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The Impact of Simulated Forest Immersion Therapy on Pain and Anxiety in Patients Axial Spondyloarthritis (axSpA)

Primary Purpose

Axial Spondyloarthritis

Status
Enrolling by invitation
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Humidified Forest Oils
Virtual Reality using Surface Pro and headphones
Sponsored by
Oregon Health and Science University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional supportive care trial for Axial Spondyloarthritis focused on measuring Forest Oils, Volatile Organic Compounds, Terpenes, Virtual Reality, Pain, Anxiety, Mood

Eligibility Criteria

18 Years - 100 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: able to read at a 5th grad level medically diagnosed with Axial Spondyloarthritis tolerate having their BP and HR taken average of greater than 3 on their last recorded pain assessments average of greater than 4 on their last BASDI recorded currently have an assigned Rheumatologist in their care delivery Exclusion Criteria: history of asthma currently pregnant inability to detect common odors from commercial fragrances smoking within 15 minutes of the start of the intervention procedure known allergy to citrus aroma hard of hearing without assistive devices limited vision not corrected by eye lenses history of hypertension uncontrolled by medications

Sites / Locations

  • Oregon Health & Science University

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Active Comparator

Arm Label

Group 1

Group 2

Arm Description

Humidified Forest Oils with Limonene

Humidified Forest Oils with Limonene & Virtual Reality using a Surface Pro tablet with headphones to experience walking on a forest path and ambient forest sounds.

Outcomes

Primary Outcome Measures

Axial Skeleton Pain
Pain on Visual Analog Scale, Scores 0-10 with higher scores reflecting greater pain
Anxiety
Anxiety as scored on STAI - State only Higher scores mean greater state anxiety, 20 items with a scoring range of 1-4 on each of them. Score is totaled and range 20-80 with higher scores reflecting higher anxiety as a state.
Blood Pressure
Blood Pressure measured by Omnicron tabletop BP and HR device, used clinically, higher Blood Pressure, both systolic and diastolic pressures, measured reflect/correlate with higher anxiety or pain status. Measure range 0-240.
Heart Rate
Heart Rate measured by Omnicron tabletop BP and HR device, used clinically, higher Heart Rate measured reflect/correlate with higher anxiety or pain status. Measure range 0-300.
Feasibility Questions
Questions regarding the intervention include the tolerance of the intervention, likes and dislikes of the experience and any suggestions to make the intervention experience better.

Secondary Outcome Measures

Bath Ankylosing Spondylitis Disease Activity Index (BASDAI)
Measures pain and functionality in Axial Spondyloarthritis by assessing individual metrics for fatigue, axial involvement, peripheral articular involvement, localized tenderness/enthesitis, and morning stiffness. Score 0-10 with higher scores reflecting higher pain and functionality issues.
Routine Assessment of Patient Index Data 3 (RAPID3)
composite index which is routinely and reliably used to assess disease activity in Axial Spondyloarthritis. Score range 0-30 with higher scores reflecting higher disease activity.

Full Information

First Posted
September 26, 2023
Last Updated
October 3, 2023
Sponsor
Oregon Health and Science University
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1. Study Identification

Unique Protocol Identification Number
NCT06072859
Brief Title
The Impact of Simulated Forest Immersion Therapy on Pain and Anxiety in Patients Axial Spondyloarthritis (axSpA)
Official Title
The Impact of Simulated Forest Immersion Therapy on Pain and Anxiety in Patients Axial Spondyloarthritis (axSpA)
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Enrolling by invitation
Study Start Date
September 21, 2023 (Actual)
Primary Completion Date
June 30, 2024 (Anticipated)
Study Completion Date
June 30, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Oregon Health and Science University

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of the study is to learn about the ease of using a humidified fragrant citrus forest oil, along with a virtual simulation of a forest environment (i.e., with sights and sounds of nature using a personal tablet Surface Pro 3 with headphones, to learn more about how these two aspects of the simulated forest immersion therapy (SFIT) may improve pain, anxiety, blood-pressure, and heart rate related to Axial Spondyloarthritis. The investigators hope to learn how well SFIT may impact pain levels, feelings of calm, as well as blood- pressure and heart rate, and how participants tolerate the experience overall.
Detailed Description
DURATION: Participation in the study will consist of 1 visit total and will last up to 2 consecutive hours. PROCEDURES: Participants will be randomized to receive either the forest oils only, or the forest oils and audio-visual forest exposure described above for up to 1 hour. Study Visit: During Visit 1 and the only study visit, the investigator will explain the study and obtain consent. The Investigator will explain this study and answer any questions the participant may have. The participant will have the opportunity to review this document in detail. Consent may be withdrawn by the participant at any time during the study. Once the written consent is signed, the participant will be asked to rest for 15 minutes. During the resting period, randomization will occur into one of two groups: Group 1 - Forest oils only, or Group 2 - Forest oils and audio-visual forest exposure Following the resting period, demographics will be collected from the participants. The investigators will then take a blood pressure and heart rate measurement. Then, the investigator will ask the participants to fill out two questionnaires. One of these questionnaires consists of two questions asking the participants about their pain level and location, the other questionnaire asks about mood state and how the participants rate various qualities of their feelings. The third questionnaire asks the participants about their pain levels specific to the past week. Participants will then be taken into the study room where they will participate in the simulated forest experience. If the participants are randomly assigned to Group 1, they will be breathing in the aroma of the forest oils for a period of 1 hour in the study room. There is an adjustable lounge chair in the room to sit in. And the participants may read or use their phone quietly. If the participants are randomly assigned to Group 2, they will be breathing in the aroma of the forest oils for a period of 1 hour in the study room while using the headphones and tablet with the simulated forest greenspace sights and sounds. There is an adjustable lounge chair in the room to sit in. The investigator will take the participants blood pressure and heart rate measurement after 30 minutes from the start of the intervention. Within 15 minutes following the simulated experience in the study room, the investigator will take one more blood-pressure and heart rate measurement. Then, the participants will fill out the same two questionnaires again, which are asking the participants about their pain level and location and mood. The investigators will then ask the participants some questions about the participants' experience before the end of the study visit. One week after the participants study visit (Study Visit 1), the investigator will ask the participants to return two follow-up questionnaires to us over encrypted and password protected OHSU email, or by arranging to drop the questionnaires off with the Study Coordinator or the Rheumatology Clinic at OHSU. RISKS: There are three risks to participation in this study and these are all considered minimal risks. Participants may have an allergic reaction, a cough, or an increase in asthma type symptoms, such as difficulty breathing related to the humidified fragrant citrus forest oil used in this study. For those in Group 2, the participants may experience a sensation of nausea (feeling queasy), discomfort related to the headphone placement, sound disturbances related to the volume of the nature sounds, or discomfort related to viewing the images of the forest greenspace environment utilized in this study. the investigators will make every effort to protect the participants privacy during this study, including password protected files, secure and encrypted email, and double locked file system. A loss of confidentiality happens when the participants private information is accessed outside the scope of this study. A loss of confidentiality is an unexpected event. BENEFITS: Participants may not directly benefit from taking part in this research. However, participation will potentially benefit patients with Axial Spondyloarthritis in the future.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Axial Spondyloarthritis
Keywords
Forest Oils, Volatile Organic Compounds, Terpenes, Virtual Reality, Pain, Anxiety, Mood

7. Study Design

Primary Purpose
Supportive Care
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
Feasibility quasi-experimental
Masking
None (Open Label)
Allocation
Randomized
Enrollment
20 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Group 1
Arm Type
Active Comparator
Arm Description
Humidified Forest Oils with Limonene
Arm Title
Group 2
Arm Type
Active Comparator
Arm Description
Humidified Forest Oils with Limonene & Virtual Reality using a Surface Pro tablet with headphones to experience walking on a forest path and ambient forest sounds.
Intervention Type
Other
Intervention Name(s)
Humidified Forest Oils
Intervention Description
60mls Limonene in 200mls water humidified with a diffuser.
Intervention Type
Other
Intervention Name(s)
Virtual Reality using Surface Pro and headphones
Intervention Description
Surface Pro has a looped visual that can be manipulated by the participant to simulate walking on a forest path or through a forest visual. This is paired with headphones to experience ambient forest sounds.
Primary Outcome Measure Information:
Title
Axial Skeleton Pain
Description
Pain on Visual Analog Scale, Scores 0-10 with higher scores reflecting greater pain
Time Frame
before intervention on visit 1, directly after intervention on visit 1, and one week later
Title
Anxiety
Description
Anxiety as scored on STAI - State only Higher scores mean greater state anxiety, 20 items with a scoring range of 1-4 on each of them. Score is totaled and range 20-80 with higher scores reflecting higher anxiety as a state.
Time Frame
before intervention on visit 1, directly after intervention on visit 1, and one week later
Title
Blood Pressure
Description
Blood Pressure measured by Omnicron tabletop BP and HR device, used clinically, higher Blood Pressure, both systolic and diastolic pressures, measured reflect/correlate with higher anxiety or pain status. Measure range 0-240.
Time Frame
before intervention on visit 1, after 30 minutes of the intervention start on visit 1, directly after intervention on visit 1, and one week later
Title
Heart Rate
Description
Heart Rate measured by Omnicron tabletop BP and HR device, used clinically, higher Heart Rate measured reflect/correlate with higher anxiety or pain status. Measure range 0-300.
Time Frame
before intervention on visit 1, after 30 minutes of the intervention start on visit 1, directly after intervention on visit 1, and one week later
Title
Feasibility Questions
Description
Questions regarding the intervention include the tolerance of the intervention, likes and dislikes of the experience and any suggestions to make the intervention experience better.
Time Frame
directly after intervention on visit 1
Secondary Outcome Measure Information:
Title
Bath Ankylosing Spondylitis Disease Activity Index (BASDAI)
Description
Measures pain and functionality in Axial Spondyloarthritis by assessing individual metrics for fatigue, axial involvement, peripheral articular involvement, localized tenderness/enthesitis, and morning stiffness. Score 0-10 with higher scores reflecting higher pain and functionality issues.
Time Frame
before intervention on visit 1, directly after intervention on visit 1, and one week later
Title
Routine Assessment of Patient Index Data 3 (RAPID3)
Description
composite index which is routinely and reliably used to assess disease activity in Axial Spondyloarthritis. Score range 0-30 with higher scores reflecting higher disease activity.
Time Frame
before intervention on visit 1, directly after intervention on visit 1, and one week later

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
100 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: able to read at a 5th grad level medically diagnosed with Axial Spondyloarthritis tolerate having their BP and HR taken average of greater than 3 on their last recorded pain assessments average of greater than 4 on their last BASDI recorded currently have an assigned Rheumatologist in their care delivery Exclusion Criteria: history of asthma currently pregnant inability to detect common odors from commercial fragrances smoking within 15 minutes of the start of the intervention procedure known allergy to citrus aroma hard of hearing without assistive devices limited vision not corrected by eye lenses history of hypertension uncontrolled by medications
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Amy Miner Ross, PhD
Organizational Affiliation
Oregon Health and Science University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Oregon Health & Science University
City
Portland
State/Province
Oregon
ZIP/Postal Code
97239
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

The Impact of Simulated Forest Immersion Therapy on Pain and Anxiety in Patients Axial Spondyloarthritis (axSpA)

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