A systematic review and meta-analysis of the effectiveness of virtual reality as an exercise intervention for individuals with a respiratory condition

Christina Condon, Wing Tung Lam, Chiara Mosley, Suzanne Gough, Christina Condon, Wing Tung Lam, Chiara Mosley, Suzanne Gough

Abstract

Background: Respiratory diseases impose an immense health burden worldwide and affect millions of people on a global scale. Reduction of exercise tolerance poses a huge health issue affecting patients with a respiratory condition, which is caused by skeletal muscle dysfunction and weakness and by lung function impairment. Virtual reality systems are emerging technologies that have drawn scientists' attention to its potential benefit for rehabilitation.

Methods: A systematic review and meta-analysis following the PRISMA guidelines was performed to explore the effectiveness of virtual reality gaming and exergaming-based interventions on individuals with respiratory conditions.

Results: Differences between the virtual reality intervention and traditional exercise rehabilitation revealed weak to insignificant effect size for mean heart rate (standardized mean difference, SMD = 0.17; p = 0.002), peak heart rate (SMD = 0.36; p = 0.27), dyspnea (SMD = 0.32; p = 0.13), and oxygen saturation SpO2 (SMD = 0.26; p = 0.096). In addition, other measures were collected, however, to the heterogeneity of reporting, could not be included in the meta-analysis. These included adherence, enjoyment, and drop-out rates.

Conclusions: The use of VRS as an intervention can provide options for rehabilitation, given their moderate effect for dyspnea and equivalent to weak effect for mean and maximum peak HR and SpO2. However, the use of virtual reality systems, as an intervention, needs further study since the literature lacks standardized methods to accurately analyze the effects of virtual reality for individuals with respiratory conditions, especially for duration, virtual reality system type, adherence, adverse effects, feasibility, enjoyment, and quality of life.

Keywords: Augmented reality; Exercise; Exergaming; Gaming; Intervention; Mixed reality; Rehabilitation; Respiratory; Virtual reality; Virtual reality system.

Conflict of interest statement

Suzanne Gough is an Associate Editor of BMJ Simulation and Technology Enhanced Learning. She has no other competing interests.

Chiara Mosley, Christina Condon, and Wing Tung Lam have no competing interests to declare.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram for article inclusion
Fig. 2
Fig. 2
Forest plots demonstrating comparisons of outcome measures among included studies. a Peak heart rate. b Mean heart rate. c SpO2. d Dyspnea

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