{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T13:09:26Z","timestamp":1790687366290,"version":"4.1.0"},"reference-count":90,"publisher":"JMIR Publications Inc.","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Internet Res"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The uptake of traditional pulmonary rehabilitation classes by patients with chronic obstructive pulmonary disease (COPD) is poor because of personal factors that prevent accessibility to the venue. Therefore, there is a need for innovative methods of pulmonary rehabilitation, and virtual reality (VR) could be a promising technology for patients with COPD to access services remotely.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to investigate whether VR improves compliance with pulmonary rehabilitation among patients with COPD, a particularly vulnerable patient group (Medical Research Council [MRC] 4 or 5), and whether VR provides a credible alternative to traditional pulmonary rehabilitation programs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was an 8-week patient trial using an innovative VR pulmonary rehabilitation program. A purposive sample of 10 patients with COPD graded MRC 4 or 5 and registered at a selected health care center and a hospital in Cumbria, United Kingdom, were included. Qualitative (focus groups and interviews) data were collected, and to further support the qualitative findings, quantitative data (self-report patient surveys) were gathered before and after the 8-week trial. The 5 self-reported surveys included the Patient Activation Measure, Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, Short Physical Performance Battery, and the Edmonton Frail Scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In a thematic analysis of the qualitative data, 11 themes emerged specific to delivering pulmonary rehabilitation using VR. The quantitative data further support the qualitative findings by revealing significant improvements in all physical measures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Overall, this study demonstrates how remotely supervised VR-based pulmonary rehabilitation could help to overcome current issues and limitations associated with providing this service to patients with COPD at scale.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/14178","type":"journal-article","created":{"date-parts":[[2020,4,10]],"date-time":"2020-04-10T00:08:01Z","timestamp":1586477281000},"page":"e14178","source":"Crossref","is-referenced-by-count":82,"title":["A Virtual Reality\u2013Supported Intervention for Pulmonary Rehabilitation of Patients With Chronic Obstructive Pulmonary Disease: Mixed Methods Study"],"prefix":"10.2196","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8594-6641","authenticated-orcid":false,"given":"Timothy","family":"Jung","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8718-3297","authenticated-orcid":false,"given":"Natasha","family":"Moorhouse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4930-7295","authenticated-orcid":false,"given":"Xin","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1617-768X","authenticated-orcid":false,"given":"Muhammad Farhan","family":"Amin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2020,7,7]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2012.11.016"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD003793.pub3"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1097\/HCR.0b013e3181be7c56"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1378\/chest.128.2.663"},{"issue":"4","key":"ref5","first-page":"475","volume":"43","author":"Lacasse, Y","year":"2007","journal-title":"Eura Medicophys"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1378\/chest.06-2418"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.3109\/15412555.2012.707258"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jphys.2017.05.010"},{"key":"ref9","unstructured":"NHS Greater Glasgow and Clyde20182020-05-11MRC Grade: Functional Ability \/ Breathlessness Scalehttp:\/\/www.nhsggc.org.uk\/about-us\/professional-support-sites\/cdm-local-enhanced-services\/copd\/symptoms\/mrc-grade\/"},{"key":"ref10","unstructured":"Royal College of Physicians London20172020-05-25Pulmonary Rehabilitation: Beyond Breathing Betterhttps:\/\/www.rcplondon.ac.uk\/projects\/outputs\/pulmonary-rehabilitation-beyond-breathing-better"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1093\/occmed\/kqx086"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-020750"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1177\/1479972310393756"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jphys.2017.02.002"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1017\/S1463423615000286"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.4104\/pcrj.2013.00062"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.3233\/NRE-172355"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1016\/j.jfma.2015.07.012"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1080\/09638288.2018.1459881"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.compbiomed.2015.03.011"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1016\/j.chb.2017.01.013"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.2522\/ptj.20150539"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.cd013195"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.2500\/aap.2015.36.3812"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2014.10.019"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.163.5.2101039"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1378\/chest.130.4.1117"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1177\/1049732311405801"},{"key":"ref29","unstructured":"CaseyMMulkernsAO?DonnellCMcDonnellTIntechOpen20192020-05-26Pulmonary Rehabilitation in COPD: Current Practice and Future Directionshttps:\/\/www.intechopen.com\/books\/copd-an-update-in-pathogenesis-and-clinical-management\/pulmonary-rehabilitation-in-copd-current-practice-and-future-directions"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1016\/j.maturitas.2016.07.005"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00125707"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2006.01.026"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.2147\/copd.s3375"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.1016\/j.genhosppsych.2006.11.005"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.1002\/1099-1166(200012)15:12<1090::aid-gps249>3.0.co;2-l"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.1016\/s0025-7125(16)31294-9"},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.1080\/08039480310000824"},{"key":"ref38","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2018.11.006"},{"key":"ref39","doi-asserted-by":"publisher","DOI":"10.1038\/s41533-018-0085-7"},{"key":"ref40","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.98.12020363"},{"key":"ref41","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.5257"},{"key":"ref42","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD010255.pub2"},{"key":"ref43","doi-asserted-by":"publisher","DOI":"10.2196\/rehab.7511"},{"key":"ref44","doi-asserted-by":"publisher","DOI":"10.1111\/resp.12966"},{"key":"ref45","doi-asserted-by":"publisher","DOI":"10.1080\/1360144x.2016.1181071"},{"key":"ref46","doi-asserted-by":"publisher","DOI":"10.2196\/10201"},{"key":"ref47","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-013682"},{"key":"ref48","doi-asserted-by":"publisher","DOI":"10.1177\/0269215513512495"},{"key":"ref49","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph10116184"},{"key":"ref50","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.8640"},{"key":"ref51","doi-asserted-by":"publisher","DOI":"10.1080\/09638280802062553"},{"key":"ref52","doi-asserted-by":"publisher","DOI":"10.1089\/tmj.2012.0272"},{"key":"ref53","doi-asserted-by":"publisher","DOI":"10.1177\/1357633X14552382"},{"key":"ref54","doi-asserted-by":"publisher","DOI":"10.1111\/hex.12443"},{"key":"ref55","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2018.04.033"},{"key":"ref56","unstructured":"World Health Organization20172020-05-11Chronic Obstructive Pulmonary Disease (COPD)https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/chronic-obstructive-pulmonary-disease-(copd)"},{"key":"ref57","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61728-0"},{"key":"ref58","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(14)70359-6"},{"key":"ref59","doi-asserted-by":"crossref","DOI":"10.1017\/CBO9781139600484","author":"Lomborg, B","year":"2013","journal-title":"Global Problems, Smart Solutions: Costs and Benefits"},{"key":"ref60","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp08X342363"},{"key":"ref61","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S90812"},{"key":"ref62","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD002990.pub3"},{"key":"ref63","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2013.02.009"},{"key":"ref64","doi-asserted-by":"publisher","DOI":"10.1089\/cpb.2006.9.123"},{"key":"ref65","doi-asserted-by":"publisher","DOI":"10.2340\/16501977-0802"},{"key":"ref66","doi-asserted-by":"publisher","DOI":"10.1186\/1743-0003-7-15"},{"key":"ref67","doi-asserted-by":"publisher","DOI":"10.1109\/vr.2013.6549371"},{"key":"ref68","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.7467"},{"key":"ref69","doi-asserted-by":"publisher","DOI":"10.1620\/tjem.228.69"},{"issue":"3","key":"ref70","first-page":"254","volume":"10","author":"Rahman, S","year":"2010","journal-title":"World Appl Sci J"},{"key":"ref71","doi-asserted-by":"publisher","DOI":"10.3233\/NRE-2012-00804"},{"key":"ref72","doi-asserted-by":"publisher","DOI":"10.2196\/mental.5801"},{"key":"ref73","doi-asserted-by":"publisher","DOI":"10.1016\/j.ridd.2012.01.017"},{"key":"ref74","doi-asserted-by":"publisher","DOI":"10.1177\/0269215511406757"},{"key":"ref75","doi-asserted-by":"publisher","DOI":"10.1016\/j.jphys.2015.05.017"},{"key":"ref76","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbmt.2018.06.006"},{"key":"ref77","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD008349.pub4"},{"key":"ref78","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2003.09.020"},{"key":"ref79","doi-asserted-by":"publisher","DOI":"10.3109\/09638288.2012.670036"},{"key":"ref80","doi-asserted-by":"publisher","DOI":"10.1097\/WCO.0b013e3283402af5"},{"key":"ref81","doi-asserted-by":"publisher","DOI":"10.1038\/nrn3122"},{"key":"ref82","doi-asserted-by":"publisher","DOI":"10.1177\/2055207616641302"},{"key":"ref83","doi-asserted-by":"publisher","DOI":"10.3402\/qhw.v9.26152"},{"key":"ref84","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"ref85","doi-asserted-by":"publisher","DOI":"10.3109\/02699052.2012.661118"},{"key":"ref86","doi-asserted-by":"publisher","DOI":"10.1080\/09638280600841117"},{"key":"ref87","doi-asserted-by":"publisher","DOI":"10.1053\/apnu.2002.36234"},{"key":"ref88","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2013.11.021"},{"key":"ref89","doi-asserted-by":"publisher","DOI":"10.1016\/j.chb.2016.04.033"},{"key":"ref90","unstructured":"British Lung Foundation20182020-05-11Chronic Obstructive Pulmonary Disease (COPD) Statisticshttps:\/\/statistics.blf.org.uk\/copd"}],"container-title":["Journal of Medical Internet Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.jmir.org\/2020\/7\/e14178","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T18:04:16Z","timestamp":1782842656000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jmir.org\/2020\/7\/e14178"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,7]]},"references-count":90,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.2196\/14178","relation":{"has-preprint":[{"id-type":"doi","id":"10.2196\/preprints.14178","asserted-by":"object"}]},"ISSN":["1438-8871"],"issn-type":[{"value":"1438-8871","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,7]]}}}