The Effect of Video Game-Based Exercise Training in Patients With Interstitial Lung Disease

Istinye University

Status: Not yet enrolling

Conditions: Interstitial Lung Disease

Treatments: Behavioral: Home exercises; Behavioral: Virtual reality exercises

Study type: Interventional

Funder types: Other

Identifiers

NCT07167238

2025/353

Details and patient eligibility

About

The goal of this prospective randomized controlled clinical trial is to evaluate the effects of video game-based physiotherapy and rehabilitation on functional exercise capacity and respiratory parameters in individuals with interstitial lung disease (ILD). The study also aims to compare the outcomes of video game-based rehabilitation with conventional physiotherapy, identify alternative breathing exercises for pulmonary involvement in ILD, and provide scientific evidence to guide clinical practice.

The main questions it aims to answer are:

Does video game-based rehabilitation improve respiratory function parameters in individuals with ILD?

Does video game-based rehabilitation reduce dyspnea and exercise intolerance, thereby improving functional exercise capacity?

Does video game-based rehabilitation increase participation and completion rates in pulmonary rehabilitation programs? Study Design: A total of 42 participants diagnosed with mild-to-moderate ILD will be recruited. Participants will be randomized into two groups (21 in the intervention group, 21 in the control group) using stratified randomization to ensure homogeneity by age, sex, and ILD type.

Arms: 2 (Intervention group and Control group)

Intervention:

Intervention group: Structured video game-based exercise training sessions as part of a pulmonary rehabilitation program.

Control group: Conventional pulmonary rehabilitation program.

Assessments: Respiratory function, functional exercise capacity, and symptom levels will be measured before and after the intervention.

Inclusion criteria:

Diagnosis of mild-to-moderate ILD

Aged 20-70 years

Referral by a treating physician

Willingness and ability to participate

No physical or cognitive barriers to exercise training

Exclusion criteria:

Cardiovascular disease (e.g., acute heart failure, unstable angina, recent myocardial infarction)

Cognitive impairment

History of cerebrovascular event

History of cancer

Withdrawal criteria:

Development of clinical hemodynamic instability

Major surgical complication during the study

Missing ≥ 3 consecutive training sessions in the intervention group

Withdrawal of consent

Full description

Interstitial lung diseases (ILDs) are chronic parenchymal disorders characterized by varying degrees of inflammation and fibrosis, leading to exertional dyspnea, exercise intolerance, ventilatory restriction, and reduced health-related quality of life. Beyond pulmonary involvement, patients often experience fatigue, peripheral muscle weakness, anxiety, and reduced participation in daily activities. Pulmonary rehabilitation is a key non-pharmacological strategy for ILD; however, adherence and completion rates remain limited due to barriers such as symptom burden, transportation, and the repetitive nature of conventional exercise training.

Technology-assisted rehabilitation, particularly video game-based training (exergaming), has emerged as a promising strategy to enhance motivation and adherence while preserving the physiological benefits of exercise. Exergaming provides real-time feedback, goal-oriented tasks, and progressive challenges that may improve enjoyment, engagement, and consistency of participation. In respiratory rehabilitation, game-guided breathing exercises may reinforce techniques such as pursed-lip breathing, diaphragmatic breathing, and thoracic expansion, which optimize ventilatory mechanics and potentially reduce dyspnea. Additionally, whole-body functional games can promote aerobic capacity, coordination, and peripheral muscle endurance.

This randomized controlled trial is designed to compare the effects of video game-based rehabilitation combined with conventional physiotherapy versus conventional physiotherapy alone in individuals with mild-to-moderate ILD. A total of 42 participants will be randomized into two parallel arms (intervention and control). The intervention arm will receive supervised video game-based exercise sessions in addition to standard pulmonary rehabilitation, while the control arm will perform conventional home-based physiotherapy and rehabilitation only.

Primary outcomes include changes in respiratory function parameters, functional exercise capacity, and symptom perception before and after the 8-week intervention. The study also aims to examine whether video game-based rehabilitation increases adherence and completion rates compared to conventional programs.

The expected impact of this study is to provide scientific evidence regarding the feasibility, safety, and effectiveness of integrating video game-based rehabilitation into pulmonary rehabilitation for ILD. If successful, this approach may help overcome barriers to participation, improve functional outcomes, and support broader implementation of engaging, patient-centered rehabilitation strategies.

Enrollment: 42 estimated patients

Sex: All

Ages: 20 to 70 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Having been diagnosed with mild to moderate interstitial lung disease
• Being between the ages of 20 and 70
• Being referred to the study by their physician
• Being willing and able to participate
• Having no physical or cognitive disability that would prevent them from participating in exercise training

Exclusion criteria

• Presence of cardiovascular disease (acute heart failure, unstable angina, or recent myocardial infarction, etc.)
• Presence of cognitive impairment that prevents participation in exercise training
• Presence of a history of cerebrovascular accident
• Presence of a history of cancer

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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42 participants in 2 patient groups

Video game-based exercise training

Experimental group

Description:

In addition to the unsupervised conventional pulmonary rehabilitation program, they will participate in a supervised video game-based exercise protocol twice a week. The conventional physiotherapy and rehabilitation program will include posture exercises combined with breathing exercises three times a day, every weekday, and a walking program twice a week, along with breathing exercises. The supervised video game-based exercise program will include five different five-minute breathing labs and breathing games, two days a week, and 40 minutes of Nintendo Wii Fit games, which include lower extremity, upper extremity, and balance exercises.

Treatment:

Behavioral: Virtual reality exercises

Conventional Pulmonary Rehabilitation

Active Comparator group

Description:

Only the unsupervised conventional pulmonary rehabilitation (PR) program will be applied on this group. The conventional PR program will include posture exercises combined with breathing exercises three times a day, every weekday, and a walking program twice a week, along with breathing exercises Conventional PR program including: Breathing exercises (pursed-lip breathing, thoracic expansion, diaphragmatic breathing, breathing control) Postural exercises combined with breathing Walking program (30 min, 2×/week at Borg scale 4-6)

Treatment:

Behavioral: Home exercises