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Virtual reality for COPD exacerbation: a randomized controlled trial [with consumer summary]
Kizmaz E, Telli Atalay O, Cetin N, Ugurlu E
Respiratory Medicine 2024 Aug-Sep;230:107696
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Pulmonary rehabilitation (PR) is an effective treatment method for chronic obstructive pulmonary disease (COPD). However, individuals with chronic diseases that require lifelong treatment and experience exacerbations need motivational methods. OBJECTIVES: The aim of this study was to examine the effects of virtual reality on symptoms, daily living activity, functional capacity, anxiety and depression levels in COPD exacerbation. METHODS: Fifty patients hospitalized for COPD exacerbation were included in the study. They were randomly assigned to two groups. Twenty-five patients participated in a traditional PR (once-daily until discharge), including pedaling exercises. The second/25 patients followed the same protocol but experienced cycling simulation in the forest via virtual reality (VR plus PR). All patients were evaluated using 1-minute/Sit-to-Stand test (STST), modified-Medical Research Council (mMRC) scale, COPD Assessment test (CAT), Hospital Anxiety and Depression Scale (HADS), and London Chest Activities of Daily Living (LCADL) before and after the treatment. RESULTS: The STST showed an increase in both groups post-treatment, notably higher in the VR plus PR (p = 0.037). Dyspnea levels and CAT scores decreased in all patients, but the decrease was greater in the PR plus VR group for both parameters (p = 0.062, p = 0.003; respectively). Both groups experienced a reduction in the HADS scores compared to the pre-treatment, with a more significant decrease in depression and the total score in the VR plus PR (p < 0.05). LCADL's sub-parameters and total score, excluding household, decreased in both groups after treatment (p < 0.05). The improvement was more substantial in the VR plus PR. CONCLUSIONS: Virtual reality provides benefits in the management of COPD exacerbations and can be used safely. CLINICAL TRIAL REGISTIRATION: Registered at ClinicalTrials.gov, registration ID: NCT05687396.

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