Discussion
CKD, chronic kidney disease, anxiety, chronic kidney diseaseCurrently, depression, Depression, trauma
Symptoms of anxiety and depression are common in patients treated with renal replacement therapy by hemodialysisThe studies by Zhang et al. (2014) showed that depression and anxiety were more common in the group of hemodialysis patients compared to the group of healthy personsThe literature describes many of the benefits of practicing and increasing regular physical activity for the health and well-being of patients with chronic kidney diseaseCurrently, we are also witnessing a dynamic increase in the number of clinical studies that unequivocally confirm the beneficial role of physical exercises in the treatment of chronic kidney disease (CKD). However, despite the existence of documented examples of effective exercise programs considered safe and therapeutically beneficial, physiotherapy in nephrology remains limited worldwideFor several decades, scientists and clinicians have been conducting research or implementing exercise programs in hemodialysis patients, the main goal of which is to improve their health, including mental healthOwn research showed that after a 3-month exercises on a bicycle with the use of low-intensity virtual reality, a decrease in depression symptoms measured by the Beck Depression Inventory (BDI) was observed. Similar results were presented in the work of Rhee et al. (2019), who assessed a six-month physical activity during hemodialysisResearch confirms that hemodialysis patients show symptoms of anxiety. The presented studies showed a decrease in anxiety symptoms measured by the GAD 7 questionnaire after the use of an intervention consisting in performing physical activity in virtual reality.In the available literature, no studies were found that would be based on a similar analysis in the group of patients treated with hemodialysis. It was the first study to assess the effect of exercises with the use of virtual reality performed during hemodialysis on the occurrence of anxiety and depression symptoms in a group of HD patients. The performed preliminary examinations showed that there may be a relationship between physical activity with the use of virtual reality and the reduction of symptoms of anxiety and depression in patients treated with hemodialysis. The analysis of the literature confirmed the effectiveness of exercises with the use of virtual reality in the treatment of symptoms of depression and anxiety in other groups of patientsResearch on the use of virtual reality in reducing anxiety symptoms has also been reviewed. Viana et al. (2020) found that playing a exercises game appears to be a useful method of reducing anxiety in healthy womenDuring the analysis of the literature, research using virtual reality exercises, the aim of which was to improve physical fitness in groups of people treated with dialysis, has been foundStudies by other authors have confirmed the positive impact of virtual reality exercise on the quality of life. The use of video games during exercise training enables an interesting form of rehabilitation focused on fun and is an effective supplement to traditional therapyThere is no doubt that accumulating evidence documents the advantages and health benefits of positive emotions and psychological resources in the context of stress and illness-related trauma. VR technology can become a powerful tool for delivering mental health programs to clinical populations during outpatient treatment sessionsIt is worth emphasizing that physical exercises with the use of virtual reality during hemodialysis treatment means: the possibility of using the time that the patient spends in the dialysis center (no additional time is required outside of dialysis), attraction for patients (reduction of the monotony of dialysis), promotion of a healthy lifestyle, safety (medical supervision of the staff and availability of medical equipment) and improvement of mental health.