Kasimova L N, Kuznetsov A N, Kropinova I I, Kuznetsov D V, Volovik M G, Svyatogor M V, Sychugov E M, Borovskoy G Y, Khalak M E
MD, DSc, Professor, Head of Psychiatry Department; Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia.
Head of Immersive Technologies and Remote Rehabilitation Laboratory; Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia.
Sovrem Tekhnologii Med. 2024;16(5):35-42. doi: 10.17691/stm2024.16.5.04. Epub 2024 Oct 30.
was to develop the rehabilitation technology that enables the monitoring of psychophysiological stress markers during exposure therapy of post-traumatic stress disorder in combatants using virtual reality (VR).
The study involved 69 men: 31 combatants (mean age - 35.61±9.13 years) and 38 healthy research subjects - a control group (mean age - 24.68±5.71 years) not engaged in active combat.Post-traumatic stress disorder was diagnosed using Structured Clinical Interview for DSM and Mississippi Scale.We suggested an original hardware and software system for exposure therapy in VR. Stimulus material included a number of virtual scenes: three combat scenes and a non-combat one.Heart rate variability was recorded to control a patient's state during the session. As markers of stressogenic situations we used CS-index (suggested by S.V. Bozhokin), as well as the indices of functional reserve and tension degree of the regulatory systems (according to R.M. Baevskiy).
There were revealed three main responses on VR scenes with an original content. The three variants were called as follows: "anxious", "neutral", and "inverse". The suggested methodology enables to continuously monitor psychophysiological parameters during a certain session, and analyze their dynamics within a therapy course.Using calculated indicators by Baevsky makes it possible to classify combatants by adaptive potential at the beginning and at the end of the exposure therapy course in VR; make use of online-control of a patient's functional state in virtual environment, and create conditions for controlled information influence (CS-index by Bozhokin).The preliminary results presented in the study are promising regarding the possibility to choose a personalized program of rehabilitation measures for each response type using a developed hardware and software system. Biological feedback on heart rate variability included in hardware and software system will contribute to train and harness a patient's habit of an operative independent correction of the patient's state.
旨在开发一种康复技术，该技术能够在使用虚拟现实（VR）对战斗人员的创伤后应激障碍进行暴露疗法期间监测心理生理应激标志物。
该研究涉及69名男性：31名战斗人员（平均年龄 - 35.61±9.13岁）和38名健康研究对象——一个未参加过实战的对照组（平均年龄 - 24.68±5.71岁）。使用《精神疾病诊断与统计手册》结构化临床访谈和密西西比量表对创伤后应激障碍进行诊断。我们提出了一种用于VR暴露疗法的原创硬件和软件系统。刺激材料包括多个虚拟场景：三个战斗场景和一个非战斗场景。记录心率变异性以在治疗过程中控制患者状态。作为应激源情况的标志物，我们使用了CS指数（由S.V.博日金提出），以及调节系统的功能储备和紧张程度指数（根据R.M.巴耶夫斯基）。
在具有原创内容的VR场景中发现了三种主要反应。这三种变体分别被称为：“焦虑型”、“中性型”和“反向型”。所建议的方法能够在特定治疗过程中持续监测心理生理参数，并分析它们在治疗过程中的动态变化。使用巴耶夫斯基计算的指标可以在VR暴露疗法课程开始和结束时根据适应潜力对战斗人员进行分类；利用虚拟环境中患者功能状态的在线控制，并为可控信息影响创造条件（博日金的CS指数）。该研究中呈现的初步结果对于使用所开发的硬件和软件系统为每种反应类型选择个性化康复措施方案的可能性很有前景。硬件和软件系统中包含的心率变异性生物反馈将有助于训练和培养患者对自身状态进行有效独立调整的习惯。
