Effect of Video Game-Based Breathing Exercises on Respiratory Dysfunction in ACOS
Trial statusNot yet recruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age40-74
SponsorIstinye University
About this trial
Asthma and COPD are significant respiratory diseases that can coexist, referred to as Asthma-COPD Overlap Syndrome (ACOS). Patients with ACOS experience more severe clinical outcomes, including rapid decline in lung function, increased symptom burden, and reduced quality of life. Pulmonary rehabilitation-particularly breathing exercises-is a core non-pharmacological intervention recommended for this patient group. In recent years, video game-based applications have emerged as innovative tools that enhance motivation and participation in exercise programs. However, studies investigating the effects of video game-based breathing exercises in ACOS patients are extremely limited. Additionally, although dysfunctional breathing patterns are common in this group, few studies have addressed targeted interventions. The objective of the present study is to evaluate the effects of video game-based breathing exercises on dysfunctional breathing in ACOS patients.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Aged between 40 and 74 years
Diagnosed with Asthma-COPD Overlap Syndrome (ACOS)
Nijmegen Questionnaire score ≥ 23
No severe asthma
Disqualifiers
Contraindicated for pulmonary rehabilitation
Diagnosed with cancer
Having severe cardiovascular disease
History of thoracic surgery
Trial design
Design model
Parallel
Treatments tested in this trial
Video game-based breathing exercises
Other interventionİndividuals will be enrolled in the video game-based breathing exercise program. Participants in the study group will undergo the "Breathing Games" exercise program twice a week for 8 weeks, with each session lasting approximately 50 minutes. This video game-based breathing exercise program includes warm-up, cool-down, and five breathing games designed for the target patients.From the second week onward, posture exercises combined with the breathing games will be added.Thus, the exercise program will consist of a warm-up phase lasting approximately 10 minutes, including breathing control, stretching exercises, and rest; 25-30 minutes of five breathing games combined with posture exercises; followed by a cool-down phase of about 10 minutes with breathing control, stretching exercises, and rest.Additionally, participants will be provided with a home exercise program to be performed twice daily for 30 minutes, three days a week, over 8 weeks.
Group 2:Telerehabilitation-based breathing exercises
Other interventionA telerehabilitation-based breathing exercise program will be administered to the control group with a frequency and duration similar to those of the intervention group (2 days per week, 8 weeks, 45-50 minutes/session). Session duration, total exercise time, home program, and interaction with the physiotherapist are planned similarly in both groups, aiming for the primary difference between groups to be solely the mode of delivery. In the control group, the level of interaction will be maintained by providing visual cues and real-time feedback during exercises. The telerehabilitation intervention will be conducted via the WhatsApp application on the patient's device. In addition, individuals will be prescribed a home exercise program to be performed 3 days a week, twice daily for 30 minutes, over the course of 8 weeks.
Treatment groups
30 Participants
are divided into 2 treatment groupsGroup A: Group 1: The group receiving video game-based breathing exercisesExperimental treatment 1 intervention
Group B: Group 2:Telerehabilitation-based breathing exercisesActive comparator 1 intervention
Trial outcomes
Primary outcomes
1
Capnography
It will be used to evaluate whether ventilation is adequate and if the breathing pattern is appropriate. It is a monitoring device that continuously records the concentration of CO₂ in the exhaled gases during respiration graphically (in mmHg), providing information about the patient's respiratory rate per minute and the amount of CO₂ exhaled in each breath. It measures the partial pressure of CO₂ in the exhaled air, referred to as end-tidal CO₂ (ETCO₂), which is a reliable and time-sensitive clinical measurement of respiratory function. ETCO₂ shows good concurrent validity when compared directly with blood measurements. A value of 35 mmHg or below is commonly used as a cutoff point to define hypocapnia.
Time frame
All assessments will be performed on the participants at the first session and repeated after 8 weeks.Secondary outcomes
1
FEV₁ assesment
Pulmonary function will be assessed using the Cosmed Micro Quark spirometer in accordance with ATS and ERS criteria. Patients will be informed before the test, which will be performed in a seated position after 15 minutes of rest. With a nasal clip applied and mouthpiece in place, patients will be instructed to take a deep inspiration, exhale forcefully and rapidly, and then inhale deeply again. The test will be repeated three times, and the valid result will be accepted.Forced expiratory volume in one second (FEV₁) will be measured and recorded in liters (L).
Time frame
All assessments will be performed on the participants at the first session and repeated after 8 weeks.2
Breath-Holding Time Test
It is a simple test commonly used to assess respiratory functions. The purpose is to measure how long a person can hold their breath after taking a normal breath
Time frame
All assessments will be performed on the participants at the first session and repeated after 8 weeks.3
Nijmegen Questionnaire
The Nijmegen Questionnaire is a valid and reliable self-report tool used for the diagnosis of dysfunctional breathing syndrome. Dysfunctional breathing is a disorder characterized by irregular or abnormal breathing patterns, often confused with conditions such as asthma or anxiety. The questionnaire was developed to assess the frequency of respiratory-related symptoms and consists of 16 items in total. These items include clinically relevant symptoms such as shortness of breath, chest pain, dizziness, and tingling sensations. Each item is scored on a scale from 0 (never) to 4 (very often), and the total score provides information about the severity of dysfunctional breathing.
Time frame
All assessments will be performed on the participants at the first session and repeated after 8 weeks.4
Posture Assessment - Posture Screen Application
Posture examination will be performed using the PostureScreen® Mobile application through a photographic method. This application essentially digitizes a valid posture assessment technique, namely the photographic method using a vertical plumb line or lead wire method. This examination is simple, quick, easily repeatable, and does not require in-depth knowledge of posturology. For cervical measurements, forward head tilt, cervical lordosis angle, and lateral deviations of the neck will be evaluated. For thoracic measurements, thoracic kyphosis angle, shoulder height difference, thoracic scoliosis, and scapular position will be assessed.
Time frame
All assessments will be performed on the participants at the first session and repeated after 8 weeks.Sponsors and contacts
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Source ClinicalTrials.gov
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