title: In-class Active Video Game Supplementation and Adherence to Cardiac Rehabilitation.
abstract: OBJECTIVE
  The application of active video games (AVGs) during cardiac rehabilitation (CR) sessions could potentially facilitate patient adherence. The feasibility, safety, and efficacy of in-class AVG supplementation as an alternative to conventional phase 2 programs were investigated.
  
  
  METHODS
  A pilot, evaluator-blinded, intention-to-treat, randomized controlled trial recruited 32 low-moderate risk CR participants and allocated them to conventional or AVG-supplemented exercise. Both groups experienced equal exercise loads for 6 weeks. Patients were assessed at baseline, end of the program, and after an 8-week followup. Adherence and safety-related outcomes were the primary endpoints. Secondary outcomes included change in exercise capacity, daily physical activity (PA), energy expenditure (EE), and psychometric profiling.
  
  
  RESULTS
  Patients (males 81%; 60 ± 10 years) presented with typical cardiovascular risk factors and similar baseline characteristics. Participants did not perceive an increased risk of injury and were more interactive. At the end of the program, there was a lower tendency for dropping out (6% vs 19%, P > .05), a significant improvement in PA (322 vs 247 arbitrary acceleration units/min, P = .047) and related EE per body weight (13 vs 11 kcal/kg/d, P = .04) among AVG participants compared with controls. No significant differences between groups for adverse medical events, exercise capacity, affect toward exercise, anxiety, depression, or quality-of-life changes were reported.
  
  
  CONCLUSIONS
  The additional use of AVGs during CR sessions is feasible, safe, and significantly improved daily PA and EE. A dropout reduction trend among its users, which needs to be confirmed in a larger trial, raises awareness to AVG supplementation as a promising strategy to increase CR adherence.
authors.affiliation: School of Medicine, Trinity College, University of Dublin, Dublin, Ireland (Drs Ruivo and Gormley); University Hospital Kerry and University College Cork, Cork, Ireland (Mss Karim and O'Shea and Drs Keary and O'Brien) and Faculty of Medicine, University of Porto, Oporto, Portugal (Dr Oliveira).
authors.forename: Jorge Manuel Arsénio Dos Santos
authors.initials: JMADS
authors.lastname: Ruivo
authors.forename: Kay
authors.initials: K
authors.lastname: Karim
authors.forename: Roisin
authors.initials: R
authors.lastname: OʼShea
authors.forename: Rosa Celeste Santos
authors.initials: RCS
authors.lastname: Oliveira
authors.forename: Louis
authors.initials: L
authors.lastname: Keary
authors.forename: Claire
authors.initials: C
authors.lastname: OʼBrien
authors.forename: John Patrick
authors.initials: JP
authors.lastname: Gormley
mesh_terms: D000072038:Cardiac Rehabilitation / Q000379:methods*; D015444:Exercise; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010865:Pilot Projects; D012307:Risk Factors; D016896:Treatment Outcome; D018910:Video Games