Effect of Motion-Controlled Video Games-Based Virtual Reality Exercise on Patients with Post-COVID-19 Condition…, 2025, Polat et al.

[SNT Gatchaman]

Effect of Motion-Controlled Video Games-Based Virtual Reality Exercise on Patients with Post-COVID-19 Condition: A Randomized Controlled Trial

Spoiler: Authors

Polat, Musa; Oba, Pınar; Karadağ, Ahmet

OBJECTIVE
Virtual reality (VR) exercises may offer a comprehensive rehabilitation approach for many conditions. This study primarily aimed to evaluate the effectiveness of VR exercises compared with conventional exercise in reducing pain intensity in individuals with post-COVID-19 condition (PCC). Secondary analyses explored their effects on fatigue, functional capacity, mood, and quality of life.

MATERIALS AND METHODS
A single-center, randomized, assessor-blinded intervention study was conducted with 79 individuals between July 2021 and February 2022. The primary outcome was pain intensity measured using the Visual Analog Scale (VAS). Secondary outcomes included mood (Hospital Anxiety and Depression Scale, HADS), fatigue (Fatigue Severity Scale, FSS), quality of life (SF-12), and functional exercise capacity (6-Minute Walk Test, 6 MWT). Participants completed supervised exercise sessions 3 times weekly for 30–45 min over 8 weeks. The conventional exercise program involved moderate-intensity aerobic, strength, stretching, and neuromuscular exercises. VR exercises were delivered semi-immersively using motion-controlled video games. Time × group interactions were analyzed using linear mixed-effects model.

RESULTS
In both groups, 6MWT, SF-12 physical and mental components increased, while VAS, FSS and HADS anxiety and depression scores decreased. Time-group interaction was observed in favor of VRG for VAS [F(1, 59.4) = 56.3, p = 0.001], as well as HADS-D [F(1, 54.6) = 7.40, p = 0.008] and FSS [F(1, 61.4) = 8.96, p = 0.004].

CONCLUSIONS
While structured exercise improves the physical and psychological conditions of individuals with PCC, virtual reality exercises stand out in pain, also fatigue, and depression.

Web | DOI | PDF | Healthcare | Open Access

 

[SNT Gatchaman]

"Guys. Exercise therapy-based rehabilitation, but with virtual reality."

"Yeah cool. Let's have it unblinded and rely on subjective outcomes, with no long-term follow-up."

"Sounds promising."

 

[Utsikt]

2.7. Adverse Events Monitoring​

Participants were monitored throughout all sessions for potential adverse events, including dizziness, nausea, headache, visual discomfort, muscle or joint pain, and excessive fatigue, cardiovascular or autonomic symptoms such as palpitations, shortness of breath, or lightheadedness by the physiotherapist. Post-exertional malaise (PEM) was specifically monitored by questioning participants before and after each session about disproportionate fatigue, muscle soreness, or prolonged recovery.

It’s almost amusing to look at how confused the researchers are about PEM.

This is how they describe it in the limitations:

Finally, participants were not assessed for PEM using a standardized instrument. However, we used FITT-VP principles to determine exercise intensity and routinely questioned participants regarding symptoms of PEM and other adverse effects before and after each session. No participants discontinued their sessions for reasons related to PCC symptoms or exercise intolerance.

Look at the misleading scales on the graphs! Surely this can’t get published:


It doesn’t look like there was much of a dose response relationship:

The time × group interaction was not statistically significant for 6MWT [F(1, 48.8) = 1.90, p = 0.175], HADS-A [F(1, 59.98) = 0.28, p = 0.601], SF-12 Physical [F(1, 69.54) = 0.009, p = 0.926] and SF-12 Mental [F(1, 71.4) = 0.76, p = 0.388] (Table 3).

It also looks like there were very few differences between the groups, but the authors don’t seem too bothered about it.

They also appear to be fans of the deconditioning and activity avoidance models:

Exercise is a recognized method for alleviating fatigue that arises in the PCC [5,30,31,32,33,35,38,43,44]. However, conventional exercise may be perceived by patients as an unpleasant obligation, leading to low motivation and poor compliance, also can exacerbate symptoms [45]. Furthermore, fatigue traps individuals in a vicious cycle, leading to a decrease in physical activity, a subsequent decline in fitness, and ultimately, intensified fatigue [39].

VR exercise, by contrast, may help break this obstacle by transforming exercise into a more engaging, motivating, and enjoyable experience, thereby freeing individuals from this cycle [43]. Evidence indicates that VR environments in PCC may increase compliance with training programs and enhance participant satisfaction [43]. It has also been reported that the gamified version of VR leads to physiological improvements that directly reduce fatigue, such as raising the fatigue threshold [18]. Ahmad et al. similarly found that VR exercise reduced fatigue but found no difference compared to conventional exercise [43]. That is likely due to their use of treadmill-based VR rather than motion-controlled video game–mediated exercise.

 

[rvallee]

The premise makes no sense. It's equivalent to comparing walking on flat ground and walking the same distance on a treadmill with a viewscreen showing beautiful vistas. There is not a damn thing that the VR component involves that changes anything. Parts of medicine are becoming a giant farce.

They can say what they want with their cheap excuses about motivation, it's never been shown to be a factor. WTH is this damn nightmare? It's like the whole of humanity is a bunch of 12 years-old.

 

[rvallee]

That is likely due to their use of treadmill-based VR rather than motion-controlled video game–mediated exercise.

No, it bloody isn't, WTH?

OK enough for today.