Effects of immersive and non- immersive virtual reality on anxiety and cognition in Parkinson's disease: A comparative study

Introduction: Parkinson's disease (PD) is chronic and progressive, manifested by both motor and non-motor symptoms, such as anxiety. Anxiety occurs in more than 50% of patients. Rehabilitation in PD is more focused on controlling motor symptoms. However, non-motor symptoms affect independence, functionality, and motivation. Purpose: The present study aimed to compare the effects of immersive virtual reality (IVR) and non-immersive virtual reality (NIVR) training on anxiety and cognition in PD patients. Methods: Two VR devices were used: Nintendo Wii (NIVR) and Samsung Gear VR (IVR). A convenience sample of 60 participants was distributed into 3 groups: a no intervention control group (CG) and two training groups (IVR and NIVR). All were evaluated at the baseline (T1), 7 days after (T7), and 30 days after training (T30). The Beck Anxiety Inventory (BAI), Semantic Verbal Fluency test (VF), and Digits subtest in reverse order (DR) were evaluated. The intervention protocol consisted of 10 sessions, each lasting 1 h, twice a week, for 5 weeks. According to the motor and cognitive requirements of games, 4 games were selected for each VR system. The Friedman test was used for comparing groups at different times (P <= 0.05). Results: The findings revealed a significant decrease in the BAI score in the IVR group (F = 15 217; p < 0.001) between T1 and T7 (and between T1 and T30. No significant differences were found between T7 and T30. No significant differences were found for the cognition variables. Conclusion: IVR is a useful and feasible tool for managing anxiety symptoms in patients with PD.