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

Summary

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

Conditions

• Interstitial Lung Disease

Interventions

BEHAVIORAL

Virtual reality exercises

Program Duration: 8 weeks Implementation: The conventional program plus supervised video game-based training sessions. Additional Protocol: Video Game-Based Exercises 1. Breathing Labs - Breathing Games (Slovenia) Frequency: 3 days per week, on non-walking days, supervised at the hospital. Structure: 5 mini-games per session, performed sequentially. Exercises: Balloon: Weeks 1-4: Level 1; Weeks 5-8: Level 2. Focus on sustained controlled exhalation. Plane: Weeks 1-4: \~6 sec breath cycle; Weeks 5-8: \~8 sec breath cycle. Wolf: Weeks 1-4: Easy; Weeks 5-8: Medium. Flowers: Weeks 1-4: Sunflower module; Weeks 5-8: Rose module. Pluto: Weeks 1-4: Easy; Weeks 5-8: Medium. Intensity: Target MBS 4-6/10 for dyspnea and fatigue. 2. Nintendo Wii / Wii Fit - Functional Training Duration: \~5 minutes per game, 30-40 minutes total per session. Games and targets: Lower limb/aerobic: Basic Run, Basic Step, Obstacle Course, Island Cycling. Upper limb: Boxing, Canoe. Balance: Rhythm Parade.

BEHAVIORAL

Home exercises

Program Duration: 8 weeks Implementation: Home-based, instructed face-to-face at baseline by a physiotherapist, supported with video materials, and monitored with regular feedback. A) Posture + Breathing Exercises Frequency: 3 sessions per day (morning, noon, evening) Content: Shoulder girdle mobilization: Scapular elevation-depression, abduction-adduction (3 sets × 3 repetitions). Stretching exercises: Shoulder, cervical, and trunk muscles; 5-second hold at end range. Combined with breathing: Inspiration during concentric phase, expiration during eccentric phase. B) Breathing Exercises Frequency: 3 sessions per day; 10 repetitions of each exercise per session Content: Pursed-Lip Breathing, Thoracic Expansion Exercises, Diaphragmatic Breathing, Breathing Control C) Walking Program Frequency: 2 days per week Duration: 30 minutes (5 min warm-up, 20 min walking, 5 min cool-down) Intensity: Self-selected pace targeting Modified Borg Scale (MBS) 4-6/10 for dyspnea.

Sponsors & Collaborators

• Istinye University

  lead OTHER

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Model

PARALLEL

Eligibility

Min Age

20 Years

Max Age

70 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2026-01-25

Primary Completion

2026-09-25

Completion

2026-11-25