Effect of Video Game-Based Breathing Exercises on Respiratory Dysfunction in ACOS

Asthma and COPD are significant respiratory diseases that can coexist, referred to as Asthma-COPD Overlap Syndrome (ACOS). Patients with ACOS experience more severe clinical outcomes, including rapid decline in lung function, increased symptom burden, and reduced quality of life. Pulmonary rehabilitation-particularly breathing exercises-is a core non-pharmacological intervention recommended for this patient group. In recent years, video game-based applications have emerged as innovative tools that enhance motivation and participation in exercise programs. However, studies investigating the effects of video game-based breathing exercises in ACOS patients are extremely limited. Additionally, although dysfunctional breathing patterns are common in this group, few studies have addressed targeted interventions. The objective of the present study is to evaluate the effects of video game-based breathing exercises on dysfunctional breathing in ACOS patients.

Inclusion Criteria: * Aged between 40 and 74 years * Diagnosed with Asthma-COPD Overlap Syndrome (ACOS) * Nijmegen Questionnaire score ≥ 23 * No severe asthma * No severe COPD * In a stable condition (no acute exacerbation in the last 4 weeks) * To have the cognitive level suitable to adapt to video games Exclusion Criteria: * Contraindicated for pulmonary rehabilitation * Diagnosed with cancer * Having severe cardiovascular disease * History of thoracic surgery * Presence of acute infectious disease * Cognitive impairment * Presence of vertigo, epilepsy, or visual impairment