Using multisensory virtual reality nature immersion as a therapeutic modality for improving HRV and cognitive functions in post-traumatic stress disorder: a pilot-study

Introduction: Immersive virtual reality (VR) applications are burgeoning within healthcare as they promote high levels of engagement. Notwithstanding, existing solutions only stimulate two of our five senses (audio and visual), thus may not be optimal in the sense of promoting immersion and of “being present”. In this paper, we explore the benefits of an immersive multisensory experience as a therapeutic modality for participants suffering from post-traumatic stress disorder (PTSD). Methods: In addition to 360-degree videos and corresponding natural sounds, nature smells are also presented by means of a portable ION 2 scent diffusion device attached to an Oculus Quest 2 VR head-mounted display. A 3-week 12-sessions protocol was applied to a sample of 20 participants diagnosed with PTSD. Results and discussion: We report the outcomes seen from a battery of qualitative metrics, including cognitive functioning tests, psychological symptoms, severity of PTSD, and several self-reported questionnaires and heart rate variability (HRV) metrics. Results are compared not only between pre-and post intervention, but also after a 3-month follow-up period. Results suggest a decrease in the severity of PTSD, as well as improvements in processing speed and sustained attention post-intervention, but also sustained decrease in the severity of PTSD and in dissociative tendencies at the 3-month follow-up. Overall, participants rated the experience as highly immersive and produced very mild to no symptoms of cybersickness, thus corroborating the feasibility and usefulness of the proposed multisensory immersive VR tool for reducing PTSD symptoms.