The Effect of Different Virtual Reality-Based Exercise Trainings on Pulmonary Function, Respiratory and Peripheral Muscle Strength, Functional Capacity and Balance in Children With Bronchiectasis

Study Overview
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Brief Summary
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Bronchiectasis is defined as abnormal, chronic and permanent enlargement of one or more bronchi. Disease symptoms; often productive cough, dyspnea, fatigue and wheezing. Changing pulmonary mechanics, inadequate gas exchange, decreased muscle mass and associated psychological problems may cause dyspnea, decreased exercise capacity and health-related quality of life. Exercise training as a part of pulmonary rehabilitation is used to reduce the severity of symptoms; is an effective treatment to improve exercise capacity and health status. Virtual reality based exercise training has taken its place in many areas of rehabilitation as a current and new approach. In the studies in the literature, Nintendo Wii Fit games are an effective, motivating, entertaining and clinically useful method for reducing symptoms in the rehabilitation of chronic lung diseases. Wii Fit games generally include strengthening, aerobics and balance exercises. Developed by BreathingLabs, Breathing Games, which is based on breathing exercises, are a new product, a virtual reality application that has been included in a limited number of studies, has shown its effect on reducing respiratory problems and is open to research effects for many patient groups. The importance of this study is that it will be the first study on Nintendo Wii Fit games based exercise training and Breathing Games based breathing exercises training in children with bronchiectasis. The aim of this study is to investigate the effect of different virtual reality-based exercise trainings on pulmonary function, respiratory and peripheral muscle strength, functional capacity and balance in children with bronchiectasis.

Official Title
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The Effect of Different Virtual Reality-Based Exercise Trainings on Pulmonary Function, Respiratory and Peripheral Muscle Strength, Functional Capacity and Balance in Children With Bronchiectasis

Conditions
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Bronchiectasis

Intervention / Treatment
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* Other: Conventional Chest Physiotherapy
* Other: Nintendo Wii Fit Based Exercise Training
* Other: BreathingLabs Breathing Games Based Exercise Training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Bronchiectasis diagnosis Stable clinical condition (no exacerbation in last 4 weeks) Exclusion Criteria: Documented diagnosis of vestibular, neurological or orthopedic disorders which may affect balance and mobility Subjects previously involved in exercise training or physiotherapy programs Previous history of lung or liver transplantation

Ages Eligible for Study
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Minimum Age: 8 Years
Maximum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Control Group<br>Patients in this group will receive conventional chest physiotherapy, two times a day, 7 days a week for 8 weeks. After the training given by the physiotherapist, all exercise sessions will be performed at home. | Other: Conventional Chest Physiotherapy<br>* Programme will include diaphragmatic breathing exercise, thoracic expansion exercises, incentive spirometer exercise (Triflo), oscillatory PEP (Flutter), postural drainage, coughing techniques and teaching respiratory control.<br>|
| Experimental: Nintendo Wii Fit Training Group<br>In addition to conventional chest physiotherapy programme, patients in this group will also receive Nintendo Wii Fit based exercise training for 40 minutes, 2 times in a week for 8 weeks. All exercise sessions will be supervised by physiotherapist in a clinic per week. | Other: Conventional Chest Physiotherapy<br>* Programme will include diaphragmatic breathing exercise, thoracic expansion exercises, incentive spirometer exercise (Triflo), oscillatory PEP (Flutter), postural drainage, coughing techniques and teaching respiratory control.<br>Other: Nintendo Wii Fit Based Exercise Training<br>* Nintendo Wii Fit based exercise training will be given under the supervision of a physiotherapist. The one session will be included: warm-up exercises for 5 minutes (yoga games; deep breathing and half moon etc.), aerobic exercises for 30 minutes (aerobic games; Twisting and Squat, Step Plus, Jogging Plus and Hula Hoop etc.) and cooling exercises in 5 minutes (yoga games; deep breathing and half moon etc.).<br>|
| Experimental: BreathingLabs Breathing Games Training Group<br>In addition to conventional chest physiotherapy programme, patients in this group will also receive BreathingLabs Breathing Games based exercise training for 40 minutes, 2 times in a week for 8 weeks. All exercise sessions will be supervised by physiotherapist in a clinic per week. | Other: Conventional Chest Physiotherapy<br>* Programme will include diaphragmatic breathing exercise, thoracic expansion exercises, incentive spirometer exercise (Triflo), oscillatory PEP (Flutter), postural drainage, coughing techniques and teaching respiratory control.<br>Other: BreathingLabs Breathing Games Based Exercise Training<br>* BreathingLabs Breathing Games based exercise training will be given under the supervision of a physiotherapist. The one session will be included: warm-up exercises for 5 minutes (respiratory control exerice and coughing techniques), breathing games exercises for 30 minutes (breathing games; Kite, Balloon, Pluto, Butterflies and Plane etc.) and cooling exercises in 5 minutes (respiratory control exerice and coughing techniques).<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Respiratory Function Test | Change from baseline Forced Vital Capacity (FVC) at 8 weeks | Eight weeks | 
| Respiratory Function Test | Change from baseline Forced Expiratory Volume in 1 second (FEV1) at 8 weeks | Eight weeks | 
| Respiratory Function Test | Change from baseline Peak Expiratory Flow (PEF) at 8 weeks | Eight weeks | 
| Respiratory Muscle Strength | Change from baseline maximum inspiratory pressure (MIP) at 8 weeks | Eight weeks | 
| Respiratory Muscle Strength | Change from baseline maximum expiratory pressure (MEP) at 8 weeks | Eight weeks | 
| Functional Capacity | Change from baseline distance covered in six-minute walk test at 8 weeks | Eight weeks | 
| Balance | Change from baseline postural stability test score in Biodex Balance System SD at 8 weeks | Eight weeks | 
| Balance | Change from baseline limits of stability test score in Biodex Balance System SD at 8 weeks | Eight weeks | 
| Balance | Change from baseline sensory integriation and balance test score in Biodex Balance System SD at 8 weeks | Eight weeks | 
| Peripheral Muscle Strength | Change from baseline M. Quadriceps strength at 8 weeks | Eight weeks | 
| Peripheral Muscle Strength | Change from baseline M. Biceps strength at 8 weeks | Eight weeks | 
| Peripheral Muscle Strength | Change from baseline handgrip strength at 8 weeks | Eight weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Bronchiectasis, Virtual Reality, Exercise Training, Pulmonary Function, Functional Capacity, 6 Minute Walk Test, Balance, Muscle Strength