Virtual Reality on a Home-Based Phase III Cardiac Rehabilitation Program, Effect on Executive Function, Quality of Life, And Depression, Anxiety and Stress: A Randomized Controlled Trial

Purpose: To analyse the effect of a six-month home-based phase III cardiac rehabilitation (CR) specific exercise program, performed in a virtual reality (Kinect) or conventional (booklet) environment, on executive function, quality of life and depression, anxiety and stress of subjects with coronary artery disease.
Methods: A randomized controlled trial was conducted with subjects, who had completed phase II, randomly assigned to intervention group 1 (IG1), whose program encompassed the use of Kinect (n=11); or intervention group 2 (IG2), a paper booklet (n=11); or a control group (CG), only subjected to the usual care (n=11). The three groups received education on cardiovascular risk factors. The assessed parameters, at baseline (M0), 3 (M1) and 6 months (M2), were executive function, control and integration in the implementation of an adequate behaviour in relation to a certain objective, specifically the ability to switch information (Trail Making Test), working memory (Verbal Digit Span test), and selective attention and conflict resolution ability (Stroop Test), quality of life (MacNew Questionnaire) and depression, anxiety, and stress (Depression, Anxiety and Stress Scale 21). Descriptive and inferential statistical measures were used, significance level was set at .05.
Results: The IG1 revealed significant improvements, in the selective attention and conflict resolution ability, in comparison with the CG in the variable difference M0-M2 (p=.021) and in comparison with the IG2 in the variable difference M1-M2 and M0-M2 (p=.001 and p=.002, respectively). No significant differences were found in the quality of life, and depression, anxiety, and stress.
Conclusions: The virtual reality format had improved selective attention and conflict resolution ability, revealing the potential of CR, specifically with virtual reality exercise, on executive function.
Keywords: Virtual reality exercise; cardiac rehabilitation; executive function; quality of life; depression, anxiety and stress