The effects of Nintendo Wii exergaming and inspiratory muscle training on cardiopulmonary capacity, physical performance, and quality of life in older patients with heart failure: a randomized controlled intervention study

BACKGROUND: Older adults with heart failure (HF) often face barriers to participating in center-based cardiac rehabilitation (CR). Home-based strategies such as exergaming and inspiratory muscle training (IMT) may offer viable alternatives. This study aimed to compare the efficacy of these two interventions and inform individualized home-based CR programs.METHODS: Thirty-one older adults with HF were randomized into Nintendo Wii (NW), IMT, or control groups. The NW group received supervised exergaming three times per week for 8 weeks. The IMT group performed unsupervised breathing exercises twice daily at 30% of maximal inspiratory pressure. The control group received no intervention. All groups were provided with educational materials. Primary outcomes included physical performance, frailty, sarcopenia risk, functional status, and muscle strength. Secondary outcomes were pulmonary function, 6-min walk distance (6MWD), respiratory muscle strength, and health-related quality of life (HRQoL). Assessments were repeated at week 8.RESULTS: Eighteen participants (N.=6 per group) completed the study. The NW group showed trends toward improvement in sarcopenia risk, 6MWD, and HRQoL, while the IMT group showed moderate gains in 6MWD and inspiratory strength. There were significant differences between groups compared to the control group but did not exceed the minimum clinically important difference (MCID) thresholds. The overall dropout rate was 42%, mainly due to health issues and COVID-19 concerns. No adverse events were reported. Both interventions were reported as feasible and safe.CONCLUSIONS: NW and IMT appear to be feasible and safe for older adults with limited access to conventional CR. Further large-scale studies are warranted.