Principal Investigator: Jason Wiese
Keywords: Decannualation , Spinal Cord Injuries , Stressful , Anxiety , Virtual Reality Department: School Of Computing
IRB Number: 00121564
Specialty: Physical Medicine and Rehabilitation, Psychology, Clinical, Physical Medicine and Rehabilitation
Sub Specialties: Spine,
Recruitment Status: Not yet recruiting

Contact Information

Heidi Hansen
heidi.hansen@hsc.utah.edu
801.587.2373

Brief Summary

The mechanical ventilation weaning is the process that readies individuals for decannulation. This process is important step for the rehabilitation of individuals with complex spinal cord injuries. The mechanical ventilation weaning process towards is stressful and the goal of decannulation can be notably extended due to anxiety-producing elements of the process. Virtual reality has demonstrated value in reducing anxiety and providing distraction during unpleasant medical procedures. Further, it has been used effectively to enhance biofeedback in breathing protocols for diaphragmatic breathing. Barring one conference abstract, the authors are unaware of any studies regarding the use of virtual reality to enhance mechanical ventilation weaning towards decannulation for individuals with spinal cord injury. Accordingly, a mixed methods feasibility study is proposed. The study objectives include:

1) uncovering need for a system to reduce anxiety during mechanical ventilation weaning

2) examine technology acceptability 

3) identify practicality of using virtual reality technology during mechanical ventilation weaning

This virtual reality system is not intended to cure, mitigate, treat, or prevent any disease.

Inclusion Criteria

Sixty adults with new spinal cord injury/disorder (SCI/D) who require ventilator support, their caregivers, and medical providers will be recruited for this feasibility study.

Potential participants with SCI/D and their caregivers will be recruited from the University of Utah Inpatient Medical Rehabilitation Unit. Medical chart review will be conducted by HIPAA and CITI credentialed providers from the PM&R clinics to obtain information about the patient’s health pertinent to ventilator needs and inform participant inclusion.

Participants between the ages of 18 and 75 are invited to participate.

English-speaking patients interested in participating and able to consent will be included.

Participants with SCI/D who require ventilator support or prolonged mechanical ventilation (PMV), will be defined as having at least 14 days of mechanical ventilation for at least six hours per day.

Caregivers will be defined as non-professional individuals who identify as a willing to offer physical or emotional care for the patient.  

Medical providers related to the SCI/D participant's care will also be recruited. This will include physicians, nurses, respiratory therapists, speech therapists, occupational therapists, and rehabilitation psychologists.

Exclusion Criteria

Potential participants with SCI/D and their caregivers will be excluded if: (a) they have severe cognitive or communication disorders (i.e., diagnosis of major neurocognitive disorder, active delirium, or aphasia), (b) presence of a clinically unstable systemic illness or other health condition judged to interfere with participation as determined by the referring provider, (c) severe mental illness and/or substance use disorder judged to interfere with participation as determined by the referring provider, and/or are (d) unable to understand or complete the survey questionnaires and consent. Exclusion criteria A-C are noted in medical health records and will be reviewed by the PI, a rehabilitation psychologist with clinical and research expertise in evaluating these conditions. 

Medical providers related to the SCI/D participant's care will be excluded if they are not directly involved in the patient's care or respiratory support.