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Updated: Sep 11, 2025

The use of Biofeedback in Clinical Virtual Reality: The INTREPID Project
Published on: November 12, 2009
Randomized Controlled Trial of Starship Rescue: A Cognitive Behavior Therapy and Biofeedback-Based Computer Game to
Hiran Thabrew1, Harshali Kumar1, Tarique Naseem2
1Psychological Medicine, University of Auckland, Auckland, New Zealand.
Objectives:
This study was undertaken to investigate the comparative efficacy of a cognitive behavior therapy and biofeedback-based computer game (Starship Rescue: Vortex of Anxiety [SRVA]) and placebo well-being-focused computer game (Starship Rescue: Voyage of Wellness) for reducing symptoms of anxiety and improving quality of life among children and young people aged 8-18 with long-term physical conditions (LTPCs).
Materials And Methods:
A randomized controlled trial was conducted with 60 participants (30 per arm). Primary outcomes were change in anxiety symptoms on the Generalized Anxiety Disorder 7-item (GAD-7) and Spence Children's Anxiety Scale (SCAS) at 4 weeks. Secondary outcomes were changes in anxiety symptoms at 3 months; changes in quality of life using the Pediatric Quality of Life Inventory (PedsQL) at 4 weeks and 3 months; and acceptability of SRVA recorded at 4 weeks.
Results:
Participants in both groups experienced reduced anxiety (from a moderate to mild level) and improved quality of life at 4 weeks and 3 months. There were no significant group differences or time-by-group interactions observed for GAD-7, SCAS, or PedsQL. While SRVA was broadly acceptable, some suggestions for improvement of content and design were provided by users.
Conclusions:
Although this is the second study to demonstrate that SRVA can reduce levels of anxiety in children and young people with LTPC, previous questions regarding its efficacy and component-related benefits and new questions regarding the clinical value of physical health-oriented eHealth interventions remain unanswered. Further research is needed before SRVA can be recommended for clinical use.
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