Preselected and preferred immersive virtual reality versus narrative alone to induce post-stress relaxation in patients with pulmonary arterial hypertension: A pilot study on perceived stress and heart rate

Objectives: Several studies have shown the effectiveness of immersive virtual reality (IVR)-based relaxation techniques in alleviating stress within the general population. However, few data are available on patients, or on the effectiveness of different scenarios in inducing relaxation. This pilot study aims to compare the effectiveness of three relaxation techniques—preselected IVR (IVR-PS), preferred IVR (i.e. chosen by the participant from different alternatives—IVR-PR), and narrative alone (CTR)—in reducing physiological and psychological stress in 16 pulmonary arterial hypertension (PAH) female patients (N = 16, average age: 46 ± 10.66 years; average education: 13.31 ± 3.8 years; mean duration of illness: 8.56 ± 5.24 years) following an acute stress. Methods: Patients performed a mental stress test followed by three different relaxation sessions presented in a randomized order on three separate occasions. Self-perceived stress, level of relaxation, and heart rate (HR) were monitored during the sessions. Participants' ratings of their experiences were also collected. Results: The results indicated that the three relaxation methods were equally effective in reducing perceived stress induced by acute stress and in lowering HR. However, greater cognitive activation was reported in the two IVR conditions compared with the narrative condition. Conclusions: This is the first study to show evidence of the impact of IVR on a rare population. Despite the lack of significant differences between the two IVR and narrative-alone conditions in physiological and subjective relaxation, more than half of the participants expressed a subjective preference for the virtual experience, especially for the preferred one.