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Zhang B, Guo C, Hui V, Wong KP, Liu Y, Liu Z, Xu Y, Xiao Q, Chen SC, Qin J. Evaluating the effectiveness of video-game based swallowing function training in patients with dysphagia: study protocol for a randomized controlled trial. Trials 2023; 24:735. [PMID: 37974234 PMCID: PMC10655413 DOI: 10.1186/s13063-023-07738-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 10/17/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Dysphagia can lead to serious complications such as aspiration and aspiration pneumonia, timely and effective rehabilitation training can improve the swallowing function of patients. However, the conventional rehabilitation training methods used in clinical settings have shortcomings such as poor adherence of patients. We present the study design of a randomized controlled trial that evaluated whether video-game based swallowing rehabilitation training can effectively improve swallowing in patients with dysphagia and whether it has additional benefits compared with conventional training methods to improve swallowing function and training compliance among patients with dysphagia. METHODS A randomized controlled trial with 4 weeks of intervention and 4 weeks of follow-up will be conducted in a rehabilitation center in Beijing, China. We will enroll 78 patients aged 18-80 years with dysphagia. Participants will be randomly assigned to the experimental group (video-game based swallowing function training) and the control group (conventional swallowing function training). All participants will receive 30 min of training per day, 5 times per week, for a total of 4 weeks. The primary outcome is swallowing function. Secondary outcomes include patients' quality of life, training compliance, and training satisfaction. Outcomes are assessed at baseline (pre-treatment), 4 weeks of treatment (post-treatment), and 8 weeks (follow-up), and the assessor is not aware of the participants' grouping. DISCUSSION The protocol describes a new rehabilitation training method for dysphagia, which involves participant eligibility recruitment, recruitment strategies, and data analysis plan. The results of the study will inform the rehabilitation training and clinical care management of swallowing function in patients with dysphagia. TRIAL REGISTRATION ClinicalTrials.gov, NCT05978700. Registered on 28 July 2023.
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Affiliation(s)
- Bohan Zhang
- Centre for Smart Health, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
| | - Cai Guo
- Centre for Smart Health, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
- School of Computing and Information Engineering, Hanshan Normal University, Guangdong, China
| | - Vivian Hui
- Centre for Smart Health, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
| | - Ka Po Wong
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
| | - Yue Liu
- Tiantan Xiaotangshan Rehabilitation Center, Beijing Xiaotangshan Hospital, Beijing, China.
| | - Zihan Liu
- Tiantan Xiaotangshan Rehabilitation Center, Beijing Xiaotangshan Hospital, Beijing, China
| | - Yanan Xu
- Tiantan Xiaotangshan Rehabilitation Center, Beijing Xiaotangshan Hospital, Beijing, China
| | - Qian Xiao
- School of Nursing, Capital Medical University, Beijing, China
| | - Shu-Cheng Chen
- Centre for Smart Health, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
| | - Jing Qin
- Centre for Smart Health, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
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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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Silva J, Hipólito N, Machado P, Flora S, Cruz J. Technological features of smartphone apps for physical activity promotion in patients with COPD: A systematic review. Pulmonology 2023:S2531-0437(23)00124-1. [PMID: 37394341 DOI: 10.1016/j.pulmoe.2023.06.005] [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: 02/02/2023] [Revised: 06/13/2023] [Accepted: 06/14/2023] [Indexed: 07/04/2023] Open
Abstract
INTRODUCTION Low physical activity (PA) levels have a negative impact on the health status of patients with Chronic Obstructive Pulmonary Disease (COPD). Smartphone applications (apps) focused on PA promotion may mitigate this problem; however, their effectiveness depends on patient adherence, which can be influenced by the technological features of the apps. This systematic review identified the technological features of smartphone apps aiming to promote PA in patients with COPD. METHODS A literature search was performed in the databases ACM Digital Library, IEEE Xplore, PubMed, Scopus and Web of Science. Papers including the description of a smartphone app for PA promotion in patients with COPD were included. Two researchers independently selected studies and scored the apps features based on a previously developed framework (38 possible features). RESULTS Twenty-three studies were included and 19 apps identified, with an average of 10 technological features implemented. Eight apps could be connected to wearables to collect data. The categories 'Measuring and monitoring' and 'Support and Feedback' were present in all apps. Overall, the most implemented features were 'progress in visual format' (n = 13), 'advice on PA' (n = 14) and 'data in visual format' (n = 10). Only three apps included social features, and two included a web-based version of the app. CONCLUSIONS The existing smartphone apps include a relatively small number of features to promote PA, which are mostly related to monitoring and providing feedback. Further research is warranted to explore the relationship between the presence/absence of specific features and the impact of interventions on patients' PA levels.
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Affiliation(s)
- J Silva
- School of Health Sciences (ESSLei), Polytechnic of Leiria, Portugal
| | - N Hipólito
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Portugal; Health Data Science of the Department of Community Medicine, Information and Health Decision Sciences of the Faculty of Medicine of the University of Porto, Porto, Portugal
| | - P Machado
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Portugal
| | - S Flora
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Portugal
| | - J Cruz
- School of Health Sciences (ESSLei), Polytechnic of Leiria, Portugal; Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Portugal.
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Reilly C, Sails J, Stavropoulos-Kalinoglou A, Birch RJ, McKenna J, Clifton IJ, Peckham D, Birch KM, Price OJ. Physical activity promotion interventions in chronic airways disease: a systematic review and meta-analysis. Eur Respir Rev 2023; 32:32/167/220109. [PMID: 36697208 PMCID: PMC9879326 DOI: 10.1183/16000617.0109-2022] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 11/02/2022] [Indexed: 01/27/2023] Open
Abstract
Physical inactivity is common in people with chronic airways disease (pwCAD) and associated with worse clinical outcomes and impaired quality of life. We conducted a systematic review and meta-analysis to characterise and evaluate the effectiveness of interventions promoting step-based physical activity (PA) in pwCAD. We searched for studies that included a form of PA promotion and step-count outcome measure. A random-effects model was used to determine the overall effect size using post-intervention values. 38 studies (n=32 COPD; n=5 asthma; n=1 bronchiectasis; study population: n=3777) were included. Overall, implementing a form of PA promotion resulted in a significant increase in step-count: median (IQR) 705 (183-1210) when compared with usual standard care: -64 (-597-229), standardised mean difference (SMD) 0.24 (95% CI: 0.12-0.36), p<0.01. To explore the impact of specific interventions, studies were stratified into subgroups: PA promotion+wearable activity monitor-based interventions (n=17) (SMD 0.37, p<0.01); PA promotion+step-count as an outcome measure (n=9) (SMD 0.18, p=0.09); technology-based interventions (n=12) (SMD 0.16, p=0.01). Interventions promoting PA, particularly those that incorporate wearable activity monitors, result in a significant and clinically meaningful improvement in daily step-count in pwCAD.
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Affiliation(s)
- Caroline Reilly
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Joe Sails
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | | | - Rebecca J. Birch
- Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, UK
| | - Jim McKenna
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Ian J. Clifton
- Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, UK,Department of Respiratory Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Daniel Peckham
- Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, UK,Department of Respiratory Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Karen M. Birch
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds, UK
| | - Oliver J. Price
- Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, UK,Department of Respiratory Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK,School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds, UK,Corresponding author: Oliver J. Price ()
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You KL, Delaney RK, McKinley N, Healy P, Thomas TH. Who Engages and Why It Matters? INTERNATIONAL JOURNAL OF GAMING AND COMPUTER-MEDIATED SIMULATIONS 2023. [DOI: 10.4018/ijgcms.316968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
While the use and benefits of serious games in health care are increasingly recognized, the impact of individuals' game engagement remains understudied, limiting the potential for impact. This pilot study aims to describe game engagement and its associations with learning outcomes, sociodemographics, and health factors in women with advanced cancer receiving a 12-week self-advocacy serious game intervention. Game engagement was collected from study tablets and weekly self-reported surveys. Participants' game engagement was overall high but with large amounts of variation and did not differ by their sociodemographics and health factors. Participants with lower baseline symptom severity were more likely to repeat game scenarios, and those who engaged in all scenarios had higher connected strength post-intervention. Knowing what prevents patients with advanced cancer from engaging in the serious game enlightens ways to refine the gamified interventions. Future research is suggested to evaluate patients' engagement to deepen understanding of its impacts on learning outcomes.
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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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