Mobility ImpairmentsNCT06682143
The Effects of Virtual Reality Greenspace on Stress Among Adults With Mobility Impairments
A study testing Virtual Reality (VR) in people with Mobility Impairments, run by University of Alabama at Birmingham at 1 site in United States.
Trial summary
The purpose of this project is to examine the effects of virtual reality greenspace exposure on physiological and affective acute stress responses among adults with mobility impairments. Read more about this study
- Who is it for?
- Ages 18 to 75 years
- Conditions the study is for
- Mobility Impairments
- What is being tested?
- Virtual Reality (VR)
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 25 participants
- Where
- 1 siteUnited States
- Study dates
- 7 Apr 2025to 30 Jun 2027
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 75 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Age between 18 and 75 years
- A self-reported lower extremity mobility impairment (e.g., cerebral palsy, spinal cord injury, multiple sclerosis, stroke) with partial or full use of the upper extremities.
Who cannot join
- Impairment in visual acuity as measured by a Snellen eye chart <20/70 after correction
- Regular engagement (>20 minutes/week) in virtual reality greenspace activity
- Having an endocrine disorder (that can affect cortisol levels)
- Taking oral corticosteroids
- Score below 24 on the Mini Mental State Exam
Trial locations and contacts
1 site in 1 country.
United States1 site
University of Alabama at Birmingham
Birmingham, Alabama, 35294
About this study
Official title: The Effects of Virtual Reality Greenspace Exposure on Physiological and Affective Acute Stress Responses Among Adults With Mobility Impairments: A Pilot Study
The purpose of this project is to examine the effects of virtual reality greenspace exposure on physiological and affective acute stress responses among adults with mobility impairments.
Read the detailed description
Exposure to greenspace is known to yield numerous mental and physical health benefits such as improved mood, decreased stress, and increased levels of physical activity. Regular access to greenspace however is difficult for various segments of the population including individuals with disabilities or chronic health conditions. Numerous factors contribute to this difficulty including architectural barriers, shortage of accessible trails, and limited transportation options. These challenges have led to a growing interest in exploring the use of virtual reality (VR) greenspace environments. Studies have demonstrated that VR greenspace exposure can reduce stress and improve mood and mental well-being in various populations but has not been tested among individuals with mobility impairments who experience high levels of stress. During a single lab visit, participants will be randomized to VR greenspace activity or control, undergo the Trier Social Stress Test. The VR group will then engage in a series of nature-based VR activities. The Control group will sit quietly. Assessments will be collected at 4 timepoints. Physiological stress responses will be measured via changes in BP, HR, and two saliva measures (salivary alpha-amylase, salivary cortisol). Affective response (stress, affect, anxiety) will be assessed using self-report surveys. This study will provide insight into the influence of VR greenspace exposure on stress recovery (physiological and affective responses), among individuals with mobility impairments.
- Conditions
- Mobility Impairments
- Being tested
- Virtual Reality (VR), Control
- Keywords
- stress, mobility impairment, virtual reality, greenspace
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Virtual Reality (VR)Behavioural
Participants will engage in a virtual reality greenspace activity for a period of 5 minutes
ControlBehavioural
Participants will sit quietly for a period of 5 minutes
| Study group | Role | What they receive |
|---|---|---|
| Virtual reality | Experimental | Participants will be outfitted with a virtual reality headset. While seated in a recliner chair, participants will engage in a pre-specified VR nature experience called Nature Treks VR for 5 minutes. Receives: Behavioral: Virtual Reality (VR) |
| Control | Placebo comparator | Participants will be seated in a recliner chair and asked to sit quietly for 5 minutes. Receives: Behavioral: Control |
What is being measured
The primary outcome is the main question the study is designed to answer.
Perceived Stress Scale (PSS)
The survey consists of 10 questions that assess the frequency of feelings and thoughts related to stress on a 5-point Likert scale (Never = 0, Almost never = 1, Sometimes = 2, Fairly often = 3; Very often = 4). To calculate a total PSS score, responses to the four positively stated items (items 4, 5, 7 and 8) first need to be reversed (i.e. 0 => 4; 1 => 3; 2 => 2; 3 => 1; 4 => 0). The PSS score is then obtained by summing across all items. Higher scores indicate higher levels of perceived stress.
Measured: The survey will be completed at 4 timepoints: 1) Baseline (Stage 1) 2) Immediately after the Trier Social Stress Test (Stage 2); 3) Immediately following the VR or control activity; 4) 20 minutes after completion of the activity (VR or control).
State-Trait Anxiety Inventory (STAI) short form
The 5-item short form of the State-Trait Anxiety Inventory (STAI) is designed to quickly assess anxiety levels. The questions measure state (temporary feelings of anxiety) and trait anxiety (general tendency to experience anxiety).The STAI short form is scored by summing the responses to each of the five items, which are rated on a 4-point Likert scale ranging from 1 (not at all) to 4 (very much so). The total score can range from 5 to 20, with higher scores indicating higher levels of anxiety.
Measured: The survey will be completed at 4 timepoints: 1) Baseline (Stage 1); 2) Immediately after the Trier Social Stress Test (Stage 2); 3) Immediately following the VR or control activity; 4) 20 minutes after completion of the activity (VR or control).
Positive and Negative Affect Schedule
The Positive and Negative Affect Schedule (PANAS) is designed to measure positive and negative affect. It consists of 20 items, with 10 items each for positive affect (PA) and negative affect (NA). Respondents rate each item on a 5-point Likert scale ranging from 1 (very slightly or not at all) to 5 (extremely). Positive Affect Score: Sum the scores of items 1, 3, 5, 9, 10, 12, 14, 16, 17, and 19. Scores can range from 10 to 50, with higher scores indicating higher levels of positive affect. Negative Affect Score: Sum the scores of items 2, 4, 6, 7, 8, 11, 13, 15, 18, and 20. Scores can range from 10 to 50, with higher scores indicating higher levels of negative affect.
Measured: The survey will be completed at 4 timepoints: 1) Baseline (Stage 1); 2) Immediately after the Trier Social Stress Test (Stage 2); 3) Immediately following the VR or control activity; 4) 20 minutes after completion of the activity (VR or control).
Saliva stress biomarkers
Saliva samples will be collected to measure stress biomarkers. The process is simple and non-invasive:
Preparation: Participants should avoid eating, drinking (except water), brushing teeth, or using mouthwash for at least 30 minutes before sample collection.
Collection: Participants will be provided with a sterile saliva collection device. They will be asked to spit into the device until it reaches the indicated fill line.
Storage: The collected saliva samples will be stored in a cooler bag and then later transported to the UAB lab for storage and analyses.
Measured: The saliva will be collected at 4 timepoints: 1) Baseline (Stage 1); 2) Immediately after the Trier Social Stress Test (Stage 2); 3) Immediately following the VR or control activity; 4) 20 minutes after completion of the activity (VR or control).
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted12 Nov 2024
- Study start7 Apr 2025
- Primary completion30 Dec 2026 (estimated)
- Study completion30 Jun 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Mobility ImpairmentsStudies of the same condition, open and under way.
- More trials run by University of Alabama at BirminghamThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 25 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Alabama at Birmingham
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Laurie A Malone, PhD, University of Alabama at Birmingham
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06682143
- Sponsor's protocol ID
- IRB-300012947
- Other IDs
- Faculty Development Grant
- Status last verified
- Jun 2026
- First submitted
- 22 Oct 2024
- Last updated
- 25 Jun 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: This is a pilot study so IPD will not be shared.
Study at a glance
From the registry record, last updated by the sponsor on 25 Jun 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Effects of Virtual Reality Greenspace Exposure on Physiological and Affective Acute Stress Responses Among Adults With Mobility Impairments: A Pilot Study
- ClinicalTrials.gov ID
- NCT06682143
- Acronym / sponsor ID
- IRB-300012947
- Conditions
- Mobility Impairments
- Keywords
- stress, mobility impairment, virtual reality, greenspace
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 25 participants (actual)
- Lead sponsor
- University of Alabama at BirminghamUniversity, hospital or other
- Study start
- 7 Apr 2025 (actual)
- Primary completion
- 30 Dec 2026 (estimated)
- Study completion
- 30 Jun 2027 (estimated)
- First posted
- 12 Nov 2024 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this project is to examine the effects of virtual reality greenspace exposure on physiological and affective acute stress responses among adults with mobility impairments.
Detailed description
Exposure to greenspace is known to yield numerous mental and physical health benefits such as improved mood, decreased stress, and increased levels of physical activity. Regular access to greenspace however is difficult for various segments of the population including individuals with disabilities or chronic health conditions. Numerous factors contribute to this difficulty including architectural barriers, shortage of accessible trails, and limited transportation options. These challenges have led to a growing interest in exploring the use of virtual reality (VR) greenspace environments. Studies have demonstrated that VR greenspace exposure can reduce stress and improve mood and mental well-being in various populations but has not been tested among individuals with mobility impairments who experience high levels of stress. During a single lab visit, participants will be randomized to VR greenspace activity or control, undergo the Trier Social Stress Test. The VR group will then engage in a series of nature-based VR activities. The Control group will sit quietly. Assessments will be collected at 4 timepoints. Physiological stress responses will be measured via changes in BP, HR, and two saliva measures (salivary alpha-amylase, salivary cortisol). Affective response (stress, affect, anxiety) will be assessed using self-report surveys. This study will provide insight into the influence of VR greenspace exposure on stress recovery (physiological and affective responses), among individuals with mobility impairments.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Virtual reality | Experimental | Behavioral: Virtual Reality (VR)Participants will be outfitted with a virtual reality headset. While seated in a recliner chair, participants will engage in a pre-specified VR nature experience called Nature Treks VR for 5 minutes. |
| Control | Placebo comparator | Behavioral: ControlParticipants will be seated in a recliner chair and asked to sit quietly for 5 minutes. |
Who may qualify
- Ages
- 18 to 75 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (2 listed)
- Age between 18 and 75 years
- A self-reported lower extremity mobility impairment (e.g., cerebral palsy, spinal cord injury, multiple sclerosis, stroke) with partial or full use of the upper extremities.
Key exclusion criteria (5 listed)
- Impairment in visual acuity as measured by a Snellen eye chart <20/70 after correction
- Regular engagement (>20 minutes/week) in virtual reality greenspace activity
- Having an endocrine disorder (that can affect cortisol levels)
- Taking oral corticosteroids
- Score below 24 on the Mini Mental State Exam
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Virtual Reality (VR)Participants will engage in a virtual reality greenspace activity for a period of 5 minutes | Behavioural | Virtual reality |
| ControlParticipants will sit quietly for a period of 5 minutes | Behavioural | Control |
Primary outcome
Perceived Stress Scale (PSS)
Time frame: The survey will be completed at 4 timepoints: 1) Baseline (Stage 1) 2) Immediately after the Trier Social Stress Test (Stage 2); 3) Immediately following the VR or control activity; 4) 20 minutes after completion of the activity (VR or control).
The survey consists of 10 questions that assess the frequency of feelings and thoughts related to stress on a 5-point Likert scale (Never = 0, Almost never = 1, Sometimes = 2, Fairly often = 3; Very often = 4). To calculate a total PSS score, responses to the four positively stated items (items 4, 5, 7 and 8) first need to be reversed (i.e. 0 => 4; 1 => 3; 2 => 2; 3 => 1; 4 => 0). The PSS score is then obtained by summing across all items. Higher scores indicate higher levels of perceived stress.
State-Trait Anxiety Inventory (STAI) short form
Time frame: The survey will be completed at 4 timepoints: 1) Baseline (Stage 1); 2) Immediately after the Trier Social Stress Test (Stage 2); 3) Immediately following the VR or control activity; 4) 20 minutes after completion of the activity (VR or control).
The 5-item short form of the State-Trait Anxiety Inventory (STAI) is designed to quickly assess anxiety levels. The questions measure state (temporary feelings of anxiety) and trait anxiety (general tendency to experience anxiety).The STAI short form is scored by summing the responses to each of the five items, which are rated on a 4-point Likert scale ranging from 1 (not at all) to 4 (very much so). The total score can range from 5 to 20, with higher scores indicating higher levels of anxiety.
Positive and Negative Affect Schedule
Time frame: The survey will be completed at 4 timepoints: 1) Baseline (Stage 1); 2) Immediately after the Trier Social Stress Test (Stage 2); 3) Immediately following the VR or control activity; 4) 20 minutes after completion of the activity (VR or control).
The Positive and Negative Affect Schedule (PANAS) is designed to measure positive and negative affect. It consists of 20 items, with 10 items each for positive affect (PA) and negative affect (NA). Respondents rate each item on a 5-point Likert scale ranging from 1 (very slightly or not at all) to 5 (extremely). Positive Affect Score: Sum the scores of items 1, 3, 5, 9, 10, 12, 14, 16, 17, and 19. Scores can range from 10 to 50, with higher scores indicating higher levels of positive affect. Negative Affect Score: Sum the scores of items 2, 4, 6, 7, 8, 11, 13, 15, 18, and 20. Scores can range from 10 to 50, with higher scores indicating higher levels of negative affect.
Saliva stress biomarkers
Time frame: The saliva will be collected at 4 timepoints: 1) Baseline (Stage 1); 2) Immediately after the Trier Social Stress Test (Stage 2); 3) Immediately following the VR or control activity; 4) 20 minutes after completion of the activity (VR or control).
Saliva samples will be collected to measure stress biomarkers. The process is simple and non-invasive: Preparation: Participants should avoid eating, drinking (except water), brushing teeth, or using mouthwash for at least 30 minutes before sample collection. Collection: Participants will be provided with a sterile saliva collection device. They will be asked to spit into the device until it reaches the indicated fill line. Storage: The collected saliva samples will be stored in a cooler bag and then later transported to the UAB lab for storage and analyses.
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 25 Jun 2026.
- Individual participant dataSharing planned: No. This is a pilot study so IPD will not be shared.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Virtual Reality (VR) in people with Mobility Impairments, run by University of Alabama at Birmingham at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 2 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: under way, not looking for participants, as of the sponsor's last update on 25 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Perceived Stress Scale (PSS) (time frame: The survey will be completed at 4 timepoints: 1) Baseline (Stage 1) 2) Immediately after the Trier Social Stress Test (Stage 2); 3) Immediately following the VR or control activity; 4) 20 minutes after completion of the activity (VR or control).). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 25 Jun 2026.