An Exploratory Study of Meditation With and Without Immersive Virtual Reality: Effects on Anxiety and Voice-Related Outcomes.

OBJECTIVES

Immersive virtual reality (IVR) has emerged as a promising adjunct in clinical interventions, enabling practice within realistic, immersive environments that closely simulate real-world experiences. However, its potential role in voice therapy and meditation-based approaches remains limited. In this exploratory study, the authors sought to evaluate the effects of meditation, with and without an IVR environment, on anxiety and potential voice-related outcomes in individuals with voice concerns, with the goal of refining a feasible protocol for future research.

METHODS

Twenty-six patients with voice concerns were randomized to one of two groups: Meditation with IVR (MVR), and Meditation without IVR (M). Meditation was administered prior to voice therapy tasks in each session, and across four sessions, for both groups. Voice recordings were obtained using a standardized protocol and analyzed in Praat using the Phonanium plug-in. Data were analyzed using mixed-design ANCOVAs, with Bonferroni-corrected post hoc comparisons, and effect sizes reported. Psychological outcomes were assessed using the State-Trait Anxiety Inventory (STAI-Y1). Acoustic and aerodynamic outcomes included smoothed cepstral peak prominence (CPPS) and maximum phonation time (MPT), respectively.

RESULTS

STAI-Y1 scores reached statistical significance, decreased from pre- to post-intervention in both groups, with a larger effect in the MVR group, compared with the M group. Of note, the magnitude of the pre‑post reduction did not differ reliably between groups (lessening showing improvement). After adjusting for baseline values, the improvement in MPT was not statistically significant. In contrast, CPPS increased with a significant change in the outcome from pre- to post session in the M group, however there was no significant change in the MVR group. Clinical significance was not established for any of the measures.

CONCLUSION

The admittedly small data set in this exploratory study suggests IVR meditation may be particularly effective for reducing anxiety and improving respiratory-phonatory efficiency, whereas non-VR meditation may facilitate greater improvements in voice quality. The attrition rate for the MVR group was considerably less than that of the M group. These findings suggest that IVR meditation may serve as a valuable adjunct to voice therapy, though its effects differ by outcome type. Future research should investigate underlying mechanisms and long-term applications for the integration of IVR meditation into evidence-based voice therapy.