Chen Jinsong, Yang Tingzhong, He Qilian, Pang Mingli, Cao Ying, Liu Zheng, Li Linfei, Liu Hsing-I, Bullen Christopher
Department of Public Administration, Law School, Hangzhou City University, Hangzhou, China.
School of Public Affairs, Zhejiang University, Hangzhou, China.
JMIR Serious Games. 2025 May 30;13:e69510. doi: 10.2196/69510.
Chronic obstructive pulmonary disease (COPD) requires consistent sustained management, including regular physical activity, pulmonary rehabilitation, and self-care adherence. Despite strong clinical guidelines, patient engagement remains a major challenge, leading to suboptimal disease control and increased health care use. Gamified interventions have emerged as potential tools to improve adherence, motivation, and outcomes in chronic disease management. However, their effectiveness and implementation in COPD remain underexplored.
This review synthesizes current evidence on gamified interventions for COPD management to evaluate their effectiveness, focusing on patient engagement, physical outcomes, and quality of life.
We conducted a systematic search in PubMed, Scopus, Web of Science, Embase, IEEE Xplore, Cochrane Library, and China National Knowledge Infrastructure for studies published from January 2014 to October 2024. Only original studies involving trials (both randomized controlled trials [RCTs] and non-RCTs), intervention studies, feasibility studies, cross-sectional surveys, or qualitative studies were included.
A total of 29 studies met the inclusion criteria: 11 (38%) RCTs; 7 (24%) pilot studies; 5 (17%) observational studies (including qualitative studies); and 6 (21%) other studies using gamified technologies such as virtual reality, exergames, and mobile apps. Compared to nongamified methods, gamified interventions provided an engaging, home-based alternative for COPD management, supporting long-term rehabilitation. Gamification features such as real-time feedback, adaptive challenges, and personalized goals increased patient adherence and motivation, with high engagement seen in virtual reality and exergame-based interventions, and showed notable improvements in COPD management, enhancing exercise tolerance, self-management, and symptom control. However, most of the studies (22/29, 76%) were of short duration, with small sample sizes.
Gamified COPD management tools offer flexibility and empower patients to self-manage their condition, potentially reducing the need for clinic visits. Gamified interventions show promise in COPD management, although current studies have methodological limitations. Future research should focus on conducting larger trials to assess the sustained impact of gamified interventions on COPD outcomes; developing culturally relevant adaptations to enhance the global applicability of these interventions; and collaborating with patients, clinicians, and game developers to make the interventions more engaging and effective.
慢性阻塞性肺疾病（COPD）需要持续稳定的管理，包括定期体育活动、肺康复和自我护理依从性。尽管有强有力的临床指南，但患者参与仍然是一个重大挑战，导致疾病控制不理想和医疗保健使用增加。游戏化干预已成为改善慢性病管理中依从性、动机和结果的潜在工具。然而，它们在COPD中的有效性和实施情况仍未得到充分探索。
本综述综合了当前关于COPD管理游戏化干预的证据，以评估其有效性，重点关注患者参与度、身体结果和生活质量。
我们在PubMed、Scopus、Web of Science、Embase、IEEE Xplore、Cochrane图书馆和中国知网中进行了系统检索，以查找2014年1月至2024年10月发表的研究。仅纳入涉及试验（随机对照试验[RCT]和非RCT）、干预研究、可行性研究、横断面调查或定性研究的原始研究。
共有29项研究符合纳入标准：11项（38%）RCT；7项（24%）试点研究；5项（17%）观察性研究（包括定性研究）；6项（21%）使用虚拟现实、运动游戏和移动应用等游戏化技术的其他研究。与非游戏化方法相比，游戏化干预为COPD管理提供了一种引人入胜的家庭式替代方案，支持长期康复。实时反馈、适应性挑战和个性化目标等游戏化功能提高了患者的依从性和动机，虚拟现实和基于运动游戏的干预中参与度较高，并在COPD管理方面显示出显著改善，增强了运动耐量、自我管理和症状控制。然而，大多数研究（22/29，76%）持续时间较短，样本量较小。
游戏化的COPD管理工具具有灵活性，使患者能够自我管理病情，可能减少门诊就诊需求。游戏化干预在COPD管理中显示出前景，尽管目前的研究存在方法学局限性。未来的研究应侧重于进行更大规模的试验，以评估游戏化干预对COPD结果的持续影响；开展与文化相关的调整，以提高这些干预措施的全球适用性；并与患者、临床医生和游戏开发者合作，使干预措施更具吸引力和有效性。
