Efficacy of Motion-Sensing Game–Assisted Pulmonary Rehabilitation in Patients With Chronic Obstructive Pulmonary Disease: Systematic Review and Meta-Analysis of Randomized Controlled Trials
Bibliographic record
Abstract
Background: While motion-sensing game (MSG) platforms provide immersive, real-time feedback environments for rehabilitation, research findings on their effectiveness in chronic obstructive pulmonary disease (COPD) pulmonary rehabilitation remain heterogeneous. Objective: This study aims to systematically evaluate the efficacy of MSG-assisted pulmonary rehabilitation for patients with COPD. Methods: This meta-analysis was conducted in accordance with the Cochrane Handbook for Systematic Reviews of Interventions and the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 statement. Eight electronic databases (PubMed, Cochrane Library, Embase, CINAHL, Web of Science, Scopus, China National Knowledge Infrastructure, and Wanfang) were systematically searched from inception to March 2025. Randomized controlled trials (RCTs) comparing MSG-assisted versus conventional pulmonary rehabilitation in patients with COPD were included. Data analysis was performed using Review Manager 5.3 (Cochrane Collaboration) and Stata 17 (StataCorp LLC). Mean differences (MDs) and odds ratios (ORs) with 95% CIs were calculated. Risk of bias was assessed using the revised Cochrane Risk of Bias tool (Cochrane Collaboration), and evidence quality was evaluated using the Grading of Recommendations Assessment, Development, and Evaluations (GRADE) approach. Results: Analysis of 12 RCTs (n=776) demonstrated that MSG-assisted pulmonary rehabilitation, compared with conventional pulmonary rehabilitation, significantly improved 6-Minute Walk Distance (MD 23.23, 95% CI 14.47-31.99; P<.001), upper limb strength via 30-Second Arm Curl Test (MD 1.83, 95% CI 0.63-3.03; P=.003), balance performance (Balance Evaluation Systems Test; MD 2.34, 95% CI 1.52-3.17; P<.001), and exercise adherence (OR 3.00, 95% CI 1.38-6.52; P=.005). Additionally, significant improvements were observed in dyspnea severity (MD -0.25, 95% CI -0.48 to -0.02; P=.03), health-related quality of life (MD -6.00, 95% CI -10.96 to -1.04; P=.02), and psychological outcomes including anxiety (MD -2.41, 95% CI -3.42 to -1.39; P<.001) and depression (MD -1.40, 95% CI -2.69 to -0.42; P=.03). The overall methodological quality of the included studies was suboptimal with most evidence rated as "low" or "very low" quality. Conclusions: MSG-assisted pulmonary rehabilitation demonstrates significant improvements in exercise capacity, respiratory symptoms, quality of life, and psychological well-being among patients with COPD. Despite potential benefits, the predominance of low-quality evidence highlights the necessity for risk-benefit assessment before clinical implementation. Future research priorities should include larger, methodologically rigorous RCTs, standardized intervention protocols, investigation of sustained therapeutic effects, and cost-effectiveness analyses to establish definitive evidence for optimal implementation of gaming technology in pulmonary rehabilitation programs.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.017 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.063 | 0.012 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; both teacher heads agree on what is shown here.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".