cieślik B, Mazurek J, Rutkowski S, Kiper P, Turolla A, Szczepąńska-Gieracha J. Virtual reality in psychiatric disorders: A systematic review of reviews. Complement Ther Med. 2020;52:102480. DOI:10.1016/j.ctim.2020.102480
  2. van Loenen I, Scholten W, Muntingh A, Smit J, Batelaan N. The Effectiveness of Virtual Reality Exposure-Based Cognitive Behavioral Therapy for Severe Anxiety Disorders, ObsessiveCompulsive Disorder, and Posttraumatic Stress Disorder: Metaanalysis. J Med Internet Res. 2022;24(2):e26736. Published 2022 Feb 10. DOI:10.2196/26736
  3. Kothgassner OD, Goreis A, Bauda I, Ziegenaus A, Glenk LM, Felnhofer A. Virtual reality biofeedback interventions for treating anxiety: a systematic review, meta-analysis and future perspective. Wien Klin Wochenschr. 2022;134(Suppl 1):49-59. DOI:10.1007/s00508-021-01991-z
  4. Szczepąńska-Gieracha J, Jóźwik S, Cieślik B, Mazurek J, Gajda R. Immersive Virtual Reality Therapy as a Support for Cardiac Rehabilitation: A Pilot Randomized-Controlled Trial. Cyberpsychol Behav Soc Netw. 2021;24(8):543-549. DOI:10.1089/cyber.2020.0297
  5. Salahuddin NH, Schütz A, Pitschel-Walz G, et al. Psychological and psychosocial interventions for treatment-resistant schizophrenia: a systematic review and network meta-analysis. Lancet Psychiatry. 2024;11(7):545-553. DOI:10.1016/S2215-0366(24)00136-6
  6. Li Pira G, Aquilini B, Davoli A, Grandi S, Ruini C. The Use of Virtual Reality Interventions to Promote Positive Mental Health: Systematic Literature Review. JMIR Ment Health. 2023;10:e44998. Published 2023 Jul 6. DOI:10.2196/44998
  7. Voinescu A, Sui J, Stanton Fraser D. Virtual Reality in Neurorehabilitation: An Umbrella Review of Meta-Analyses. J Clin Med. 2021;10(7):1478. Published 2021 Apr 2. DOI:10.3390/jcm10071478
  8. Leonardi S, Maggio MG, Russo M, Bramanti A, Arcadi FA, Naro A, et al. Cognitive recovery in people with relapsing/ remitting multiple sclerosis: A randomized clinical trial on virtual reality-based neurorehabilitation. Clin Neurol Neurosurg. 2021;208:106828. DOI:10.1016/j.clineuro.2021.106828
  9. Bruschetta R, Maggio MG, Naro A, et al. Gender Influences Virtual Reality-Based Recovery of Cognitive Functions in Patients with Traumatic Brain Injury: A Secondary Analysis of a Randomized Clinical Trial. Brain Sci. 2022;12(4):491. Published 2022 Apr 12. DOI:10.3390/brainsci12040491
  10. Heslot C, Cogné M, Guillouët E, et al. Management of unfavorable outcome after mild traumatic brain injury: Review of physical and cognitive rehabilitation and of psychological care in post-concussive syndrome. Neurochirurgie. 2021;67(3):283-289. DOI:10.1016/j.neuchi.2020.09.001
  11. Rajendram C, Ken-Dror G, Han T, Sharma P. Efficacy of mirror therapy and virtual reality therapy in alleviating phantom limb pain: a meta-analysis and systematic review. BMJ Mil Health. 2022;168(2):173-177. DOI:10.1136/bmjmilitary-2021-002018
  12. Hali K, Manzo MA, Koucheki R, et al. Use of  virtual reality for the management of phantom limb pain: a systematic review. Disabil Rehabil. 2023;46(4):629-636. DOI:10.1080/09638288.2023.2172222
  13. LeMarshall SJ, Stevens LM, Ragg NP, Barnes L, Foster J, Canetti EFD. Virtual reality-based interventions for the rehabilitation of vestibular and balance impairments post-concussion: a scoping review. J Neuroeng Rehabil. 2023;20(1):31. Published 2023 Mar 3. DOI:10.1186/s12984-023-01145-4
  14. Ross RE, Hart E, Williams ER, et al. Combined Aerobic Exercise and Virtual Reality-Based Upper Extremity Rehabilitation Intervention for Chronic Stroke: Feasibility and Preliminary Effects on Physical Function and Quality of Life. Arch Rehabil Res Clin Transl. 2022;5(1):100244. Published 2022 Nov 11. DOI:10.1016/j.arrct.2022.100244
  15. Wang S, Meng H, Zhang Y, et al. Effect of Virtual RealityBased Rehabilitation on Mental Health and Quality of Life of  Stroke Patients: A  Systematic Review and Meta-analysis of  Randomized Controlled Trials. Arch Phys Med Rehabil. 2024;106(4):607-617. DOI:10.1016/j.apmr.2024.10.006
  16. Wan Y, Gao H, Zhou K, Zhang X, Xue R, Zhang N. Virtual reality improves sleep quality and associated symptoms in patients with chronic insomnia. Sleep Med. 2024;122:230-236. DOI:10.1016/j.sleep.2024.08.027
  17. Cinalioglu K, Lavín P, Bein M, et al. Effects of virtual reality guided meditation in older adults: the protocol of a pilot randomized controlled trial. Front Psychol. 2023;14:1083219. Published 2023 Jul 28. DOI:10.3389/fpsyg.2023.1083219
  18. Pallavicini F, Pepe A, Clerici M, Mantovani F. Virtual Reality Applications in Medicine During the COVID-19 Pandemic: Systematic Review. JMIR Serious Games. 2022;10(4):e35000. Published 2022 Oct 25. DOI:10.2196/35000
  19. Tortora C, Di Crosta A, La Malva P, et al. Virtual reality and cognitive rehabilitation for older adults with mild cognitive impairment: A systematic review. Ageing Res Rev. 2023;93:102146. DOI:10.1016/j.arr.2023.102146