Effect of Virtual Reality on Stress Reduction and Change of Physiological Parameters Including Heart Rate Variability in People With High Stress: An Open Randomized Crossover Trial

Introduction: Although, attempts to apply virtual reality (VR) in mental healthcare are rapidly increasing, it is still unclear whether VR relaxation can reduce stress more than conventional biofeedback.Methods: Participants consisted of 83 healthy adult volunteers with high stress, which was defined as a score of 20 or more on the Perceived Stress Scale-10 (PSS-10). This study used an open, randomized, crossover design with baseline, stress, and relaxation phases. During the stress phase, participants experienced an intentionally generated shaking VR and serial-7 subtraction. For the relaxation phase, participants underwent a randomly assigned relaxation session on day 1 among VR relaxation and biofeedack, and the other type of relaxation session was applied on day 2. We compared the State-Trait Anxiety Inventory-X1 (STAI-X1), STAI-X2, the Numeric Rating Scale (NRS), and physiological parameters including heart rate variability (HRV) indexes in the stress and relaxation phases.Results: A total of 74 participants were included in the analyses. The median age of participants was 39 years, STAI-X1 was 47.27 (SD = 9.92), and NRS was 55.51 (SD = 24.48) at baseline. VR and biofeedback significantly decreased STAI-X1 and NRS from the stress phase to the relaxation phase, while the difference of effect between VR and biofeedback was not significant. However, there was a significant difference in electromyography, LF/HF ratio, LF total, and NN50 between VR relaxation and biofeedback.Conclusion: VR relaxation was effective in reducing subjectively reported stress in individuals with high stress.

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Pain Monitoring Using Heart Rate Variability and Photoplethysmograph-Derived Parameters by Binary Logistic Regression

Journal of Medical and Biological Engineering ◽

10.1007/s40846-021-00651-x ◽

2021 ◽

Author(s):

D. F. Jhang ◽

Y. S. Chu ◽

J. H. Cai ◽

Y. Y. Tai ◽

C. C. Chuang

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Logistic Regression ◽

Rating Scale ◽

Binary Logistic Regression ◽

Numeric Rating Scale ◽

Classification Model ◽

Generation Process ◽

Postoperative Intensive Care ◽

Postoperative Intensive Care Unit

Abstract Purpose To construct a pain classification model using binary logistic regression to calculate pain probability and monitor pain based on heart rate variability (HRV) and photoplethysmography (PPG) parameters. Methods Heat stimulation was used to simulate pain for modeling the pain generation process, and electrocardiography and PPG signals were recorded simultaneously. After signal analysis, statistical analysis was performed using SPSS to determine the parameters that were significant for pain. Thereafter, a pain classification model with HRV and PPG parameters was established using binary logistic regression. Results The sensitivity and specificity of the pain classification model were 60.0% and 72.0%, respectively. When pain occurred, the probability calculated using the pain classification model increased from < 50% to > 50%. When the pain was relieved, the probability decreased to < 50%. The probability of pain was consistent with the numeric rating scale value, which indicated that the model can correctly determine the presence of pain. Conclusion This pain classification model has sufficient robustness and adaptability to be applied to different healthy people for classification and monitoring. This model is helpful in establishing a real-time pain monitoring system to improve pain management for patients in the postoperative intensive care unit and patient-controlled analgesia and provide a reference for doctors regarding medication.

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Comparison between the analgesic effectiveness and patients’ preference for virtual reality vs. topical anesthesia gel during the administration of local anesthesia in adult dental patients: a randomized clinical study

Scientific Reports ◽

10.1038/s41598-021-03093-2 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

May Almugait ◽

Ammar AbuMostafa

Keyword(s):

Heart Rate ◽

Virtual Reality ◽

Local Anesthesia ◽

Rating Scale ◽

Topical Anesthesia ◽

The Other ◽

Dental Patients ◽

Randomized Clinical Study ◽

Significant Difference ◽

The Difference

AbstractThis study aimed to compare the analgesic effectiveness of virtual reality vs. topical anesthesia gel during the administration of local anesthesia (injections to numb the gums) in adult dental patients; as well as to determine which approach is preferred by the patients. Twenty-one adult patients received dental anesthetic injections bilaterally for their maxillary premolars area. We predicted that VR would be more effective than a topical anesthetic gel at reducing pain during injections into the gums. Using a within subject design, each patient received two injections during a single dental visit. Pain was measured after each injection. One side was of the mouth was injected under the influence of the topical anesthesia (TA) 20% benzocaine. The other side of the mouth was injected when the patient was in virtual reality (VR) watching an animated movie using an Oculus Quest® helmet to distract them during the other injection, treatment order randomized. Immediately after each injection, the patients were directed to rate their pain experience using the Wong-Baker Faces Pain-rating Scale (W-BFPS), and to choose which delivery system they preferred. Heart rates were recorded prior to and after the injections using a finger pulse oximeter. Participants reported the predicted pattern of a lower W-PFPS score (less pain intensity) during needle injection while in VR than the injection with topical anesthesia gel, however, the difference was not statistically significant. A statistically significant majority of the participants (p = 0.021) preferred VR to TA. No statistically significant difference heart rate during VR vs. TA was found. Although dental patients reported less pain during VR distraction vs. topical gel anesthetic, the difference was not significant. A statistically significant majority of patients preferred virtual reality over topical anesthesia during their future injections. However, no significant difference in heart rate was found.

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670. Heart Rate Variability Responses to a Standardized Virtual Reality Exposure in Veterans with PTSD

Biological Psychiatry ◽

10.1016/j.biopsych.2017.02.1079 ◽

2017 ◽

Vol 81 (10) ◽

pp. S271 ◽

Cited By ~ 2

Author(s):

Samuel Ridout ◽

Christopher Spofford ◽

Mascha van ׳t Wout ◽

William Unger ◽

Noah Philip ◽

...

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Virtual Reality ◽

Virtual Reality Exposure

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Oral paracetamol versus zolmitriptan to treat acute migraine attack in the emergency department

10.22514/sv.2021.040 ◽

2021 ◽

Keyword(s):

Emergency Department ◽

Rating Scale ◽

Rescue Therapy ◽

Tertiary Care ◽

Numeric Rating Scale ◽

Controlled Study ◽

Care Hospital ◽

Acute Migraine ◽

Pain Scores ◽

Significant Difference

Background: Treatment provided in an emergency department is aimed at alleviating pain immediately with minimized adverse effects as well as warding off further migraine attacks. The primary aim of this article is to compare the effectiveness of oral paracetamol versus zolmitriptan in treating acute migraine attacks. Methods: This prospective, randomized, and controlled study was carried out at a tertiary care hospital visited by 95,000 patients annually. The study recruited 200 participants who were randomized into two groups. One group received 1000 mg paracetamol while the other group received 2.5 mg zolmitriptan orally. Baseline pain scores were recorded using the Visual Analogue Scale (VAS) and Numeric Rating Scale (NRS) at 15, 30 and at 60 min following administration of the study drugs. Patients requiring further treatment were provided fentanyl at a dosage of 1 µg/kg as a rescue therapy. Results: A significant decrease was evident in VAS and NRS scores following the administration of the study drugs in both groups (P < 0.001). The change in VAS pain scores after 15, 30 and 60 min was calculated as 17.0 ± 13.9, 41.2 ± 16.3 and 61.2 ± 17.5 mm, respectively, in the paracetamol group and 14.2 ± 11.7, 39.2 ± 17.9 and 59.2± 19.3 mm, respectively, in the zolmitriptan group, which did not indicate significant differences (P = 0.103, P = 0.425, P = 0.483, respectively). Likewise, NRS pain scores showed a downward trend in line with VAS pain scores and did not yield a significant difference (P = 0.422). No significant difference concerning rescue therapy was noted between the two groups (P = 0.596). Conclusion: Oral paracetamol and zolmitriptan prove to be similarly effective and have low incidence of acute side effects in treating acute migraine cases without aura.

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Autonomie Correlates of Antidepressant Treatment Using Heart-Rate Variability Analysis

The Canadian Journal of Psychiatry ◽

10.1177/070674379804300209 ◽

1998 ◽

Vol 43 (2) ◽

pp. 183-186 ◽

Cited By ~ 66

Author(s):

Yaariv Khaykin ◽

Paul Dorian ◽

Brian Baker ◽

Colin Shapiro ◽

Paul Sandor ◽

...

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Standard Deviation ◽

Rating Scale ◽

Antidepressant Treatment ◽

Response To Therapy ◽

Heart Rate Variability Analysis ◽

Randomized Evaluation ◽

Temporal Domain ◽

Percentage Difference

Objective: To assess the 24-hour temporal-domain heart-rate variability correlates of treatment with fluoxetine or doxepinfor depression. Method: A randomized evaluation of fluoxetine and doxepin measured a 50% change in the Hamilton Depression Rating Scale (HDRS) score as a response to therapy and was correlated with measures of standard deviation of the mean of all 5-minute segments of normal electrocardiographic R-R intervals (SDANN), standard deviation of all normal R-R intervals (SDNN), root mean square of successive differences in R-R intervals (r-MSSD), and percentage difference between adjacent normal R-R intervals that are greater than 50 msec (pNN50)from 24-hour electrocardiogram (ECG) tapes. Results: Ten out of 14 patients responded. Response was associated with an increase in SDANN of 17% (P < 0.05). Nonresponse was associated with a 17% decrease in SDANN and a 22% decrease in SDNN (both P < 0.05). No other measures correlated with therapeutic response. No heart-rate variability (HRV) differences between the 2 drug therapies were observed. Conclusion: Twenty-four-hour HRV measures may be useful in assessing response to antidepressant therapy.

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Comparative Review of the Correlation Between Electroneurography, Electromyography, Hematology Tests, or the Heart Rate Variability Test, with an Improvement in the Severity of Bell’s Palsy Symptoms

Journal of Acupuncture Research ◽

10.13045/jar.2021.00052 ◽

2021 ◽

Vol 38 (3) ◽

pp. 192-199

Author(s):

Ji-Min Hwang ◽

Jun-Yeon Kim ◽

Ha-Na Kim ◽

Kyeong-Ju Park ◽

Min-Gi Jo ◽

...

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Negative Correlation ◽

Bell’S Palsy ◽

Nerve Degeneration ◽

Total Power ◽

Mean Corpuscular Hemoglobin ◽

Bell's Palsy ◽

Comparative Review ◽

Significant Difference

Background: In this retrospective study, we aimed to determine which diagnostic tests were associated with an improvement in Bell’s palsy symptoms. Methods: There were 30 patients who visited Kyung Hee University Korean Medicine Hospital from April 1, 2017 to February 29, 2020, and who received East-West collaboration treatment for Bell’s palsy. The tests included electroneurography (ENoG), electromyography (EMG), hematology, and heart rate variability (HRV) results which were used to determine if any test correlated with improvement of Bell’s palsy symptoms. Results: The initial severity of symptoms did not correlate with the tests performed, with the exception of mean corpuscular hemoglobin concentration (p = 0.013). For both ENoG for oculi degeneration and mean EMG tests, the rate of nerve degeneration showed a significant negative correlation with the improvement of Bell’s palsy symptoms. Amongst the HRV test indicators, the square root of the mean of the sum of the squares of differences between the adjacent normal R-R wave interval, the standard deviation of intervals, total power, very low frequency, and high frequency of the wave was negatively correlated with improvement of Bell’s palsy symptoms. Similarly, glycosylated hemoglobin Type A1c (HbA1c) and erythrocyte sedimentation rate (ESR) showed a negative correlation with improvement of symptoms of Bell’s palsy. With the exception of HbA1c and ESR, the remaining hematology test results showed no significant difference when comparing before and after treatment. Conclusion: ENoG, EMG, HRV test, HbA1c, and ESR negatively correlated with improvements in Bell’s palsy symptoms and may determine the prognosis of Bell’s palsy.

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Validation of the Software-Hardware Complex “Rytm” for Measurement of the RR Intervals and Heart Rate Variability Analysis During Exercise and Recovery Period

Teorìâ ta Metodika Fìzičnogo Vihovannâ ◽

10.17309/tmfv.2021.1.08 ◽

2021 ◽

Vol 21 (1) ◽

pp. 61-68

Author(s):

Lyubomyr Vovkanych ◽

Yuriy Boretsky ◽

Viktor Sokolovsky ◽

Dzvenyslava Berhtraum ◽

Stanislav Kras

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Recovery Period ◽

Intraclass Correlation ◽

Step Test ◽

Heart Rate Variability Analysis ◽

Test Protocol ◽

Rr Intervals ◽

Significant Difference ◽

Very High

The study purpose was estimation of the accuracy of RR time series measurements by SHC “Rytm” and validity of derived heart rate variability (HRV) indexes under physical loads and recovery period. Materials and methods. The participants were 20 healthy male adults aged 19.7 ± 0.23 years. Data was recorded simultaneously with CardioLab CE12, Polar RS800, and SHC “Rytm”. Test protocol included a 2 minute step test (20 steps per minute, platform height – 40 cm) with the next 3 minute recovery period. HRV indexes were calculated by Kubios HRV 2.1. Results. The RR data bias in the case of physical loads was -0.06 ms, it increased to 0.09-0.33 ms during the recovery period. The limits of agreement for RR data ranged from 3.7 ms to 22.8 ms, depending on the period of measurements and pair of compared devices. It is acceptable for the heart rate and HRV estimation. The intraclass correlation coefficients (0.62–1.00) and Spearman correlation coefficient (0.99) were high enough to suggest very high repeatability of the data. We found no significant difference (p > 0.05) and good correlation (r = 0.94-1.00) between the majority of HRV indexes, calculated from data of Polar RS800 and SHC “Rytm” in conditions of physical loads (except for LF/HF ratio) and in the recovery period. The only one index (RMSSD) was different (p < 0.05) in case of Polar RS800 and SHC “Rytm” data, obtained in the recovery period. The largest numbers of different HRV indexes have been found during the comparison of CardioLab CE12 and Polar RS800 – RMSSD, pNN50, and SD1. Correlation between HRV indexes (r = 0.81-1.00) was very high in all pairs of devices in all periods of measurements. Conclusions. The SHC “Rytm” appears to be acceptable for RR intervals registration and the HRV analysis during physical loads and recovery period.

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A comparison of pain registration by Visual Analog Scale and Numeric Rating Scale – a cross-sectional study of primary triage registration

10.1101/2020.11.03.20225367 ◽

2020 ◽

Author(s):

Jofrid Kollltveit ◽

Malin Osaland ◽

Marianne Reimers ◽

Magnus Berle

Keyword(s):

Emergency Department ◽

Visual Analog Scale ◽

Rating Scale ◽

Emergency Admission ◽

Numeric Rating Scale ◽

University Hospital ◽

Analog Scale ◽

Cross Sectional ◽

Significant Difference ◽

Numeric Rating

BackgroundPain is a subjective sensation; self-reporting is important for quantifying pain intensity. There are several different validated tools for this, such as Visual Analog Scale and Numeric Rating Scale. In the clinic, these terms are often used as equivalent. The objective of this study was to examine correlation and agreement between the pain registration tools in triage in an emergency department.Materials and MethodsThe study was performed in the Department of Emergency Medicine at Haukeland University Hospital in the period June-August 2019. We registered the pain score with two tools in 200 unselected patients in emergency admission with pain. In addition, we registrered gender, age, triage and general department affiliation.ResultsWe found a strong correlation between the pain registration tools by Spearmans correlation test (rho=0,930, p<0,001). There were no significant difference between the pain registration tools within the subgroups. Bland-Altman analysis show agreement between the two pain registration tools.ConclusionsIn an Emergency Department triage is it acceptable to use Visual Analog Scale and Numeric Rating Scale as equivalent, as long as the correct terminology is used.

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Heart Rate Variability During Early Mobilization in Patients with Acute Ischemic Stroke

European Neurology ◽

10.1159/000492794 ◽

2018 ◽

Vol 80 (1-2) ◽

pp. 50-54 ◽

Cited By ~ 2

Author(s):

Masafumi Nozoe ◽

Miho Yamamoto ◽

Miki Kobayashi ◽

Masashi Kanai ◽

Hiroki Kubo ◽

...

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Nervous Activity ◽

Early Mobilization ◽

Sympathetic Nervous Activity ◽

Parasympathetic Nerve ◽

Significant Difference ◽

Sympathetic Nervous

Autonomic dysfunction is one of the predictors of poor outcome in patients with acute ischemic stroke. We compared the heart rate variability (HRV) during early mobilization in patients with or without neurological deterioration (ND). We enrolled 7 acute ischemic patients with ND and 14 without ND and measured their HRV in the rest and mobilization by electrocardiography. There was a significant difference in sympathetic nervous activity during mobilization between the 2 groups. However, no significant differences in blood pressure, heart rate, and parasympathetic nerve activity were observed. In patients with acute ischemic stroke, it is likely that the increase in sympathetic nervous activity during mobilization is associated with ND.

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To Assess and Correlate Resting Heart Rate, Body Composition and Heart Rate Variability in Judo and Wushu Players

International Journal of Science and Healthcare Research ◽

10.52403/ijshr.20210768 ◽

2021 ◽

Vol 6 (3) ◽

pp. 413-421

Author(s):

Sapna Yadav ◽

Gaurav Kadyan

Keyword(s):

Heart Rate ◽

Heart Rate Variability ◽

Body Composition ◽

Body Mass ◽

Body Fat ◽

Visceral Fat ◽

Whole Body ◽

Resting Heart Rate ◽

Body Density ◽

Significant Difference

Background: This study aimed to compare and correlate the resting heart rate, body composition and heart rate variability among judo and wushu players. Method: 40 athletes (20 judo and 20 wushu players) were included in the study. Body composition (BMI, subcutaneous body mass, skeletal body mass, body fat %, body density, Visceral fat, Lean body mass) was evaluated with the help of 7 skinfold thickness and body circumferences with the help of Harpenden calliper and measuring tape respectively. HRV (RMSSD, SDNN, LF/HF, LFnu and HFnu) was recorded in resting state (~5min) with the help of Heart wear shimmer ECG device. Result: No significant difference of body composition and HRV variables (p> 0.05) was found between the two groups except Body fat % and body density (p<0.05) which differ significantly among the two groups. In Judo, LF/HF and LFnu showed significant positive correlation with BMI (p<0.05, r=-0.488), subcutaneous whole-body mass (p<0.05, r=-0.464), visceral fat (p<0.05, r =-0.508), and body fat % (p<0.05, r =-0.626. Whereas HFnu showed significant negative correlation with BMI (p<0.05, r=-0.488), subcutaneous whole-body mass (p<0.05, r=-0.464), visceral fat (p<0.05, r=-0.505) and body fat % (p<0.05, r=-0.626). Whereas no correlation was found between HRV and Body composition in wushu players. Conclusion: Reduction in body fat % and visceral fat in judo players indicate improved sympathovagal balance which can be due to the adaptation induced by training loads. Similar results were not seen in wushu players because of high amount of body fat% and visceral fat. Keywords: Body composition, combat sports, heart rate variability, Body fat %, resting heart rate.

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