Effectiveness of Active Video Games as a Training Tool in Patients With Interstitial Lung Disease: A Randomised Controlled Trial

Abstract

Background and Objective: Active video games (AVG) offer an alternative or complementary approach to traditional rehabilitation, yet their effects in patients with interstitial lung disease (ILD) remain underexplored. This study aimed to evaluate the effectiveness of AVG in individuals with ILD. Methods: Forty-five patients with ILD were randomised into three equal groups: AVG, traditional aerobic exercise (TAE), and control (CG). Both the AVG and TAE groups participated in 30 min of moderate-intensity cycling twice weekly for 8 weeks. The AVG group additionally completed 30 min of exergaming after cycling. All groups were instructed to walk 30 min twice weekly. Outcomes were assessed at week 8. Primary outcomes included exercise capacity measured by the 6-min walk test (6MWT), incremental shuttle walk test (ISWT), and endurance shuttle walk test (ESWT). Secondary outcomes included spirometry, respiratory and quadriceps strength, fatigue, dyspnea, physical activity (PA) and psychological state. Satisfaction, attendance, and enjoyment were also recorded. Results: After 8 weeks, the AVG group demonstrated greater improvements in 6MWT distance (p = 0.035), maximal inspiratory pressure (p = 0.002), St George's Respiratory Questionnaire (SGRQ) symptoms (p = 0.005) and activity (p = 0.008) scores, International Physical Activity Questionnaire (IPAQ) (p = 0.001), and the London Chest Activities of Daily Living Scale (LC-ADL) (p = 0.001) compared to TAE and CG. No significant differences were observed in ISWT, forced vital capacity (FVC), maximal expiratory pressure, quadriceps strength, dyspnea, or Hospital Anxiety and Depression Scale (HADS) scores (p > 0.05). Conclusion: AVG combined with traditional aerobic exercise appears to be a safe and effective intervention in ILD, improving submaximal capacity, symptom control, physical activity, satisfaction, and adherence. Trial Registration: NCT06087692 at https://clinicaltrials.gov/ct2/show/NCT06087692.