Virtual Reality Intervention for Fear of Falling
Research type
Research Study
Full title
Augmenting psychological treatment for fear of falling using Virtual Reality: A feasibility study in older adults
IRAS ID
287360
Contact name
Hamish McLeod
Contact email
Sponsor organisation
NHS Greater Glasgow and Clyde
Duration of Study in the UK
0 years, 6 months, 17 days
Research summary
Research Summary:
Background:
Falls in older adults are expensive to the NHS and reduce patients’ quality of life. Fear of falling (FoF) increases the risk of falls and so is an important treatment target. Virtual reality (VR) is an interactive computer generated environment, often viewed via a wearable headset. If effective, VR-supported exposure treatments, exposing and habituating patients to feared scenarios, could potentially save therapeutic labour and costs in FoF treatment. However, few VR treatment protocols have been co-productively designed alongside end-users. This feasibility study will evaluate the acceptability of a custom-designed VR FoF intervention targeting psychological process related to FoF in older adults.Aims:
- Evaluate feasibility, including acceptability and tolerability, of a bespoke VR intervention in older adults.
- Determine if patients are willing to participate in this type of treatment approach.
- Develop and evaluate FoF measurements within virtual environments.Methods:
The recruitment target is 20 older adult participants (generally ≥65 years) with current or past FoF from NHS Glasgow psychology services. They will evaluate a short VR intervention, involving psychological exposure to commonly feared scenarios (e.g. icy surfaces, dim lighting). In light of COVID-19, this will be conducted remotely, without participants interacting with researchers in person. Screenshots, videos and written information on the intervention will be sent to participants. The intervention itself will be designed in collaboration with computer science colleagues. Outcomes gathered will include quantitative routine outcome measures used in older adult psychology services (e.g. anxiety scales) and qualitative semi-structured interview feedback via phone.Applications:
Results will form the beginnings of a co-produced intervention. The rich user experience data will aid psychologists and software-developers in designing future automated VR interventions.Summary of Results:
Background:Falls in older adults are expensive to the NHS and reduce quality of life. A third of older adults (≥65 years) fall annually, increasing with age. Fear of falling (FoF) is a reduced confidence in balancing abilities, usually associated with reduced daily activities and exercise. This can develop whether people have had past falls or not and can increase falling risk through impaired balance abilities. This heightened anxiety negatively affects attention relating to movement. Given the role of these psychological processes, Virtual reality (VR) exposure treatments can potentially improve FoF and reduce clinician labour. Moreover, few VR treatments have been designed co-productively.
Aims:
To evaluate older people’s perceived acceptability, tolerability and feasibility of a VR FoF exposure intervention. To determine if these patients are willing to participate in actual VR.
Methods:
Older people with current or previous FoF from NHS Glasgow Psychology services received visual and written information on a VR intervention, involving exposure to feared scenarios. This was designed alongside Clinical Psychology experts, service-users and Computer science colleagues. Participants engaged in semi-structured telephone interviews, providing feedback, including perceived tolerability, feasibility and acceptability. These were analysed via qualitative thematic analysis. They also completed mental health measures on anxiety, mood and FoF. Six participants ultimately engaged, with five completing both the mental health measures and interview, and one completing the mental health measures only.
Main findings & Conclusions:
Ten sub-themes were found within four overarching themes. Additional comments emphasised fall experiences, physical health, motivation and effects of COVID-19 on exercise. Results suggested older people are mainly positive and willing to engage in VR for FoF. Most could envisage it in usual treatment. Implications for intervention development included increased reassurance from clinicians, clear explanation of technology, more VR tasks outside the home and adaptations for health conditions. Recruiting participants via clinicians was effective. Future research should improve VR content and test in-vivo with larger samples; effort should be made to include more diversity, including males, non-white ethnicities and lower socioeconomic backgrounds, to better reflect older people’s views.
REC name
West Midlands - South Birmingham Research Ethics Committee
REC reference
21/WM/0059
Date of REC Opinion
22 Feb 2021
REC opinion
Favourable Opinion