Virtual reality therapy to break the isolation of seniors – Clinical study at the Nice University Hospital

The “Aging Well” project launched in January 2020 by the Nice University Hospital and supported by several sponsors and partners, aims to invent a model for aging well and the future of health care. In this context, the gerontology teams at Nice University Hospital and the company C2Care have set up a clinical study integrating virtual reality, with personalized immersive content.

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The “Aging Well” project launched in January 2020 by the Nice University Hospital and supported by several sponsors and partners, aims to invent a model for aging well and the future of health care. In this context, the gerontology teams at Nice University Hospital and the company C2Care have set up a clinical study integrating virtual reality, with personalized immersive content. 

Reminiscence triggered by virtual reality could have a positive impact on the mood of EHPAD residents with mild to moderate cognitive disorders, common symptoms of Alzheimer’s disease. Alzheimer’s disease and related diseases reduce the quality of life of the patient and often lead to mood disorders (depression, apathy and anxiety disorders). Moreover, the isolation linked to the health crisis has accentuated these disorders. Reminiscence therapy (RT) is part of the psycho-social therapies recommended by the High Authority for Health (HAS, of 2015). Virtual reality therapy is a new approach used in gerontology in various indications (cognitive training, fall prevention, diagnostic assistance). It constitutes an interesting and innovative support thanks to its immersive specificities. Virtual reality can also be used therapeutically to stimulate autobiographical memory in the elderly. 

This pilot study will allow us to answer the question, “Can virtual reality be useful in EHPAD to reduce mood disorders in residents in mild to moderate stages of illness?”
The Nice University Hospital study includes EHPAD residents in two groups. Each participant benefits from virtual reality exposure sessions. The first group exposes the residents to personalized films based on the salient elements of their life history. The second group offers neutral exhibitions. Residents are randomly assigned to these groups.

THE RESEARCH TEAM HOPES THAT THE PROTOCOL WILL

  • Improve participants’ mood (quantified by clinical scales)
  • To reduce the prescription of psychotropic drugs
  • To get positive feedback from residents, care teams and families
  • To observe more reminiscences in the personalized video group compared to the neutral group.


If the results of the study are conclusive, the Nice University Hospital and C2Care teams will demonstrate that virtual reality therapy can be considered as a non-drug therapy of choice in routine geriatric care.

For Cassandra Quin, psychologist specialized in gerontology in charge of the Reminiscences and Emotions project: “The interest of this research protocol lies in the personalization of the videos. It is not simply a virtual reality session… We offer a possibility to the residents, in a context of health crisis, to go back to places or memories that they know and have invested emotionally when they can no longer move outside the EHPAD “.

The feedback from the residents is very encouraging, like that of Mrs. J (91 years old) resident at the EHPAD of Cimiez. She mentions the pleasure of being able to participate twice a week in virtual reality sessions. The feeling of loneliness, particularly present during this health crisis, is reduced thanks to the exposure to personalized films. On the subject of virtual reality, Mrs. J emphasizes: “This experience is great! It’s new and I’m very happy to do this with you!”

THE CLINICAL STUDY IN FIGURES

  • Total duration of the study: 15 months
  • Duration of the inclusion phase: 12 months
  • Duration of participation for a patient: 6 weeks
  • Protocol started on December 02, 2020
  • Number of inclusions in the EHPAD-USLD of the Cimiez hospital of the CHU of Nice and in the EHPAD Clos de Cimiez on 09/08/2021: 13 residents.
  • Minimum age of participants: 65 years or older
  • The project plans to include 30 residents


Press release of September 20, 2021.

Do you need further information or have any specific questions ?

FAQ

Virtual reality (VR) is an innovative technology that enables patients to be exposed to immersive and controlled environments, facilitating the management of numerous psychological and psychiatric disorders. Its use in mental health offers several advantages:
  • Gradual and Controlled Exposure: VR allows patients to confront anxiety-inducing situations in a secure environment, gradually adjusting the intensity of stimuli to promote habituation and emotional regulation.
  • Realistic and Reproducible Environments: Unlike traditional techniques, VR provides immersive scenarios that can be consistently reproduced, ensuring a coherent and effective approach.
  • Increased Patient Engagement: The interactive and immersive nature of VR enhances treatment adherence and motivates patients to continue their therapy.
  • Personalized Treatment: Virtual environments can be adapted to meet the specific needs of each patient.
  • Versatile Applications: VR is used to treat anxiety disorders (phobias, post-traumatic stress disorder, obsessive-compulsive disorders), addictions, mood disorders, and even cognitive remediation.
The use of virtual reality in healthcare is not new! It has been studied and utilized for over 30 years in the medical and psychological fields. As early as the 1990s, researchers began exploring its potential for treating anxiety disorders, particularly phobias and post-traumatic stress disorder. Since then, numerous scientific studies have confirmed its effectiveness in addressing various psychiatric, neurological, and cognitive disorders.
Today, VR is widely integrated into therapeutic and medical practices, with clinically validated protocols. It is used in hospitals, clinics, and psychologists' offices worldwide to provide patients with innovative, effective, and safe treatments.
To use virtual reality, one must immerse themselves in a virtual environment. There are several ways to achieve this.
In the past, the CAVE system (Cave Automatic Virtual Environment), a 3D setup consisting of multiple screen walls, was the primary method used. This system allowed users to be fully immersed in the virtual world, with their movements detected in real-time. However, this technology was expensive and not widely accessible.
Since around 2016, with the introduction of virtual reality headsets like the Oculus Rift and HTC Vive, VR has become much more accessible. These headsets immerse users in virtual reality through an enclosed screen that projects digital images. The user's head movements are tracked, enabling them to look around and interact with the environment as they would in the real world.
Today, VR headsets are wireless and standalone, providing maximum comfort and ease of use without requiring external sensors or cables.
A virtual environment is an immersive digital simulation created through virtual reality. It allows users to navigate in a 3D space that accurately replicates everyday situations or specific contexts.
In mental health, these environments are designed to help individuals gradually face certain situations, manage their emotions, or enhance cognitive skills. By interacting with these virtual spaces, patients can engage in meaningful experiences tailored to their needs.
You need to equip yourself with a virtual reality headset. Our software is compatible with Meta Quest 2, 3, and 3S. 
You will then only need an internet connection. 
Numerous studies confirm that virtual reality is safe to use. However, some restrictions are in place to protect users from potential adverse effects.
For instance, individuals with epilepsy and pregnant women should avoid this type of therapy.
As with any immersive technology, prolonged use may cause visual fatigue or mild discomfort, particularly for those sensitive to motion sickness. Therefore, it is recommended to take regular breaks and adjust session durations according to individual needs.
Virtual environments are designed to be gradual and controlled, minimizing the risk of excessive anxiety. Most users quickly adapt to immersion and experience the benefits of this innovative approach from the first sessions.
Anxiety disorders and phobias can be effectively treated using virtual reality. Patients are gradually and progressively exposed to anxiety-inducing situations in various environments while remaining in a safe space. This process helps develop a sense of habituation, ultimately reducing or even eliminating anxiety over time.
Behavioral and substance addictions can also be addressed through virtual reality. By incorporating synthetic stimuli into the environments that trigger craving responses, patients struggling with addiction can work on their cravings to diminish the urge to consume.
Additionally, multiple environments—such as bars, casinos, and social settings—enable cognitive work on dysfunctional beliefs associated with specific temptation scenarios.
Regarding eating disorders, virtual reality software helps target key etiological factors, such as body dysmorphia, allocentric lock (a tendency to focus on others rather than oneself), and food cravings.
Currently, our TERV (Virtual Reality Exposure Therapy) solutions include multiple software programs designed to address critical psychiatric, psychological, and neuropsychological determinants such as relaxation, cognitive stimulation, behavioral activation, and social skills training.
Reminiscence therapy is also a major therapeutic tool in treating depression. By allowing patients to relive sensations linked to past pleasurable activities (such as sports, driving, or traveling), virtual reality stimulates hypoactive brain areas, enhancing therapeutic success. VR serves as an excellent mediator for reigniting engagement in enjoyable activities.
Moreover, cognitive stimulation for elderly individuals is another area where virtual reality proves beneficial. By leveraging technology to make stimulation activities more engaging and accessible, patients and nursing home residents can improve executive functions and memory through specially designed applications.
Today, virtual reality in mental health care is advancing rapidly. Researchers, clinicians, and developers continue to explore new therapeutic targets to offer innovative and effective treatment solutions in the near future.
VR can be used by all healthcare professionals assisting patients with anxiety, phobias, post-traumatic stress disorders, addictions, or other psychological challenges.
It is particularly beneficial for psychologists, psychiatrists, neuropsychologists, specialized nurses, as well as psychomotor therapists, physiotherapists, dietitians, sophrologists, and hypnotherapists. With a wide range of immersive environments, VR enhances therapeutic approaches and provides innovative tools to improve patient care.
Healthcare providers incorporating virtual reality exposure therapy (VRET) expand their range of treatment options. VRET is a well-established therapeutic technique with scientific validation from cognitive-behavioral therapy research.
  • Professional Differentiation: Integrating VR into practice allows therapists to stand out from traditional treatment options.
  • Scientific Validation: VRET is backed by extensive research, reinforcing its credibility as an effective treatment method.
  • Improved Patient Engagement: The interactive nature of VR fosters greater patient involvement in therapy.
  • Time-Saving: VR provides direct access to various exposure environments without needing external logistics.

One of the considerable advantages of virtual reality is that it is effective on a wide spectrum of populations. Existing data from the literature on the subject shows us that it is entirely possible to expose a wide age group to virtual reality, with real therapeutic benefits.

The studies attest, in fact, to excellent feasibility and significant results; particularly in adults, in the treatment of anxiety disorders (including school phobia), autism, addictions, eating disorders, neuropsychological disorders, psychotic disorders and mood disorders.

The results are identical for adolescents with a significant added value concerning therapeutic engagement where virtual reality promotes adolescents' interest in their therapy.

Among elderly subjects, study results encourage the use of virtual reality with the aim of working on cognitive stimulation, on behavioral disorders but also on anxiety.

One of the major advantages of virtual reality is its effectiveness across a broad spectrum of the population. Existing literature on the subject shows that virtual reality can be used with individuals of various age groups, providing significant therapeutic benefits.
Studies confirm excellent feasibility and significant results, particularly among adults in the treatment of anxiety disorders (including school phobia), autism, addictions, eating disorders, neuropsychological disorders, psychotic disorders, and mood disorders.
The results are equally promising for adolescents, with a notable advantage in terms of therapeutic engagement, as virtual reality enhances their interest and participation in treatment.
For older adults, research supports the use of virtual reality to improve cognitive stimulation, behavioral disorders, and anxiety management.
However, people with epilepsy and pregnant individuals are not advised to undergo this type of therapy.
Yes, all our environments are grouped within a single application.
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