An intradialytic non-immersive virtual reality exercise programme: a crossover randomized controlled trial

Abstract

Background Chronic kidney disease is closely related to a high risk of death and disability, poor physical performance, and frailty. The main objective of this research was to analyse how intradialytic administration of a non-immersive virtual reality (VR) exercise program would affect physical function and adherence to exercise in these patients. Methods A total of 56 individuals participated in two 12-week periods in a crossover randomised controlled trial. Each patient underwent a functional capacity evaluation before and after each study period. The functional tests administered included the 4-metre gait speed test, Short Physical Performance Battery (SPPB), timed up-and-go (TUG) test, one-legged stance test (OLST) for balance, sit-to-stand 10 (STS-10) and sit-to-stand 60 (STS-60) tests, and 6-minute walking test (6MWT). Adherence to the exercise program was also recorded. To assess the effect of VR exercise on the functional test outcomes over time, the patients were analysed using a 2-way repeated-measures ANOVA with time and treatment as the within-participant factors. Results By the end of the 12 weeks of exercise, compared to the control period, 33 participants showed significant change in physical function as measured through the 4-metre gait speed (0.14 m/s), SPPB (1.2 points), TUG (−1.7 seconds), OLST (7.1 seconds), STS-10 (−5.8 seconds), STS-60 (5.0 repetitions), and 6MWT (85.2 metres) with adherence rates exceeding 70%. There were no changes in the biochemical data or in the medications in the period of the study. Conclusion An intradialytic non-immersive VR exercise program improves patient physical function.

The Effectiveness of a Four-Week Digital Physiotherapy Intervention to Improve Functional Capacity and Adherence to Intervention in Patients with Long COVID-19

“…The results showed that the functional capacity outcomes improve significantly ( p < 0.05), reducing the level of perceived exertion, improving the ability of these patients in basic physical activities such as walking or sitting, maintaining balance while standing up and getting up from a chair, showing us the clinical relevance of the intervention. Our improvement results are in line with published data in several pathologies, such as renal [ 60 ], multiple sclerosis [ 61 ], head and neck cancer patients [ 62 ] and COVID-19 patients [ 63 ].…”

The effects of virtual reality‐based exercise in adults receiving haemodialysis treatment: A systematic review and meta‐analysis of randomized controlled studies

“…After that, 3589 titles and abstracts were screened, and a further 3575 studies were excluded because they did not meet the inclusion criteria. The remaining 14 studies were assessed for eligibility criteria, and the five studies meeting the eligibility criteria were included in this systematic review and meta‐analysis (Martínez‐Olmos et al, 2022; Maynard et al, 2019; Segura‐Ortí et al, 2019; Segura‐Ortí & García‐Testal, 2019; Zhou et al, 2020). The Cohen's k was equal to 1.00 in the study selection.…”

“…The procedure of VR‐based exercise was intradialytic exercise with different type of exercise. The type of exercise was only muscle‐strengthening exercise in three studies (Martínez‐Olmos et al, 2022; Segura‐Ortí & García‐Testal, 2019; Zhou et al, 2020), and it was combination of aerobic and muscle‐strengthening exercises in two studies (Maynard et al, 2019; Segura‐Ortí et al, 2019). The practitioner of VR‐based exercise to participants was a physiotherapist in all included studies.…”

“…The risk of overall bias was some concern in three studies Segura-Ortí & García-Testal, 2019;Zhou et al, 2020) and high risk in two studies (Martínez-Olmos et al, 2022;Maynard et al, 2019).…”

“…In the included studies, the risk of overall bias was generally some concern as well as high in two studies (Martínez-Olmos et al, 2022;Maynard et al, 2019), because large proportions of missing data were reported in these studies and appropriate analyses such as ITT analysis were not performed. Additionally, no randomization process or deviations from the intended intervention was reported in studies rated as of some concern for overall Furthermore, of the five included RCTs used CONSORT flow diagram (Martínez-Olmos et al, Maynard et al, 2019;.…”