Accepted for/Published in: JMIR Serious Games
Date Submitted: Dec 3, 2024
Date Accepted: Mar 31, 2025
Efficacy of motion-sensing game-assisted pulmonary rehabilitation in patients with chronic obstructive pulmonary disease: a meta-analysis of randomized controlled trials
ABSTRACT
Background:
While motion-sensing game (MSG) platforms offer immersive, real-time feedback environments for rehabilitation, research findings on effectiveness in chronic obstructive pulmonary disease (COPD) pulmonary rehabilitation remain heterogeneous.
Objective:
To systematically evaluate the efficacy of MSG-assisted pulmonary rehabilitation for patients with COPD.
Methods:
Seven electronic databases (PubMed, Cochrane Library, EMBASE, CINAHL, Web of Science, China National Knowledge Infrastructure, and Wanfang databases) were systematically searched from inception to November 2024. Randomized controlled trials (RCTs) comparing MSG-assisted versus conventional pulmonary rehabilitation in COPD patients were included. The review protocol adhered to PRISMA guidelines. Data analysis was conducted using Review Manager 5.3 and Stata 17. Mean differences (MDs) and odds ratios (ORs) with 95% confidence intervals (CIs) were used to calculate variables. The revised Cochrane Risk of Bias tool was used to evaluate the risk of bias.
Results:
Analysis of 12 RCTs (n=776) demonstrated that MSG-assisted pulmonary rehabilitation, compared to routine pulmonary rehabilitation, significantly improved six-minute walk distance (MD = 23.23, 95% CI: 14.47-31.99, P<0.00001), upper limb strength via 30-second arm curl test (MD = 1.83, 95% CI: 0.63-3.03, P=0.003), balance performance (BESTest) (MD = 2.34, 95% CI: 1.52-3.17, P<0.00001), and exercise adherence (OR = 3.00, 95% CI: 1.38-6.52, P=0.005). Additionally, significant improvements were observed in dyspnea severity (MD = -0.25, 95% CI: -0.48 to -0.02, P=0.03), health-related quality of life (MD = -6.00, 95% CI: -10.96 to -1.04, P = 0.02), and psychological outcomes including anxiety (MD = -2.41, 95% CI: -3.42 to -1.39, P < 0.00001) and depression (MD = -1.40, 95% CI: -2.69 to -0.42, P = 0.03).
Conclusions:
MSG-assisted pulmonary rehabilitation demonstrates significant improvements in exercise capacity, respiratory symptoms, quality of life, and psychological well-being among COPD patients. Clinical Trial: PROSPERO International Prospective Register of Systematic Reviews: CRD42024603044; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=603044
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