A Pilot Study Using Virtual Game System to Maintain Adherence to Home-Based Exercise Following Pulmonary Rehabilitation in Chronic Obstructive Pulmonary Disease

SESSION TITLE: COPD Posters III SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM PURPOSE: Virtual game systems (VGS) such as the Nintendo Wii have become a promising adjunct to pulmonary rehabilitation (PR). However, there is limited information regarding its feasibility and effectiveness in maintaining long-term home-based regular exercise in a chronic obstructive pulmonary disease (COPD) population. We sought to determine if a VGS given to COPD patients upon discharge from a hospital-based PR program would help promote exercise and maintain gains in 6 minute walk distance (6MWD). METHODS: Patients with severe to very severe COPD admitted to an in-patient PR program at Mount-Sinai Hospital (MSH), Montreal, Canada, were recruited. Participants were randomized to receive the VGS versus usual care which included written exercise instructions upon discharge. Participants in the VGS group received 3 to 6 hours of individualized training in the hospital and later at their residences using 11 pre-validated games (Nintendo Wii-Fit-U) designated to exercise upper and lower extremities. Baseline assessments included the mini-mental state exam, Berg balance test, self-efficacy, Manchester fatigue, and the 6MWD. Heart rate and oxygen saturation (SpO2) were monitored during the training sessions. Dyspnea and leg discomfort were rated using the Borg scale at the start and end of exercise. RESULTS: As of March 2015,12 participants were recruited. Six were randomized to the VGS and six to usual care. Two participants were excluded due to language barrier and inability to use the VGS. Mean (±SD) age and FEV1 were 64±10 years and 0.78±0.25 liters respectively. Baseline 6MWD was 306±81 meters. From the start to the end of the training sessions, HR increased from a mean of 83±14 to 103±17 beats per minute, SpO2 decreased from 95±1.8 to 91±2.4% while dyspnea and leg discomfort increased from 0.5±0.8 to 2.6±0.8 and 0.4±0.8 to 2.0±0.9 respectively. CONCLUSIONS: Participants were able to undergo exercise training in an ongoing pilot study to evaluate maintenance of physical exercise after PR using a VGS. Further evaluation is pending to determine if this will promote long-term adherence to exercise and prevent degradation in 6 MWD following PR. CLINICAL IMPLICATIONS: The use of a VGS may be a practical home-based modality to maintain health gains achieved in PR. DISCLOSURE: The following authors have nothing to disclose: Houssam Kotrach, Esther Dajczman, Geneviève Tremblay, Marcel Baltzan, Rima Wardini, Suzanne Levitz, Michael Rotaple, Fredericka Abcarius, Maria Stathatos, Cheng Zeng, Sophie Trottier, Danielle Lynch, Stephanie Langlois, Norman Wolkove, Charles Sounan No Product/Research Disclosure Information