title: A Feasibility Study of Virtual Reality Exercise in Elderly Patients with Hematologic Malignancies Receiving Chemotherapy.
abstract: OBJECTIVE
  Adherence to rehabilitation exercise is much lower in patients with hematologic malignancies (22.5-45.8%) than in patients with solid tumors (60-85%) due to the administration of more intensive chemotherapeutic regimens in the former. Virtual reality exercise can be performed even in a biological clean room and it may improve the adherence rates in elderly patients with hematologic malignancies. Thus, in this pilot study, we aimed to investigate the feasibility and safety of virtual reality exercise intervention using Nintendo Wii Fit in patients with hematologic malignancies receiving chemotherapy.
  
  
  METHODS
  In this feasibility study, 16 hospitalized patients with hematologic malignancies aged ≥60 years performed virtual reality exercise for 20 minutes using the Nintendo Wii Fit once a day, five times a week, from the start of chemotherapy until hospital discharge. The adherence rate, safety, and physical and psychological performances were assessed.
  
  
  RESULTS
  The adherence rate for all 16 patients was 66.5%. Nine patients completed the virtual reality exercise intervention with 88 sessions, and the adherence rate was 62.0%. No intervention-related adverse effects >Grade 2, according to National Cancer Institute Common Terminology Criteria for Adverse Events version 3.0, were observed. We noted maintenance of the physical performance (e.g., Barthel index, handgrip strength, knee extension strength, one-leg standing time, and the scores of timed up and go test and Instrumental Activities of Daily Living) and psychosocial performance (e.g., score of hospital anxiety and depression scale).
  
  
  CONCLUSIONS
  Virtual reality exercise using the Wii Fit may be feasible, safe and efficacious, as demonstrated in our preliminary results, for patients with hematologic malignancies receiving chemotherapy.
authors.affiliation: Division of Hematology and Rheumatology, Teikyo University Chiba Medical Center, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Tsuda
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Sudo
authors.forename: Goro
authors.initials: G
authors.lastname: Goto
authors.forename: Makiko
authors.initials: M
authors.lastname: Takai
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Itokawa
authors.forename: Takahiro
authors.initials: T
authors.lastname: Isshiki
authors.forename: Naoko
authors.initials: N
authors.lastname: Takei
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Tanimoto
authors.forename: Tsunehiko
authors.initials: T
authors.lastname: Komatsu
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D005081:Exercise Therapy / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D006689:Hodgkin Disease / Q000523:psychology / Q000534:rehabilitation*; D006801:Humans; D007938:Leukemia / Q000523:psychology / Q000534:rehabilitation*; D008228:Lymphoma, Non-Hodgkin / Q000523:psychology / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D016896:Treatment Outcome; D018910:Video Games; D063367:Virtual Reality Exposure Therapy / Q000379:methods