The effect of a 12-week tele-exercise using immersive virtual reality on functional capacity in adolescents with cystic fibrosis: A randomized controlled, single (assessor) - blind study.

BACKGROUND

Adolescents with cystic fibrosis (CF) have lower levels of physical activity compared to their peers. Risk of cross-contamination limits participation in face-to-face sport activities. Tele-exercise (TE) is a good alternative to deliver exercise remotely, without risk of infection. Immersive virtual reality (VR) could be a motivating method to improve the functional capacity. The primary aim was to evaluate the effect of a 12-week VR exercises on 6-min walk distance (6MWD). The secondary aims were to assess its effects on pulmonary function, muscle strength, quality of life, feasibility, and enjoyment.

METHODS

In this randomized controlled study, clinically stable participants aged between 12 and 18 years were included and randomized to a VR-based tele-exercise (VR-TE) or a TE group. Exercises were conducted in groups of 6 participants for 30 min, 3 days/week for 12 weeks in both groups. Outcome measures were 6MWD, FEV1, hand grip, shoulder flexor and knee extensor muscle strength, Cystic Fibrosis Questionnaire Revised (CFQ-R), physical activity enjoyment scale and system usability scale.

RESULTS

Twenty-one participants completed the study. Baseline pulmonary function tests, 6MWD, muscle strength, and CFQ-R scores were similar between groups. In the VR-TE group, post-training 6MWD was significantly higher than pre-training 6MWD (z = -2.93, p = 0.003). However, no statistical improvement was observed in pulmonary function, muscle strength, or quality of life. Feasibility, enjoyment, adherence, and adverse effects were similar between groups.

CONCLUSION

Virtual reality and tele-exercise are feasible and motivating methods to facilitate the participation in exercise and improve functional capacity in adolescents with CF. Longer duration of VR-based exercise might be needed to improve muscle strength and quality of life.

CLINICAL TRIALS REGISTRATION NUMBER: NCT05850351.