Martínez-Olmos FJ1, Ortega-PerezdeVillar L2, Ferrer-Sargues F3, Biviá-Roig G3, Martínez-Gramage J3, Arguisuelas-Martínez MD3, Montañez-Aguilera FJ3, Salvador-Coloma P3, Valtueña-Gimeno N3, Amer-Cuenca JJ3, Benavent-Caballer V3, Segura-Orti E3
1Universidad Cardenal Herrera-CEU, Department of Physiotherapy CEU Universities, Valencia, Spain, 2Universidad Cardenal Herrera-CEU, Department of Physiotherapy, CEU Universities, Valencia, Spain, 3Universidad Cardenal Herrera-CEU, Department of Physiotherapy, CEU Universities, VALENCIA, Spain
Background: Despite the benefits reported by the implementation of exercise during dialysis, it is not routinely implemented. It seems necessary to look for exercise options that are easy to implement and attractive for the patients. Non-immersive virtual reality (VR) has shown benefits in several cohorts.
Purpose: The objective of this study is to assess the effect on physical function of a non-immersive virtual reality exercise program intradialysis
Methods: This was a cross-randomized controlled trial. Participants were randomized in a control-RV group (CVR) or RV-control group (VRC). There were two consecutive periods of 12 weeks, one control and one exercise period. The CVR started with a control period and followed by the exercise period, and the VRC did the opposite. Functional capacity was assessed at three time points: baseline, 12 weeks and 24 weeks. The battery of test included gait speed in 4 meters, Timed Up and Go- TUG, one-leg stand balance, Sit to Stand 10 and 60 STS-10 and STS-60, 6 minutes walking test 6MWT). Intradialysis exercise consisted of a video game adapted to dialysis: Treasure hunting. It is a non-immersive VR game in which the patient must catch some objectives avoiding obstacles by moving the lower limbs. The exercise session lasted from 20 to 40 minutes. A mixed ANOVA test (time as intrasubjects factor, and group as between subjects factor) was used to assess the effect of the intervention.
Results: 47 subjects were included in the study, 22 subjects (median age 73.5 years; 13 males) in the CVR group and 25 subjects (median age 72 years, 15 males). At 24 weeks 14 subjects had abandoned the study. The results showed a significant group per time interaction. All functional tests improved after the exercise program (Gait speed in 4 meters -0.16 seconds, 95% CI -0.1- -0.2 VRC group and -0.12 seconds, 95% IC -0.06--0.17 CVR; TUG -1.8 seconds, 95% CI -1.2--2.5 VRC group and -1.3 seconds, 95% CI 0.1--2.7 CVR group; one-leg balance 6.2 seconds, 95% CI 2.6-9.8 VRC group and 8.1 seconds, 95% CI 4.2-12.0 CVR group; STS-10 -5.6 seconds, 95% CI -3.5--7.8 VRC group and -6.0 seconds, 95% CI -4.0--7.9 CVR group; and 6MWT 105.4 meters, 95% CI 76.2-134.6 VRC group and CVR group 59.5 meters, 95% CI 34.5-84.5). The follow-up of 12 weeks after the end of the program in the VRC showed a significant decrease in function in the following tests (Gait speed in 4 meters -0.13seconds, 95% CI 0.08--0.18; STS-10 -1.4 seconds, CI 95% 0.11-2.65; and 6MWT -66.4 meters, 95% CI 43.5-89.2).
Conclusion(s): A non-immersive VR exercise program during hemodialysis improves physical function. Some benefits of exercise are not maintained after 12 weeks of follow-up.
Implications: VR during hemodialysis could be used to improve and maintain physical function of hemodialysis population. The program could be implemented by heath care givers that attend the hemodialysis unit routinely.
Keywords: Exercise, Hemodialysis, Virtual Reality
Funding acknowledgements: The present study has been funded by the Universidad CEU-Cardenal Herrera, IDOC 17-19
Purpose: The objective of this study is to assess the effect on physical function of a non-immersive virtual reality exercise program intradialysis
Methods: This was a cross-randomized controlled trial. Participants were randomized in a control-RV group (CVR) or RV-control group (VRC). There were two consecutive periods of 12 weeks, one control and one exercise period. The CVR started with a control period and followed by the exercise period, and the VRC did the opposite. Functional capacity was assessed at three time points: baseline, 12 weeks and 24 weeks. The battery of test included gait speed in 4 meters, Timed Up and Go- TUG, one-leg stand balance, Sit to Stand 10 and 60 STS-10 and STS-60, 6 minutes walking test 6MWT). Intradialysis exercise consisted of a video game adapted to dialysis: Treasure hunting. It is a non-immersive VR game in which the patient must catch some objectives avoiding obstacles by moving the lower limbs. The exercise session lasted from 20 to 40 minutes. A mixed ANOVA test (time as intrasubjects factor, and group as between subjects factor) was used to assess the effect of the intervention.
Results: 47 subjects were included in the study, 22 subjects (median age 73.5 years; 13 males) in the CVR group and 25 subjects (median age 72 years, 15 males). At 24 weeks 14 subjects had abandoned the study. The results showed a significant group per time interaction. All functional tests improved after the exercise program (Gait speed in 4 meters -0.16 seconds, 95% CI -0.1- -0.2 VRC group and -0.12 seconds, 95% IC -0.06--0.17 CVR; TUG -1.8 seconds, 95% CI -1.2--2.5 VRC group and -1.3 seconds, 95% CI 0.1--2.7 CVR group; one-leg balance 6.2 seconds, 95% CI 2.6-9.8 VRC group and 8.1 seconds, 95% CI 4.2-12.0 CVR group; STS-10 -5.6 seconds, 95% CI -3.5--7.8 VRC group and -6.0 seconds, 95% CI -4.0--7.9 CVR group; and 6MWT 105.4 meters, 95% CI 76.2-134.6 VRC group and CVR group 59.5 meters, 95% CI 34.5-84.5). The follow-up of 12 weeks after the end of the program in the VRC showed a significant decrease in function in the following tests (Gait speed in 4 meters -0.13seconds, 95% CI 0.08--0.18; STS-10 -1.4 seconds, CI 95% 0.11-2.65; and 6MWT -66.4 meters, 95% CI 43.5-89.2).
Conclusion(s): A non-immersive VR exercise program during hemodialysis improves physical function. Some benefits of exercise are not maintained after 12 weeks of follow-up.
Implications: VR during hemodialysis could be used to improve and maintain physical function of hemodialysis population. The program could be implemented by heath care givers that attend the hemodialysis unit routinely.
Keywords: Exercise, Hemodialysis, Virtual Reality
Funding acknowledgements: The present study has been funded by the Universidad CEU-Cardenal Herrera, IDOC 17-19
Topic: Musculoskeletal: lower limb; Health promotion & wellbeing/healthy ageing
Ethics approval required: Yes
Institution: Hospital Manises
Ethics committee: Departamento de salud la Fe
Ethics number: FPNT-CEIB-04
All authors, affiliations and abstracts have been published as submitted.
