VIRTUAL REALITY TRAINING AFTER THORACIC SURGERY (VRTS)

Effects of Exercise Training With Virtual Reality After Thoracic Surgery

This study aims to investigate the effects of virtual reality-based exercise training after thoracic surgery. Participants undergoing lung resection surgery will be assigned to either a virtual reality exercise training group or a control group receiving standard care. Physical function, pulmonary function, exercise capacity, dyspnea, anxiety, depression, and quality of life will be evaluated before and after the intervention. The findings may help determine whether virtual reality-assisted exercise training improves postoperative recovery in patients undergoing thoracic surgery.

Study Overview

• Status: Completed
• Conditions: Exercise Training; Pulmonary Rehabilitation; Virtual Reality; Thoracic Surgery; Postoperative Recovery
• Intervention / Treatment: Other: Conventional Pulmonary Rehabilitation and Cycle Ergometer Training; Procedure: thoracic surgery; Behavioral: Virtual Reality Exercise Training

• Study Type: Interventional
• Enrollment (Actual): 30
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Denizli, Turkey (Türkiye), 20160
    • Pamukkale University Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

Age between 25 and 70 years Stable symptoms and no other disease affecting pulmonary function (e.g., scoliosis or ankylosing spondylitis) Good cooperation and ability to walk independently Patients who underwent thoracic surgery FEV1 > 2 L for pneumonectomy, > 1 L for lobectomy, and > 0.6 L for segmentectomy Maximum oxygen consumption (VO₂max) > 15-20 mL/kg/min Cycle ergometer performance > 83 W No severe visual impairment Approved for participation in exercise training by the operating physician Hodkinson Mental Test score > 6 Willingness to participate and provision of informed consent -

Exclusion Criteria:

Contraindications to pulmonary rehabilitation or physiotherapy, including unstable cardiovascular disease, severe pulmonary hypertension, severe uncorrectable hypoxemia, exercise-induced desaturation, rib fractures, subcutaneous emphysema, advanced osteoporosis, or thrombocytopenia Orthopedic or neurological disorders that may impair independent ambulation, exertional dyspnea, or exertional vertigo Requirement for repeat thoracic surgery due to previous thoracic surgical history Inability to establish verbal and/or auditory communication and cooperation Inability to cooperate due to psychological and/or perceptual impairments Withdrawal Criteria Development of unexpected chest pain during the study Occurrence of syncope or nausea during testing procedures Participants may withdraw from the study at any time without providing a reason Study Completion / Termination Criterion Achievement of the planned sample size

-

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Conventional Pulmonary Rehabilitation Group; Participants received conventional pulmonary rehabilitation and cycle ergometer training after thoracic surgery.	Other: Conventional Pulmonary Rehabilitation and Cycle Ergometer Training; Participants received conventional pulmonary rehabilitation and cycle ergometer training after thoracic surgery.; Procedure: thoracic surgery; Participants underwent thoracic surgery (lobectomy, segmentectomy, pneumonectomy, or wedge resection) according to the clinical indication before receiving the assigned rehabilitation intervention.
Experimental: Virtual Reality Exercise Training Group; Participants received conventional pulmonary rehabilitation, cycle ergometer training, and virtual reality-based exercise training after thoracic surgery.	Other: Conventional Pulmonary Rehabilitation and Cycle Ergometer Training; Participants received conventional pulmonary rehabilitation and cycle ergometer training after thoracic surgery.; Procedure: thoracic surgery; Participants underwent thoracic surgery (lobectomy, segmentectomy, pneumonectomy, or wedge resection) according to the clinical indication before receiving the assigned rehabilitation intervention.; Behavioral: Virtual Reality Exercise Training; Participants received virtual reality-based exercise training in addition to conventional pulmonary rehabilitation and cycle ergometer training after thoracic surgery.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
FEV1	Forced expiratory volume in one second (FEV1) measured by spirometry.	From baseline to 2 weeks after hospital discharge
FVC	Forced vital capacity (FVC) measured by spirometry.	From baseline to 2 weeks after hospital discharge.
FEF25-75	Forced expiratory flow between 25% and 75% of forced vital capacity measured by spirometry.	From baseline to 2 weeks after hospital discharge.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain Intensity	Pain intensity was assessed using the Visual Analog Scale (VAS).Pain intensity was assessed using the Visual Analog Scale (VAS), ranging from 0 to 10, where 0 indicates no pain and 10 indicates the worst imaginable pain. Higher scores indicate greater pain intensity.	Baseline, postoperative day 2, and hospital discharge (up to 7 days after surgery).
Exercise Capacity	Exercise capacity was assessed using the 1-minute sit-to-stand test.Exercise capacity was assessed using the 1-minute sit-to-stand test (1-min STS). The outcome was recorded as the number of completed sit-to-stand repetitions in one minute. Higher values indicate better exercise capacity.	Baseline, postoperative day 2, and hospital discharge (up to 7 days after surgery)
Anxiety and Depression	Anxiety and depression were assessed using the Hospital Anxiety and Depression. Anxiety was assessed using the Hospital Anxiety and Depression Scale - Anxiety subscale (HADS-A). Scores range from 0 to 21, with higher scores indicating greater anxiety symptoms. Depression was assessed using the Hospital Anxiety and Depression Scale - Depression subscale (HADS-D). Scores range from 0 to 21, with higher scores indicating greater depression symptoms.	Baseline, postoperative day 2, and hospital discharge (up to 7 days after surgery).
Dyspnea	Dyspnea was assessed using the Modified Borg Dyspnea Scale. Dyspnea was assessed using the Modified Borg Dyspnea Scale. Scores range from 0 to 10, where 0 indicates no dyspnea and 10 indicates maximal dyspnea. Higher scores indicate greater dyspnea severity.	Baseline, postoperative day 2, and hospital discharge (up to 7 days after surgery)
Oxygen Saturation	Peripheral oxygen saturation was measured before, immediately after, and 3 minutes after the 1-minute sit-to-stand test.Peripheral oxygen saturation (SpO₂) was measured using a pulse oximeter before, immediately after, and 3 minutes after the 1-minute sit-to-stand test. Oxygen saturation was recorded as a percentage (%), with higher values indicating better oxygenation.	Baseline, postoperative day 2, and hospital discharge (up to 7 days after surgery).
Length of Hospital Stay	Length of hospital stay was recorded as the total number of days from surgery until hospital discharge. Shorter hospital stay indicates a better outcome.	From the day of surgery until hospital discharge (typically within 7 days after surgery).
Patient satisfaction	Patient satisfaction was assessed using a short patient satisfaction questionnaire.Patient satisfaction was assessed using the Short Patient Satisfaction Questionnaire (SPSQ/HMKDF), which consists of 7 items rated on a 5-point Likert scale. Total scores range from 7 to 35, with higher scores indicating greater patient satisfaction.	Hospital discharge (up to 7 days after surgery)

Collaborators and Investigators

• Sponsor: Pamukkale University
• Investigators: Principal Investigator: Orçin T ATALAY, PhD, Pamukkale University

Study record dates

Study Major Dates

• Study Start (Actual): October 24, 2024
• Primary Completion (Actual): February 27, 2026
• Study Completion (Actual): February 27, 2026

Study Registration Dates

• First Submitted: June 26, 2026
• First Submitted That Met QC Criteria: July 7, 2026
• First Posted (Actual): July 14, 2026

Study Record Updates

• Last Update Posted (Actual): July 14, 2026
• Last Update Submitted That Met QC Criteria: July 7, 2026
• Last Verified: July 1, 2026

More Information

Terms related to this study

• Keywords: Exercise Training; Virtual Reality; Pulmonary Rehabilitation; Thoracic Surgery; Postoperative Recovery
• Additional Relevant MeSH Terms: Surgical Procedures, Operative; Thoracic Surgical Procedures
• Other Study ID Numbers: E-76351742-050.04-572695

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data will not be shared because the study was conducted as part of an academic thesis project and the informed consent process did not include provisions for public sharing of de-identified participant-level data.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No