Virtual reality–enhanced multimodal rehabilitation to improve heart and lung fitness after CABG

Effects of Multimodal Virtual Reality-based Rehabilitation on Dyspnea, Cardiorespiratory Fitness, Left Ventricular Ejection Fraction, and Quality of Life in CABG Phase II

This trial tests whether adding virtual-reality nature scenes to a multimodal exercise program helps people recovering from CABG improve breathlessness, cardiorespiratory fitness, and quality of life.

Quick facts

• Phase: NA
• Study type: Interventional
• Enrollment: 66 (estimated)
• Ages: 30 Years to 60 Years
• Sex: All
• Sponsor: Riphah International University (other)
• Locations: 1 site (Lahore, Punjab Province)
• Trial ID: NCT07331558 on ClinicalTrials.gov

What this trial studies

This randomized trial will enroll 66 patients in CABG Phase II and assign them by block randomization to three groups: in-clinic multimodal circuit training with VR nature scenes, in-clinic multimodal circuit training without VR, or multimodal circuit training delivered by telerehabilitation. All groups receive weight-bearing Liuzijue Qigong as a baseline component and follow the same circuit-based exercise content. Primary and secondary outcomes include the Dyspnea-12 questionnaire, Cooper 12-minute walk/run test for cardiorespiratory fitness, echocardiographic LVEF, EQ-5D-5L for quality of life, and PSQI for sleep quality. The study compares the added effect of immersive VR and of remote delivery against standard in-clinic multimodal rehabilitation.

Who should consider this trial

Good fit: Adults aged 30–60 who are about 12 weeks post-CABG, have LVEF <40%, persistent dyspnea rated ≥5/10, and preserved cognition (MoCA >24) are the intended participants.

Not a fit: Patients with unstable angina, uncontrolled hypertension, pacemakers or atrial fibrillation, severe valvular disease, symptomatic peripheral arterial disease, significant COPD, recent noncardiac surgery, shoulder injury, kinesiophobia, epilepsy, vertigo, or major vision impairment are excluded and unlikely to benefit from this program.

Why it matters

Potential benefit: If successful, adding VR could reduce breathlessness and improve exercise capacity and quality of life after CABG recovery.

How similar studies have performed: Small pilots and feasibility studies have shown promising results for VR in cardiac and pulmonary rehabilitation, but high-quality randomized evidence specifically in CABG Phase II is limited.

Eligibility criteria

Inclusion Criteria:

* Patients who underwent CABG surgery will be recruited after twelve weeks
* Both male and female
* Age 30-60 years old
* LVEF of \< 40%
* Persistent dyspnea with a self-rated intensity of ⩾5 (out of 10) on a visual analogue dyspnea scale (this dyspnea rating was only used as an inclusion criterion and not as a measure for outcome)
* Preserved cognitive function (Montreal Cognitive Assessment score \>24)

Exclusion Criteria:

* Patient with recurrent history of CABG
* Had a non-cardiac surgical procedure ≤2 months prior to recruitment
* Unstable angina, uncontrolled hypertension (blood pressure \>180/100 mmHg), a pacemaker or atrial fibrillation, documented peak orifice area valve stenosis, symptomatic peripheral arterial disease that limits exercise capacity.
* Documented chronic obstructive pulmonary disease (FEV1 \<60% and FVC \<60%)
* Any shoulder impairment that would limit exercise participation
* Patients with Kinesiophobia
* Epilepsy, vertigo, eyesight impairment (conditions contraindicated for VR)

Where this trial is running

Lahore, Punjab Province

• Riphah International University — Lahore, Punjab Province, Pakistan (RECRUITING)

Study contacts

• Principal investigator: Wajeeha Zia, PP-DPT — Riphah International University
• Study coordinator: Wajeeha Zia, PP-DPT

Conditions: CABG, multimodal treatment, virtual reality, telerehabilitation, education, Circuit Based Exercise, diet, psychological well-being