Virtual Reality and Videogaming in Pulmonary Rehabilitation for Asthma: A Systematic Review of Clinical Outcomes and Engagement.

Asthma is a chronic respiratory disease that significantly impacts quality of life. Pulmonary rehabilitation has been shown to improve lung function and symptoms in asthma, but its adoption is limited due to accessibility and patient engagement challenges. Virtual reality (VR) and videogaming technologies have emerged as potential tools to enhance pulmonary rehabilitation by providing an engaging and interactive environment. This systematic review aimed to evaluate the effectiveness, feasibility, safety, and patient engagement of VR and videogaming in pulmonary rehabilitation for individuals with asthma. A comprehensive search of seven electronic databases (PubMed, Embase, CINAHL, Cochrane, AMED, SPORTDiscus and PEDro) was conducted to identify studies that included VR and videogaming interventions. Studies included participants with asthma and used VR or videogaming as part of pulmonary rehabilitation. Data extraction focused on intervention types, clinical outcomes, patient engagement, and safety. Five studies were included in the final review and involved 104 participants. The studies implemented different digital tools, including the InSpire System, and games such as "Reflex Ridge" and "Serious Games". VR and videogaming interventions improved asthma control, lung function, and exercise capacity. High levels of patient engagement and adherence were reported, with no adverse events across the trial. VR and videogaming show promise as effective, feasible, and safe tools to enhance pulmonary rehabilitation in individuals with asthma. However, the heterogeneity of studies limited the ability to draw definitive conclusions, with further research needed using standardized outcomes.