Faculty members are awarded collaborative grants for research into virtual reality therapy for cancer patients and a clinically integrated gamified ambulation tool.
photos: top row: Luana Colloca (left) and Arpad Kelemen; bottom row: Martha Francis (left) and Eleanor McManuels
The University of Maryland School of Nursing’s (UMSON) Luana Colloca, MD, PhD, MS, professor, interim chair of the Department of Pain and Translational Symptom Science, and director of the Placebo Beyond Opinions Center, and Arpad G. Kelemen, PhD, professor, have received one-year, $15,000 UMNursing grants, a joint venture between UMSON and the University of Maryland Medical Center (UMMC).
Colloca has partnered with Martha E. Francis, PhD ’21, RN, FNP-BC, AOCNP, nurse practitioner and assistant professor in the University of Maryland School of Medicine’s Department of Radiation Oncology, for the project “Virtual Reality to Mitigate Cancer Related Symptoms: A Feasibility Study.
Kelemen has partnered with Eleanor McManuels, BSN, RN, OCN, TCTCN, clinical nurse II on the transplant and cellular therapy unit at UMMC, for the project “Feasibility and Usability of a Gamified mHealth Intervention for Increasing Physical Activity in Blood and Marrow Transplantation Recipients.”
In addition, the UMNursing grant provides $2,500 for each of the researchers, to be allocated based on requests over the course of the 12-month period.
About the ‘Virtual Reality to Mitigate Cancer Related Symptoms: A Feasibility Study’ Project
Cancer-related symptoms remain a major source of suffering during active oncologic treatment despite substantial advances in cancer therapeutics. In the United States, more than 20 million individuals are living with or beyond cancer, and patients undergoing active treatment frequently experience high symptom burden, including pain, fatigue, insomnia, anxiety, mood disturbance, and diminished quality of life. Current symptom management strategies rely heavily on pharmacologic interventions, including opioids, which might produce adverse effects, tolerance, dependence, and limited long-term benefit.
Virtual reality (VR) represents a promising digital therapeutic platform for delivering multimodal integrative therapies that strengthen cognitive and behavioral coping skills while improving symptom self-management. Although VR has demonstrated efficacy in chronic pain populations and acute procedural oncology settings, little is known about its effectiveness in patients actively undergoing cancer treatment, particularly when compared to identical non-immersive therapeutic content.
The objective of this pilot feasibility study is to evaluate the acceptability and preliminary efficacy of a fully remote, home-based multimodal integrative therapy delivered through VR (MIT-VR) intervention among adults undergoing active treatment for solid tumors. Thirty participants will be randomized to either immersive MIT-VR or an active control condition consisting of identical therapeutic content delivered through audio/MP4 format without immersive VR exposure. Participants will complete five sessions weekly for four weeks using a home-based telehealth model. Ecological momentary assessment will prospectively capture daily symptom trajectories in real-world settings, including pain intensity, pain unpleasantness, mood, anxiety, fatigue, and sleep disturbance. Weekly patient-reported outcomes will include PROMIS (Patient-Reported Outcomes Measurement Information System) measures and multidimensional suffering assessments.
Aim 1 will determine the feasibility, acceptability, and preliminary effects of a four-week MIT-VR program on cancer-related symptoms during active treatment. Aim 2 (exploratory) will evaluate the effects of MIT-VR on multidimensional suffering using the validated Suffering Pictogram while controlling for sleep quality and physical activity measured through wearable activity trackers.
About the “Feasibility and Usability of a Gamified mHealth Intervention for Increasing Physical Activity in Blood and Marrow Transplantation Recipients” Project
Transplant and Cellular Therapy (TCT) recipients experience prolonged inpatient stays, deconditioning, and cancer-related fatigue. The National Comprehensive Cancer Network and the Oncology Nursing Society guidelines identify exercise as the strongest evidence-based intervention for cancer-related fatigue, yet adherence to prescribed ambulation in TCT units is low. Commercially available fitness apps are poorly suited to patients managing fatigue, pain, and nausea. No clinically integrated gamified ambulation tool currently exists for this population.
Our team has developed Walking Warrior (WW), a match-3 puzzle mobile game that incentivizes prescribed ambulation. Upon completion of each game level, the application prompts the patient to achieve a clinician-configurable step target (default 100 steps) measured by the integrated step counter; achievement unlocks the next level, creating a closed-loop reinforcement cycle in which entertainment progression is contingent on physical activity rather than merely measured alongside it. Game tiles are rendered as transplant-relevant cell types and medications, embedding incidental disease-related learning. All game play and step data are logged to a secure online database accessible to the study team.
This proposal advances WW from alpha-tested prototype to first patient pilot through two phases. In Phase 1, we will rebuild WW as a single dedicated Android-native application, resolving defects and usability issues from prior alpha testing, implementing expert-recommended features, optimizing the hardware step counter integration, and validating secure logging to the existing database. In Phase 2, we will conduct a single-arm pilot enrolling 30 TCT recipients from the UMMC TCT program.
This institutional pilot will deliver a rebuilt, clinician-configurable Android-native gamified ambulation tool; rigorous feasibility and usability data in the TCT population; and the preliminary data and operational infrastructure needed to support an application evaluating WW's effect on ambulation adherence, cancer-related fatigue, and recovery outcomes.v