The impact of video game-based exercises on respiratory muscle strength and physical fitness after open cardiac surgery

The aim of this study was to investigate the effect of video game-based exercises on respiratory muscle strength and physical fitness in addition to a cardiac rehabilitation program after coronary artery bypass graft (CABG) surgery. Participants were divided into two groups: cardiac rehabilitation (CR) (n=16) and Video Game Based Exercise Training (VGBET) (n=17). The CR group received a 12-week routine CR program after surgery, and the VGBET group received video game-based breathing exercises with the 'Breathing Labs Breathing Games' application twice a day for 12 weeks in addition to the routine CR program. The GC group received aerobic exercise training 3 days a week for at least 150 minutes, with a session duration of 20-60 minutes, and a home program consisting of aerobic and strengthening exercises, while the VGBET group received an exercise program including aerobic activities with Xbox games of their choice in the unit 3 days a week. Maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) were used to assess respiratory muscle strength, Pulmonary Function Test (PFT) was used to assess respiratory function, Senior Fitness Test was used to assess physical fitness, and International Physical Activity Questionnaire-Short Form (IPAQ-SF) was used to determine the subjects' physical activity levels in daily life, The Hospital Anxiety and Depression Scale (HAD) was used to assess the severity of anxiety and depression, the EQ-5D scale was used to assess quality of life, the KATZ scale was used to assess independence in activities of daily living, the Visual Analog Scale was used to assess dyspnea and pain symptoms, and the Pittsburg Sleep Quality Index was used to assess sleep quality. Respiratory function and respiratory muscle strength increased in both groups after the intervention (p<0.05). Except for the eight-step up-and-go test, all physical fitness parameters, physical activity and daily living activity levels increased in both groups (p<0.05). No change was observed in eight-step up-and-go levels after the intervention in both groups (p>0.05). Depression and anxiety levels of the CR and CR+ VGBET groups decreased, and EQ-5D-3L, EQ-5D-3L VAS and PDQI levels increased after the intervention (p<0.05). The CR and CR+ VGBET groups showed similar improvements in depression, anxiety, EQ-5D-3L, EQ-5D-3L VAS and PDQI levels after the intervention. In the comparison between the groups, the percentage changes in inspiratory muscle strength and health-related quality of life scale EQ-5D-3L results were significantly higher in favor of CR+ VGBET. These findings suggest that video game-based exercise interventions have the potential to contribute to the recovery process of patients and improve inspiratory muscle strength and quality of life by providing an innovative alternative to traditional cardiac rehabilitation methods.