Miranda R. Donnelly, MS, OTR/L, is PhD Student, Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles.
Renee Reinberg, MA, was Student, Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, at the time of the study.
Am J Occup Ther. 2021 Nov 1;75(6). doi: 10.5014/ajot.2021.046169.
Virtual reality in head-mounted displays (HMD-VR) may be a valuable tool in occupational therapy to address anxiety. Findings from the virtual reality exposure therapy (VRET) literature may facilitate translation of HMD-VR to occupational therapy psychosocial practice.
To explore how HMD-VR has been used to treat anxiety through VRET and could be translated to occupational therapy.
We searched seven electronic databases for articles published between 2000 and 2020: CINAHL, Cochrane Library, Embase, ERIC, Ovid MEDLINE, PsycINFO, and Web of Science. Search terms included HMD-VR constructs, products, and therapy concepts. Study Selection and Data Collection: We used Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to report studies implementing VRET to treat anxiety. At least two reviewers assessed each citation, and a third resolved disagreements. Articles were included if they were in English, reported experimental data, and used HMD-VR. Letters, commentaries, book chapters, technical descriptions, theoretical papers, conference proceedings (≤4 pages), and reviews were excluded.
Twenty-eight studies used HMD-VR to treat posttraumatic stress disorder (n = 3), specific phobias (n = 19), and performance-based social anxiety (n = 6); protocols and levels of evidence varied (randomized controlled trials, n = 11; controlled trials without randomization, n = 6; case-control or cohort studies, n = 11). Qualitative examination indicates HMD-VR is an effective treatment tool.
HMD-VR can be a valuable tool for occupational therapy to simulate environments where clients with anxiety disorders participate. Eliciting presence through multisensory features and body representation may enhance outcomes. What This Article Adds: Drawing from the VRET literature, this scoping review suggests that HMD-VR can be used by occupational therapy practitioners to simulate ecologically valid environments, evaluate client responses to fearful stimuli, and remediate anxiety though immersion in virtual tasks when participation in natural contexts is unfeasible. Having ecologically valid environments is particularly important for people with anxiety disorders because they need support to cope when they encounter triggers in everyday life environments.
头戴式显示器 (HMD-VR) 的虚拟现实可能是职业治疗中解决焦虑的一种有价值的工具。虚拟现实暴露疗法 (VRET) 文献中的发现可能有助于将 HMD-VR 转化为职业治疗的心理社会实践。
探索 HMD-VR 如何通过 VRET 用于治疗焦虑，并转化为职业治疗。
我们在 2000 年至 2020 年间检索了七个电子数据库中的文章：CINAHL、Cochrane 图书馆、Embase、ERIC、Ovid MEDLINE、PsycINFO 和 Web of Science。搜索词包括 HMD-VR 结构、产品和治疗概念。
我们使用系统评价和荟萃分析的首选报告项目来报告实施 VRET 治疗焦虑的研究。至少有两名评审员评估了每篇引文，第三名评审员解决了分歧。如果文章是英文的、报告了实验数据且使用了 HMD-VR，则将其纳入。信件、评论、书籍章节、技术描述、理论论文、会议记录（≤4 页）和评论被排除在外。
28 项研究使用 HMD-VR 治疗创伤后应激障碍 (n = 3)、特定恐惧症 (n = 19) 和基于表现的社交焦虑症 (n = 6)；方案和证据水平各不相同（随机对照试验，n = 11；无随机分组的对照试验，n = 6；病例对照或队列研究，n = 11）。定性检查表明 HMD-VR 是一种有效的治疗工具。
HMD-VR 可以成为职业治疗的有价值工具，用于模拟焦虑障碍患者参与的环境。通过多感觉特征和身体表现来引起存在感可能会增强效果。这篇文章增加了什么：从 VRET 文献中汲取灵感，这项范围综述表明，职业治疗从业者可以使用 HMD-VR 模拟生态有效环境，评估客户对恐惧刺激的反应，并通过沉浸在虚拟任务中缓解焦虑，而当在自然环境中参与不可行时。拥有生态有效环境对焦虑症患者尤为重要，因为他们需要在日常生活环境中遇到触发因素时提供支持以应对。
