Authors (including presenting author) :
LI H(1), WONG SY(1), TSANG SW(1), CHAN FL(1), LAM SL(1), CHIANG KH(1)
Affiliation :
(1)Department of Physiotherapy, Shatin Hospital
Keyword 1: :
Cardiopulmonary Rehabilitation
Keyword 2: :
Virtual Reality
Keyword 3: :
Dyspnea Management
Introduction :
Dyspnea is a highly prevalent and distressing symptom among patients with cardiopulmonary conditions, significantly limiting physical activity, quality of life, and participation in rehabilitation. Conventional dyspnea management strategies, including Active Cycle of Breathing Techniques, and pacing techniques often have low adherence, particularly in elderly patients suffering from intense dyspnea during inpatient stays. Virtual Reality (VR) provides an immersive audio-visual environment that supports focused relaxation breathing, a crucial component in managing dyspnea. This technology offers an engaging, tech-assisted alternative to conventional rehabilitation for patients seeking enhanced symptom control. Emerging evidence suggests that VR-based interventions may reduce perceived breathlessness and improve exercise tolerance when integrated with physical training. However, its application in acute inpatient cardiopulmonary rehabilitation remains underexplored.
Objectives :
This pilot study aimed to evaluate the feasibility and preliminary effectiveness of integrating immersive VR-guided relaxation breathing exercises with conventional physical task training for dyspnea management in clinically stable inpatients with cardiopulmonary conditions.
Methodology :
23 clinically stable patients (mean age 79.1 ± 7.2 years) admitted to the Medical and Geriatrics wards of Shatin Hospital between July and December 2025 were recruited. Inclusion criteria included diagnosis of COPD, heart failure, chest infection, or dyspnea that limited physical function. Participants received an average of 5.3 VR-guided breathing sessions, each lasting 10 to 15 minutes. Sessions were delivered using a commercially available standalone VR headset and included guided relaxation breathing exercises at rest as well as during functional physical tasks (sit-to-stand, step-ups, and standing tolerance training). Pre- and post-intervention assessments were conducted using validated tools: the Chinese version of the Dyspnea-12 questionnaire (D-12), Modified Functional Ambulation Category (MFAC), Elderly Mobility Scale (EMS), Six-Minute Walk Test (6MWT), and Borg Rating of Perceived Exertion (RPE) scale. Statistical analysis was performed with the Wilcoxon signed-rank test.
Result & Outcome :
All 23 participants completed the intervention without major adverse events. Statistically significant improvements (p< 0.05) were observed across all outcome measures: Dyspnea-12 total score, MFAC, EMS, 6MWT distance, and RPE during equivalent physical tasks. The magnitude of change in D-12 scores reached the minimal clinically important difference reported in previous COPD studies. These preliminary findings suggest that integrating VR-guided relaxation breathing with physical task training is feasible, well-tolerated, and appears to offer clinically meaningful benefits for dyspnea management in inpatient cardiopulmonary rehabilitation.
