Evaluation of the effects of rehabilitation with the use of virtual reality in patients with chronic obstructive pulmonary disease

The objective of the study is to evaluate the usefulness of exercise training using the Xbox Kinect system during hospital rehabilitation of patients with COPD. In this project, it is proposed to: Implement and evaluate Xbox Kinect training session as a tool in pulmonary rehabilitation and compare the effects of a standard rehabilitation program with the results of the program enriched with sessions using X-box Kinect. For the study will be recruited 120 patients with COPD (II and III GOLD) Hospital Interior Ministry in Glucholazy. The subjects will be randomly assigned to 3 groups. Group I is the control group. Patients will participate in improving the existing models of pulmonary rehabilitation by Szczegielniak. Pulmonary rehabilitation program will last for three weeks Group II will participate in pulmonary rehabilitation by Szczegielniak models, in addition to participating in 20 minutes training using video games available for the Xbox Kinect system. Group III will participate in pulmonary rehabilitation by Szczegielniak models, but the training on a cycle ergometer or treadmill will be replaced by the Xbox Kinect system. Patients, depending on their exercise tolerance will be enrolled to appropriate model of rehabilitation and then undergo different types of physiotherapy treatment, mainly based on physical exercise on a bicycle ergometer. Patients with COPD will be enrolled to model B or C of PR by Szczegielniak based on the results of submaximal exercise and spirometry tests. Model B * specific respiratory exercises for 30 minutes - relaxation exercises for breathing muscles, strengthening exercises the diaphragm with resistance, exercises to increase costal or chest breathing, prolonged exhalation exercise, chest percussion, once a day for 30 min, 5-time a week; * training on a cycle ergometer or treadmill, twice a day for 20-30 min.- until the Heart Rate reaches 60% of the HRmax (220-age), * 30 minutes of fitness and respiratory exercises - coordination and balance exercises, stretching exercises using elastic bands, balls rehabilitation, sensory pillows. Performed in a standing position, kneeling, sitting, lying on side, abdomen and back. * walking / Nordic Walking (depending on weather and health condition of the patient) for 45 min.; * relaxation training by Shultz and Jacobson. The technique involves the daily practice of sessions that last around 15 minutes. During each session, the practitioner repeats a set of visualisations that induce a state of relaxation. Each session can be practiced in a position chosen amongst a set of recommended postures (for example, lying down, sitting meditation, sitting like a rag doll). The technique can be used to alleviate many stress-induced psychosomatic disorders. Model C * specific respiratory exercises for 30 minutes - relaxation exercises for breathing muscles, strengthening exercises the diaphragm with resistance, exercises to increase costal or chest breathing, prolonged exhalation exercise, chest percussion, once a day for 30 min, 5-time a week; * training on a cycle ergometer or treadmill, once a day for 20-30 min.- until the Heart Rate reaches 60% of the HRmax (220-age), * 30 minutes of fitness and respiratory exercises - coordination and balance exercises, stretching exercises using elastic bands, balls rehabilitation, sensory pillows. Performed in a standing position, kneeling, sitting, lying on side, abdomen and back. * walking / Nordic Walking (depending on weather and health condition of the patient) for 45 min.; * relaxation training by Shultz and Jacobson. The technique involves the daily practice of sessions that last around 15 minutes. During each session, the practitioner repeats a set of visualisations that induce a state of relaxation. Each session can be practiced in a position chosen amongst a set of recommended postures (for example, lying down, sitting meditation, sitting like a rag doll). The technique can be used to alleviate many stress-induced psychosomatic disorders. Interventions are delivered in a groups. Kinect training for II and III group: In each game participant is to score the highest number of points awarded for quantitative and qualitative elements. The subjects will be played in each game at a basic level. During participation in the session, patients will be equipped with a device for measuring the heart rate, so as not to exceed the value of training established during the initial investigation. If the patient does not reach the heart rate of the training session will be extended. Expected time for one session of 15-30 minutes. Each training session will be consisted of 4 Kinect Adventures games: * 20,000 Leaks - The player positions his/her limbs and head to plug cracks as sea creatures cause cracks and holes in the glass cube. Each game consists of three waves, which are timed and progress in difficulty as the game continues. As the game progresses the player may have to plug up to five cracks simultaneously requiring them to use their entire body. Each wave continues until time runs out or player is able to cover all cracks, points are awarded for each crack covered and for time remaining. * Curvy Creek - The player stands in a raft and must try to collect as many adventure pins as possible throughout the course by weight-shifting, side-stepping or reaching to steer the raft. The player loses points by crashing into barriers * Rally Ball - The player uses his/her limbs and head to hit balls at targets and blocks which are located in front of him/her. When specific targets are hit, the ball splits in to multiple balls which must be hit simultaneously, increasing the difficulty. This game consists of three rounds in which the player earns points for each target hit, balls collected, and remaining time. * Reflex Ridge - The player stands on a moving platform that travels through a wooden track course. Player must squat/duck and lean side-to-side in order to avoid obstacles. Pins can be earned by avoiding obstacles, reaching to collect pins, and remaining time. Game performance success will be evaluated as a number of points awarded to the participant. All interventions will take place in Hospital Interior Ministry in Glucholazy supervised by a physiotherapist