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Introduction: Social Anxiety Disorder (SAD) is considered themost prevalent anxiety disorder with the highest disease burden amongst anxiety disorders. Despite available effective treatment with Cognitive Behavioral Therapy, a majority of individuals with SAD do not seek treatment and many drop out when confronted with elements of exposure. Several studies highlight the many advantages virtual reality exposure holds over in vivo exposure. In this study, we investigate the added effect of real-time biofeedback during virtual reality exposure. Objectives: The current study is part of a large scale study called VR8. The current study aims to develop and evaluate the feasibility of a VR-biofeedback-intervention for adults with mild to severe social anxiety disorder, before continuing randomized controlled trials. Methods: Data from semi-structured interviews and surveys will be compared to biodata collected during VR exposure. Participants include a minimum of (n=10) patients and (n=10) clinicians from the Mental Health Services in the Region of Southern Denmark. Surveys include questionnaires used for assessment of anxiety symptoms, usability of technology, and presence in the virtual environment. Collected biodata includes heart rate variability and electrodermal activity. Behavioral markers include eye-gaze. The findings will be analyzed and discussed in a mixed methods design. Results: The study is ongoing. Preliminary results will be available at presentation. Conclusions: Successful development and implementation of a biofeedback-informed virtual reality exposure intervention may provide increased reach for patients and individuals who would have otherwise not sought- or dropped out of regular treatment, as well as inform the clinician on how to proceed during virtual exposure. Conflict of interest: Prof. Stephané Bouchard is consultant to and own equity in Cliniques et Développement In Virtuo, which develops virtual environments, and conflicts of interests are managed according to UQO's conflict of interests policy; however, Cliniques et Développeme. [ABSTRACT FROM AUTHOR]

Introduction: Social Anxiety Disorder (SAD) is the most prevalent anxiety disorder and is considered to have the largest disease burden amongst anxiety disorders. Although SAD in most cases can be treated successfully with Cognitive Behavioral Therapy, only between 33% and 50% seek treatment and many patients drop out of treatment as they are confronted with elements of exposure. Can virtual reality exposure therapy with applied biofeedback provide an accessible, feasible and effective addition in the treatment of SAD? Objectives: The current study is part of a large scale study that aims to develop and evaluate the feasibility and effect of aVR-biofeedbackintervention for adults with mild to severe social anxiety disorder. Methods: Initially, a systematic review of existing available data on the application of virtual reality exposure therapy with biofeedback will be performed. The current study will collect data from semistructured interviews and surveys. Participants include a minimum of (n=10) patients and (n=5) clinicians from the Mental Health Services in the Region of Southern Denmark. Surveys include questionnaires used for assessment of anxiety symptoms, usability of technology, and presence within the virtual environment. The findings will be analyzed and discussed in a mixed methods design. Results: Successful development and implementation of an automated virtual reality exposure therapy intervention may provide increased reach for patients and individuals who would have otherwise not sought-or dropped out of regular treatment. Conclusions: The proposed treatment may provide early intervention and prevent further escalation of SAD. Furthermore, the intervention may reduce time and resources spent by personnel in treating SAD. [ABSTRACT FROM AUTHOR]

Background & Aims: Pelvic floor muscle training (PFMT) in combination with conservative treatment is recommended as first-line treatment for patients with fecal incontinence, although its efficacy is unclear. We investigated whether supervised PFMT in combination with conservative treatment is superior to attention-control massage treatment and conservative treatment in adults with fecal incontinence., Methods: We performed a randomized, controlled, superiority trial of patients with fecal incontinence at a tertiary care center at a public hospital in Denmark. Ninety-eight adults with fecal incontinence were randomly assigned to groups that received supervised PFMT and biofeedback plus conservative treatment or attention-control treatment plus conservative treatment. The primary outcome was rating of symptom changes, after 16 weeks, based on scores from the Patient Global Impression of Improvement scale. Secondary outcomes were changes in the Vaizey incontinence score (Vaizey Score), Fecal Incontinence Severity Index, and Fecal Incontinence Quality of Life Scale., Results: In the intention-to-treat analysis, participants in the PFMT group were significantly more likely to report improvement in incontinence symptoms based on Patient Global Impression of Improvement scale scores (unadjusted odds ratio, 5.16; 95% CI, 2.18-12.19; P = .0002). The PFMT group had a larger reduction in the mean Vaizey Score (reduction, -1.83 points; 95% CI, -3.57 to -0.08; P = .04). There were no significant differences in condition-specific quality of life. In the per-protocol analyses, the superiority of PFMT was increased. No adverse events were reported., Conclusions: This randomized controlled trial of adults with fecal incontinence provides support for a superior effect of supervised PFMT in combination with conservative treatment compared with attention-control massage treatment and conservative treatment. We found that participants who received supervised PFMT had 5-fold higher odds of reporting improvements in fecal incontinence symptoms and had a larger mean reduction of incontinence severity based on the Vaizey Score compared with attention control massage treatment. Clinicaltrials.gov no: NCT01705535., (Copyright © 2019 AGA Institute. Published by Elsevier Inc. All rights reserved.)