Physiological response during activity programs using Wii-based video games in patients with cystic fibrosis (CF)

Patients with cystic fibrosis (CF) are characterized by an abnormal ventilation response that limits the exercise capacity. Exercise training increases exercise capacity, decreases dyspnea and improves health-related quality of life in CF. Adherence to pulmonary rehabilitation programs is a key factor to guarantee optimal benefits and a difficult goal in this population.The aim of this study was to determine the physiological response during three Nintendo Wii™ video game activities (VGA) candidates to be used as training modalities in patients with CF. Method: 24 CF patients (age 12.6±3.7years; BMI 18.8±2.9kgm^-2; FEV₁ 93.8±18.8%pred) were included.All participants performed, on two separate days, 3 different VGA: 1) Wii Fit Plus (Wii-Fit); 2) Wii Active (Wii-Acti), and 3) Wii Family Trainer (Wii-Train), in random order during 5min. The obtained results were compared with the 6-min walk test (6MWT). The physiological variables [oxygen uptake (VO₂), minute ventilation (V_E), and heart rate (HR)] were recorded using a portable metabolic analyzer. Results: During all VGA and 6MWT, VO₂ reached a plateau from the 3rd min. Compared with the 6MWT (1024.2±282.2mLm^-1), Wii-Acti (1232.2±427.2mLm^-1) and Wii-Train (1252.6±360.2mLm^-1) reached higher VO₂ levels during the last 3min (p<0.0001 in both cases), while Wii-Fit (553.8±113.2mLm^-1) reached significantly lower levels of VO₂ (p<0.001). Similar effects were seen for the ventilatory volume (V_E). No differences in dyspnea and oxygen saturation were seen between the different modalities. All patients were compliant with all three Wii™ modalities. Conclusion: Active video game are well tolerated by patients with CF. All the modalities evaluated imposed a constant load but were associated with different physiological responses reflecting the different intensities imposed. Wii-Acti and Wii-Train impose a significantly high metabolic demand comparable to the 6MWT. Further research is needed to evaluate the effects of VGA as a training program to increase exercise capacity for CF patients.