Benefits from Incorporating Virtual Reality in Pulmonary Rehabilitation of COPD Patients: A Systematic Review and Meta-Analysis

HIGHLIGHTS: What are the main findings? VR programs could be used to augment the therapeutic effect of PR in COPD patients. VR rehabilitation programs could be used for home based programs as they are safe and feasible. What is the implication of the main finding? Different games and environments offer the ability to tailor the exercise regimen to patients’ needs and ability providing a personalized rehabilitation. Gamification features could increase adherence and participation of COPD patients. ABSTRACT: Chronic Obstructive Pulmonary Disease (COPD) is characterized by irreversible airflow limitation. Patient participation in Pulmonary Rehabilitation (PR) programs has a beneficial effect on disease management, improving patients’ functional capacity and quality of life. As an alternative to traditional programs or as a complementary activity, the inclusion of virtual reality (VR) games is proposed. The aim of this research study was to investigate the effectiveness of incorporating VR in the pulmonary rehabilitation program of patients with COPD. A systematic literature search was performed for randomized controlled trials (RCTs) in the electronic databases Google Scholar, PubMed, and Pedro from January 2014 to March 2022. The search involved screening for studies examining the effectiveness of enhancing PR with VR. The PEDro (Physiotherapy Evidence Database) scale was chosen as the tool to assess the quality of studies. A meta-analysis was performed where possible. Six studies were included in this systematic review. The PEDro scale showed five studies of good methodological quality and one of fair quality. The variables examined were aerobic capacity for exercise, lung function, and anxiety and depression, with significant improvement regarding 6MWT and FEV1 (p < 0.05). There was variability noted in the VR applications and the proposed rehabilitation that the experimental groups followed. The application of VR is recommended for COPD patients, in combination with conventional PR. VR was found to be effective in increasing therapeutic effect and should be considered as a mean of increasing accessibility to PR. Therefore, further research, as well as additional RCTs regarding the effectiveness of VR in patients with COPD, seems necessary.