Impact of Virtual Reality Training on Quality of Life, Diaphragmatic Excursion, Pulmonary Function, and Respiratory Muscle Strength After Upper Abdominal Surgeries: A Randomized Controlled Study.

Abstract

Importance: Adding virtual reality exercise (VRE) to conventional physical therapy (CPT) may reduce upper abdominal surgery complications.

Objective: The objective of the study was to evaluate the effects of VRE on quality of life (QoL), diaphragmatic excursion, pulmonary function, respiratory muscle strength, and functional capacity after upper abdominal surgeries.

Design: This was a randomized controlled trial.

Setting: The setting was a physical therapy outpatient clinic.

Participants: Participants were 120 patients (20-65 years old) with upper abdominal surgeries. They were randomly assigned to a VRE group or a control group.

Interventions: The VRE group received 5 interactive games plus CPT; the control group received CPT alone, with supervised sessions 5 times weekly for 8 weeks.

Main outcomes and measures: The primary outcome was QoL. Secondary outcomes included diaphragmatic excursion, forced vital capacity, forced expiratory volume in 1 second, peak expiratory flow, maximum inspiratory and expiratory pressures, and functional capacity, measured at baseline and after intervention. Following trial registration and prior to data analysis, the primary outcome was revised from pulmonary function to QoL to better reflect the multidimensional objectives of the intervention; all originally registered outcomes were retained and reported as secondary outcomes.

Results: After intervention, the results revealed statistically significant differences between groups in QoL domains, with more favor to the VRE group. Mean differences and 95% CIs between the groups were 20.28 (95% CI = 18.09 to 22.48) for physical health, 23.8 (95% CI = 21.9 to 25.7) for psychological health, 22.98 (95% CI = 20.92 to 25.05) for social relationships, and 21.77 (95% CI = 19.8 to 23.73) for environmental health.

Conclusions: Integrating VRE with CPT produced clinically meaningful short-term improvements in QoL, pulmonary function, respiratory muscle strength, diaphragmatic excursion, and functional capacity compared with CPT alone following upper abdominal surgery.

Relevance: These findings support the use of VRE as an effective adjunct to postoperative rehabilitation. However, the results should be interpreted with caution due to the short follow-up period and the inability to blind participants to group allocation.