Effects of Virtual Reality and Relaxation During Non-Stress Testing

Summary

Aim:

This randomized controlled trial aimed to compare the effectiveness of virtual reality and progressive muscle relaxation exercise in reducing anxiety during the non-stress test (NST) and to evaluate their effects on maternal physiological parameters in high-risk pregnant women.

Materials and Methods:

The study was conducted as a randomized controlled trial between March 2025 and August 2025 at Kanuni Sultan Süleyman Training and Research Hospital with 126 high-risk pregnant women. Participants were randomly assigned to three groups (42 per group): virtual reality, progressive muscle relaxation exercise, and control group.

During NST monitoring, participants in the virtual reality group received VR headset-based immersive audiovisual stimulation, while participants in the progressive muscle relaxation group performed guided relaxation exercises. The control group received routine NST monitoring without any additional intervention.

Data were collected using the Informed Consent Form, Pregnant Woman Information Form, Non-Stress Test Follow-up Form, Physiological Parameters Follow-up Form, Visual Analog Scale (VAS), and State-Trait Anxiety Inventory (STAI Form TX-I). The STAI, VAS, and physiological parameters were measured before and after NST, while fetal NST parameters were recorded during the procedure.

Conditions

• Maternal Anxiety Level
• Non Stress Test (NST)
• High Risk Pregnancy
• Virtual Reality
• Progressive Muscle Relaxation Exercise
• Physiological Parameters

Interventions

BEHAVIORAL

Virtual reality glasses

The participants in the virtual reality (VR) group will be provided with a VR headset during non-stress test (NST) monitoring. They will be given the opportunity to choose one video from five available options according to their preference. The options will include nature-based audiovisual content such as natural scenery with ambient sounds, sea views with water sounds, and rain imagery with rainfall sounds. Each participant will watch the selected video during the NST. The audio level will be individually adjusted to ensure comfort and clear hearing. The adjustable VR headset, with a smartphone positioned at the front, will be properly fitted to each participant. The VR intervention will be applied for 20-30 minutes during the NST.

BEHAVIORAL

Progressive muscle relaxation exercises

Participants in the progressive muscle relaxation (PMR) group will receive a guided PMR intervention during the non-stress test (NST), lasting 20-30 minutes. The intervention will be implemented by the researcher in accordance with the guidelines recommended on the website of the Cognitive Behavioral Therapies Association.

Sponsors & Collaborators

• Kanuni Sultan Suleyman Training and Research Hospital

  collaborator OTHER

• Istanbul University - Cerrahpasa

  lead OTHER

Study Design

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

FEMALE

Healthy Volunteers

No

Timeline & Regulatory

Start

2025-03-01

Primary Completion

2025-08-01

Completion

2025-08-01

Countries

• Turkey (Türkiye)

Study Locations