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Virtual Reality Rehabilitation in Patients with Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial

Authors Rutkowski S, Rutkowska A, Kiper P, Jastrzebski D, Racheniuk H, Turolla A, Szczegielniak J, Casaburi R

Received 17 July 2019

Accepted for publication 21 November 2019

Published 13 January 2020 Volume 2020:15 Pages 117—124


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Richard Russell

Sebastian Rutkowski, 1 Anna Rutkowska, 1 Paweł Kiper, 2 Dariusz Jastrzebski, 3 Henryk Racheniuk, 1 Andrea Turolla, 2 Jan Szczegielniak, 1 Richard Casaburi 4

1Institute of Physiotherapy, Department of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland; 2Laboratory of Neurorehabilitation Technologies, Fondazione Ospedale San Camillo IRCCS, Venice, Italy; 3School of Medicine with the Division of Dentistry, Department of Lung Diseases and Tuberculosis, Medical University of Silesia, Zabrze, Poland; 4Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA

Correspondence: Sebastian Rutkowski
Institute of Physiotherapy, Department of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland
Tel +48 507027792
Fax +48 77 449 80 00

Purpose: This study compared the effects of inpatient-based rehabilitation program of patients with chronic obstructive pulmonary disease (COPD) using non-immersive virtual reality (VR) training with a traditional pulmonary rehabilitation program. The aims of this study were to determine 1) whether rehabilitation featuring both VR as well as exercise training provides benefits over exercise training (ET) alone and 2) whether rehabilitation featuring VR training instead of exercise training provides equivalent benefits.
Patients and Methods: The study recruited 106 patients with COPD to a 2-week high-intensity, five times a week intervention. Randomized into three groups, 34 patients participated in a traditional pulmonary rehabilitation program including endurance exercise training (ET), 38 patients participated in traditional pulmonary rehabilitation, including both endurance exercise training and virtual reality training (ET+VR) and 34 patients participated in pulmonary rehabilitation program including virtual reality training but no endurance exercise training (VR). The traditional pulmonary rehabilitation program consisted of fitness exercises, resistance respiratory muscle and relaxation training. Xbox 360® and Kinect® Adventures software were used for the VR training of lower and upper body strength, endurance, trunk control and dynamic balance. Comparison of the changes in the Senior Fitness Test was the primary outcome. Analysis was performed using linear mixed-effects models.
Results: The comparison between ET and ET+VR groups showed that ET+VR group was superior to ET group in Arm Curl (p< 0.003), Chair stand (p< 0.008), Back scratch (p< 0.002), Chair sit and reach (p< 0.001), Up and go (p< 0.000), 6-min walk test (p< 0.011). Whereas, the comparison between ET and VR groups showed that VR group was superior to ET group in Arm Curl (p< 0.000), Chair stand (p< 0.001), 6-min walk test (p< 0.031).
Conclusion: Results suggest that pulmonary rehabilitation program supplemented with VR training is beneficial intervention to improve physical fitness in patients with COPD.

Keywords: virtual reality, COPD, pulmonary rehabilitation, physical activity, exercise

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