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How do people with COPD experience telerehabilitation using exergaming? A qualitative study
Jenny Danielsbacka1,2, Wetter Edvin Diskin3, Lowie E G W Vanfleteren3,4,5
1Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Gothenburg, Sweden.
Background:
Centre-based pulmonary rehabilitation improves symptoms and exercise tolerance in patients with chronic obstructive pulmonary disease (COPD), but barriers such as accessibility and adherence limit participation. Home-based pulmonary telerehabilitation (PTR) may provide a feasible alternative, but patient perspectives are not well understood. This study explored the experiences and perceptions of patients with COPD regarding participation in a home-based PTR, using an exergaming system.
Methods:
This qualitative study design used individual semi-structured interviews with 11 patients with COPD who had completed a 12-week exergaming PTR programme. The interviews were transcribed verbatim and analysed via inductive content analysis, as outlined by Graneheim and Lundman.
Results:
An overarching theme was identified as "well-functioning technology at home, with continuous support from a physiotherapist, increases the opportunities for people with COPD to exercise on their own individual terms". Three major categories and nine subcategories captured participants' experiences. The first major category, "technology and equipment challenge and enable exercise at home", captured experiences of flexibility, playful feedback, and motivation, but also frustration with technical issues and limited space. The second main category, "Getting the right support adds value when exercising with exergaming", included reassurance, motivation, and enhanced self-efficacy through physiotherapist feedback, monitoring, and individual adaptation. The third category, "there are considerable challenges for people with COPD regarding exercise", encompassed symptom variability, the need to balance effort with daily capacity, and mixed experiences of competitive elements, although some participants reported functional improvements and reduced fear of exertion.
Conclusion:
Home-based exergaming PTR was acceptable and motivating when the technology was reliable and physiotherapist support was sustained. Programmes should prioritise robust equipment, clear feedback, and individualised exercise to enhance adherence and long-term benefit.
Trial Registration:
The study is registered in the database FOU i Sverige (R&D in Sweden) with registration number: 273,768, date for registration: April 1, 2020.
