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Harris C, Banks J, Edwards C, Hurst S, Hill JE. Active video games as an adjunct to pulmonary rehabilitation of patients with Chronic Obstructive Pulmonary Disease: a commentary on a systematic review. JOURNAL OF THE ASSOCIATION OF CHARTERED PHYSIOTHERAPISTS IN RESPIRATORY CARE 2024; 56:39-42. [PMID: 39105052 PMCID: PMC7616336 DOI: 10.1097/phm.0000000000001341] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Pulmonary rehabilitation is a key evidence-based intervention to improve the outcomes of people living with Chronic Obstructive Pulmonary Disease (COPD). However, there are challenges in delivering pulmonary rehabilitation including reduced referral rates and suboptimal uptake and completion rates. Active video game interventions, when used as an adjunct, may increase the adoption of and access to pulmonary rehabilitation. This commentary summarises and critically appraises a systematic review which investigated the effectiveness of active video games as a supplementary component in the pulmonary rehabilitation of individuals suffering from chronic obstructive pulmonary disease.
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Affiliation(s)
- Catherine Harris
- Health Technology Assessment Unit, University of Central Lancashire, Preston
| | - Jenna Banks
- Lancashire Teaching Hospitals NHS Foundation Trust, Preston
| | | | - Sarah Hurst
- Lancashire and South Cumbria NHS Foundation Trust, Lancashire
| | - James Edward Hill
- Health Technology Assessment Unit, University of Central Lancashire, Preston
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Huang X, Xiang X, Liu Y, Wang Z, Jiang Z, Huang L. The Use of Gamification in the Self-Management of Patients With Chronic Diseases: Scoping Review. JMIR Serious Games 2023; 11:e39019. [PMID: 38133907 PMCID: PMC10770795 DOI: 10.2196/39019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 02/26/2023] [Accepted: 11/14/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Chronic disease self-management is a public health issue of worldwide concern, and gamification is an emerging strategy to improve patients' participation in chronic disease self-management. Some studies have summarized designs for the gamification of chronic disease self-management from the perspective of eHealth technology, but they have not mentioned differences in design methods, functions, and evaluation methods of gamified designs for self-management in different chronic diseases. OBJECTIVE This scoping review aims to synthesize the characteristics of realization forms, functions, and evaluation methods in chronic disease self-management gamification to improve self-management among the chronic disease population. METHODS We applied a methodological framework for scoping reviews and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist. As of January 7, 2023, we systematically searched 9 databases for relevant studies from January 2012 to December 2022. Related data were extracted based on the research questions. We calculated the frequencies, charted the quantitative data, and coded the extracted material for qualitative content analysis. RESULTS We retrieved 16,221 records, of which 70 (0.43%) met the eligibility criteria. In the included research, the target populations for gamified designs for self-management of chronic diseases included patients with stroke, cancer, diabetes, chronic obstructive pulmonary disease, coronary heart disease, obesity, and hypertension. Almost all studies mentioned technical support for gamification (68/70, 97%), mainly in the form of active video games (58/70, 83%); however, less than half of the studies mentioned the theoretical basis for gamification (31/70, 44%). There were 37 concepts or theories relevant to gamification design, most of which were in the field of psychology or were cross-disciplinary (n=33, 89%). Gamification for the self-management of chronic diseases has been widely recognized, including for promoting physical exercise and rehabilitation training (48/99, 48%), increasing initiative for symptom management (18/99, 18%), providing psychological support (14/99, 14%), improving cognitive function (12/99, 12%), and improving medication adherence (7/99, 7%). A total of 39 studies mentioned the gamification effect; however, we did not find a unified evaluation standard. CONCLUSIONS This scoping review focuses on gamification designs for chronic disease self-management and summarizes the realization forms and functions of gamification in self-management for different patient populations. With practice in a gamified internet-based environment, patients can not only master the knowledge and skills of self-management in fascinating scenarios but also benefit from gaming experience and make better health-related decisions in real life. It is worth noting that a comprehensive evaluation of the users as well as a personalized and targeted intervention should be developed before gamification.
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Affiliation(s)
- Xiting Huang
- Nursing Department, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xinyue Xiang
- Department of Respiratory Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yang Liu
- Nursing Department, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhiqian Wang
- Nursing Department, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhili Jiang
- Nursing Department, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lihua Huang
- Nursing Department, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Dias C, Nery JTC, Hounsell MDS, Leal AB. A Multimodal Software Architecture for Serious Exergames and Its Use in Respiratory Rehabilitation. SENSORS (BASEL, SWITZERLAND) 2023; 23:8870. [PMID: 37960567 PMCID: PMC10650421 DOI: 10.3390/s23218870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 11/15/2023]
Abstract
Serious Exergames (SEGs) have been little concerned with flexibility/equivalence, complementarity, and monitoring (functionalities of systems that deal with a wide variety of inputs). These functionalities are necessary for health SEGs due to the variety of treatments and measuring requirements. No known SEG architectures include these three functionalities altogether. In this paper, we present the 123-SGR software architecture for the creation of an SEG that is appropriate to the needs of professionals and patients in the area of rehabilitation. An existing SEG was adapted and therapy-related sensor devices (Pneumotachograph, Manovacuometer, Pressure Belt, and Oximeter) were built to help the patient interact with the SEG. The architecture allows the most varied input combinations, with and without fusion, and these combinations are possible for both conscious and unconscious signals. Health and Technology professionals have assessed the SEG and found that it had the functionalities of flexibility/equivalence, complementarity, and monitoring, and that these are really important and necessary functionalities. The 123-SGR architecture can be used as a blueprint for future SEG development.
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Affiliation(s)
- Claudinei Dias
- Department of Electrical Engineering, Santa Catarina State University, Joinville 89219-710, Brazil; (J.T.C.N.); (M.d.S.H.); (A.B.L.)
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Huang H, Huang M, Chen Q, Hayter M, Watson R. Effects of Serious Games for Patients With Chronic Obstructive Pulmonary Disease: Systematic Literature Review. JMIR Serious Games 2023; 11:e46358. [PMID: 37747768 PMCID: PMC10562969 DOI: 10.2196/46358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 05/12/2023] [Accepted: 08/21/2023] [Indexed: 09/26/2023] Open
Abstract
BACKGROUND The use of serious games for rehabilitation has been an emerging intervention in health care fields, referred to as an entertaining and positive activity. Although related studies have been conducted on patients with chronic obstructive pulmonary disease (COPD), a more comprehensive study that summarizes and evaluates its effects in this area is needed. OBJECTIVE This review aimed to systematically evaluate the effects of serious games in promoting rehabilitation and related outcome measures of serious game-based engagement in patients with COPD. METHODS This review adhered to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. Searches were performed in the following databases: PubMed, Scopus, Embase (via Ovid), CINAHL, Science Direct, and China Biology Medicine disc. Only quantitative studies were included in this review, and the methodological quality and bias of the included studies were evaluated using related tools. Several outcomes, including clinical outcomes and serious game-based engagement outcomes, were ultimately collected in this review. The results were summarized and evaluated using descriptive methods due to significant heterogeneity. RESULTS In total, 11 studies were included. Serious games played a potentially positive effect on pulmonary function and exercise capacity. However, no consistent findings were reported on dyspnea and psychological status. Additionally, serious game engagement showed favorable findings on adherence, enjoyment, and acceptability. Furthermore, no serious adverse effects were identified in all included studies. CONCLUSIONS This review preliminarily indicated the potential benefits of serious games in promoting rehabilitation for patients with COPD, despite the limited quality of the included studies. More studies with high methodological quality are needed to further explore the effects of serious games in this field.
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Affiliation(s)
- Houqiang Huang
- Nursing Department, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Min Huang
- Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Qi Chen
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Mark Hayter
- School of Nursing & Public Health, Manchester Metropolitan University, Manchester, United Kingdom
| | - Roger Watson
- Nursing Faculty, Southwest Medical University, Luzhou, China
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Patsaki I, Avgeri V, Rigoulia T, Zekis T, Koumantakis GA, Grammatopoulou E. Benefits from Incorporating Virtual Reality in Pulmonary Rehabilitation of COPD Patients: A Systematic Review and Meta-Analysis. Adv Respir Med 2023; 91:324-336. [PMID: 37622840 PMCID: PMC10451922 DOI: 10.3390/arm91040026] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 07/31/2023] [Accepted: 08/08/2023] [Indexed: 08/26/2023]
Abstract
Chronic Obstructive Pulmonary Disease (COPD) is characterized by irreversible airflow limitation. Patient participation in Pulmonary Rehabilitation (PR) programs has a beneficial effect on disease management, improving patients' functional capacity and quality of life. As an alternative to traditional programs or as a complementary activity, the inclusion of virtual reality (VR) games is proposed. The aim of this research study was to investigate the effectiveness of incorporating VR in the pulmonary rehabilitation program of patients with COPD. A systematic literature search was performed for randomized controlled trials (RCTs) in the electronic databases Google Scholar, PubMed, and Pedro from January 2014 to March 2022. The search involved screening for studies examining the effectiveness of enhancing PR with VR. The PEDro (Physiotherapy Evidence Database) scale was chosen as the tool to assess the quality of studies. A meta-analysis was performed where possible. Six studies were included in this systematic review. The PEDro scale showed five studies of good methodological quality and one of fair quality. The variables examined were: aerobic capacity for exercise, lung function, anxiety and depression, with non-significant improvement for the MRC Dyspnea scale, marginally non-significant improvement regarding 6MWT (p = 0.05) and significant improvement for FEV1 (p < 0.05). There was variability noted in the VR applications and the proposed rehabilitation that the experimental groups followed. The application of VR is recommended for COPD patients, in combination with conventional PR. VR was found to be effective in increasing therapeutic effect and should be considered as a mean of increasing accessibility to PR. Therefore, further research, as well as additional RCTs regarding the effectiveness of VR in patients with COPD, seems necessary.
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Affiliation(s)
- Irini Patsaki
- Department of Physiotherapy, University of West Attica, 11521 Athens, Greece; (V.A.); (T.R.); (T.Z.); (G.A.K.); (E.G.)
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Rebelo P, Brooks D, Marques A. Measuring intensity during free-living physical activities in people with chronic obstructive pulmonary disease: a systematic literature review. Ann Phys Rehabil Med 2021; 65:101607. [PMID: 34818590 DOI: 10.1016/j.rehab.2021.101607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 09/20/2021] [Accepted: 09/24/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Measuring intensity of physical activity (PA) is important to ensure safety and the effectiveness of PA interventions in chronic obstructive pulmonary disease (COPD). OBJECTIVE This systematic review identified which outcomes, outcome measures and instruments have been used to assess single free-living PA-related intensity in people with COPD and compared the intensity level (light, moderate, vigorous) obtained by different outcome measures. METHODS PubMed, Scopus, Web of Science, Cochrane Library and EBSCO were searched for original studies of COPD and assessing single free-living PA-related intensity were included. Agreement was calculated as the number of agreements between 2 measures [same intensity level]/ number of comparisons using both measures*100. RESULTS We included 43 studies (1282 people with COPD, mean age 66 years, 65% men, 49% FEV1%pred) and identified 13 outcomes, 46 outcome measures and 22 instruments. The most-reported outcomes, outcome measures and instruments were dyspnoea with the Borg scale 0-10; cardiac function, via heart rate (HR) using HR monitors; and pulmonary gas exchange, namely oxygen consumption (VO2), using portable gas analysers, respectively. The most frequently assessed PAs were walking and lifting, changing or moving weights/objects. Agreement between the outcome measures ranged from 0 (%VO2peak vs metabolic equivalent of task [MET]; %HRpeak vs Fatigue Borg; MET vs walking speed) to 100% (%HRreserve vs dyspnoea Borg; fatigue and exertion Borg vs walking speed). %VO2peak/reserve elicited the highest intensity. Hence, Borg scores, %HRreserve and MET may underestimate PA-related intensity. CONCLUSIONS Various methodologies are used to assess single free-living PA-related intensity and yield different intensity levels for the same PA. Future studies, further exploring the agreement between the different outcome measures of PA-related intensity and discussing their advantages, disadvantages and applicability in real-world settings, are urgent. These would guide future worldwide recommendations on how to assess single free-living PA-related intensity in COPD, which is essential to optimise PA interventions and ensure patient safety.
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Affiliation(s)
- Patrícia Rebelo
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal; iBiMED - Institute of Biomedicine, Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
| | - Dina Brooks
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada; West Park Healthcare Centre, Toronto, ON, Canada
| | - Alda Marques
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal; iBiMED - Institute of Biomedicine, Department of Medical Sciences, University of Aveiro, Aveiro, Portugal.
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Colombo V, Aliverti A, Sacco M. Virtual reality for COPD rehabilitation: a technological perspective. Pulmonology 2020; 28:119-133. [PMID: 33358425 DOI: 10.1016/j.pulmoe.2020.11.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 11/24/2020] [Accepted: 11/30/2020] [Indexed: 10/22/2022] Open
Abstract
Virtual Reality (VR) is a promising technology for implementing personalized, motivating and controlled rehabilitation scenarios. Although its clear potential benefits, VR has been poorly investigated in pulmonary rehabilitation. This review analyses the state of the art, by searching the scientific and grey literature, regarding the use of VR for the rehabilitation of patients with chronic obstructive pulmonary disease, providing a technological perspective. First, the main characteristics of the included systems are presented in terms of visualization devices, way of interaction and type of feedback they provide. Then, results of the selected studies are reported considering feasibility, safety, usability and user experience as outcomes. Finally, the main findings are discussed and future directions for research are outlined.
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Affiliation(s)
- V Colombo
- Institute of Intelligent Industrial Technologies and Systems for Advanced Manufacturing - National Research Council, via Previati 1/E, 23900, Lecco, Italy; Departmentof Electronics, Information and Bioengineering -Politecnico di Milano, via Ponzio 34, 20133, Milano, Italy.
| | - A Aliverti
- Departmentof Electronics, Information and Bioengineering -Politecnico di Milano, via Ponzio 34, 20133, Milano, Italy
| | - M Sacco
- Institute of Intelligent Industrial Technologies and Systems for Advanced Manufacturing - National Research Council, via Previati 1/E, 23900, Lecco, Italy
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Sutanto Y, Makhabah D, Aphridasari J, Doewes M, Suradi, Ambrosino N. Videogame assisted exercise training in patients with chronic obstructive pulmonary disease: A preliminary study. Pulmonology 2019; 25:275-282. [DOI: 10.1016/j.pulmoe.2019.03.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 03/26/2019] [Accepted: 03/27/2019] [Indexed: 11/17/2022] Open
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