Feasibility of a Tele-game-based Exercise (Tele-exergame) Program to Prevent Deconditioning in Hospitalized COVID-19 Patients

NCT04743401 | Completed Results DMC

• 2 other identifiers: F3731-P42402
• Study Type: interventional
• Target: 54
• Locations: 1 country
• Sites: 1

Brief Summary

Conventional in-hospital mobility programs are challenging to deliver to hospitalized infected patients (e.g., COVID-19) due to infection risk to staff, staffing shortages, and potential exposure of other patients. This study evaluates a tele-exergame mobility program, a self-administered, game-based exercise intervention guided by foot-worn sensors and step-by-step interactive guidance on a tablet. The platform promotes strength, balance, and flexibility while enhancing patient motivation and engagement through cognitively demanding gamified tasks, with remote supervision and no to minimum direct physical contact.

Conditions

Inpatient; Hospitalized; COVID 19; Rehabilitation

Keywords

gaming; exer-gaming; telemedicine; inpatient; deconditioning; mobility; rehabilitation; virtual; persons under investigation for COVID; PUI

Outcome Measures

Primary Outcomes (1)

• Number of Participants Meeting Feasibility Criteria of the Tele-Exergame Program

  Feasibility was assessed using three metrics. Metric 1: Number of participants able to independently complete at least one 3-minute Tele-Exergame session guided by the interactive tablet, assessed in both groups, as both the intervention and control groups performed one 3-minute session at baseline to establish feasibility. Metric 2: Number of participants who dropped out within the first three days of inpatient stay. For the intervention group, dropout was defined as not using the Tele-Exergame on two consecutive days for any reason, withdrawal of consent, unwillingness to continue participation, or any adverse event causing inability to continue exercise (e.g., death, unconsciousness, delirium, or clinical deterioration). For the control group, dropout was defined as self-reported inability to perform any in-hospital exercise, withdrawal of consent, or study dropout. Metric 3: Number of participants with intervention-related adverse events.

  Metric 1: Baseline (during hospitalization). Metric 2: First 3 days of inpatient stay. Metric 3: From enrollment through hospital discharge (an average of 1 week)

Secondary Outcomes (2)

• Katz Activities of Daily Living Scale

  4 weeks post hospital discharge

• Life Space

  30 days post hospital discharge

Study Arms (2)

Tele-exergame arm

EXPERIMENTAL

Participants will receive standard of care plus the Tele-Exergame mobility program. The intervention is a self-administered, game-based exercise program in which foot-worn sensors track body movement and a tablet provides step-by-step interactive guidance, enabling participants to complete exercises independently without in-person supervision. At baseline, participants will complete a single 3-minute session of the Tele-Exergame to evaluate the feasibility and acceptability of self-administered exercise using the platform. Participants will then be asked to continue using the Tele-Exergame for the duration of hospitalization, with sessions performed twice daily, lasting 3 to 10 minutes based on patient ability, and a minimum of one session per day for at least three consecutive days.

Other: Tele-exergaming Tablet

Convention care or control group

NO INTERVENTION

Participants will receive standard of care only, including routine in-hospital care and any mobility encouragement provided as part of usual practice. At baseline, participants will complete a single 3-minute session of the Tele-Exergame to evaluate the feasibility and acceptability of self-administered exercise using the platform. Beyond this single baseline session, no Tele-Exergame or sensor-based exercise intervention will be provided.

Interventions

Tele-exergaming Tablet OTHER

The Tele-Exergame is a self-administered, tablet-based exercise platform guided by foot-worn sensors. The platform virtually supervises exercise tasks and coaches patients to perform evidence-based foot and ankle exercises designed to improve balance, cognition, and lower extremity vascular health. Foot-worn sensors track body movement in real time, while the tablet provides step-by-step interactive guidance, enabling patients to complete exercises independently without in-person supervision or direct physical contact. The program uses a game-based approach, similar to playing a video game, which increases patient motivation and engagement in the cognitively demanding exercise program. Sessions are performed twice daily, lasting 3 to 10 minutes based on patient ability, for the duration of hospitalization

Tele-exergame arm

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Participants: Men or women Veterans with COVID-19 or PUI or hospitalized patients with duration of admission anticipated to be greater than 72 hours admitted to MEDVAMC.
• Length of stay: Anticipated length of stay at least 3 days.
• Ambulatory. Self-report of being ambulatory with or without an assistive device in the 2 weeks before admission.

You may not qualify if:

• ICU admission: The investigators will exclude those admitted to ICU at any point in their hospital stay.
• Admission of observation only: These patients will be excluded as length of stay is usually anticipated to be less than 3 days
• Median life expectancy: Those with imminently terminal (death expected in the next 30 days) will be excluded.
• Cognitive impairment: The investigators will exclude those with delirium, dementia, or severe cognitive impairment
• Medical condition: The investigators will exclude those who have any medical diagnosis deemed by the primary physician to be a contraindication to ambulation (i.e.: unstable from pulmonary embolus, unstable angina, severe hemodynamic instability etc.)
• Foot problem: The investigators will exclude those who have active foot ulcer or infection or major lower extremities amputation.
• Vision or hearing problems: The investigators will exclude those with hearing or visual problems that cannot be corrected with medical devices (glasses or hearing aids). Hearing or visual problems can limit their ability to interact with the exergame platform.
• lack of capacity to consent, and inability or unwillingness to participate regularly in the exercise program;
• unable to communicate in English or Spanish, or unlikely to fully comply with the follow-up protocol (e.g., lack of caregiver support to safely perform exercise tasks at home or complete the questionnaires).
• Ongoing treatment: The investigators will NOT exclude those who are participating in standard of care physical therapy program (Receipt of Physical Therapy (PT), Occupational Therapy (OT), Speech Therapy (ST), Mental Health (MH), and Social Work (SW) Services). However, the investigators will document these services and will control for it. However, those who are receiving non- standard of care exercise therapy (e.g. other exercise research study) or receiving active intensive or induction therapy for cancer (e.g. undergoing active initial chemotherapy or radiotherapy).
• Others: The investigators will NOT exclude but will document common comorbidities such as pneumonia, heart failure, and chronic obstructive pulmonary disease exacerbations. Pulmonary embolism or acute coronary syndrome maybe included if there is no contraindications like severe hemodynamic instability or active angina.

Sponsors & Collaborators

• VA Office of Research and Development: lead
• Baylor College of Medicine: collaborator

Study Sites (1)

Michael E. DeBakey VA Medical Center, Houston, TX

Houston, Texas, 77030-4211, United States

Location

MeSH Terms

Conditions

COVID-19

Condition Hierarchy (Ancestors)

Pneumonia, Viral; Pneumonia; Respiratory Tract Infections; Infections; Virus Diseases; Coronavirus Infections; Coronaviridae Infections; Nidovirales Infections; RNA Virus Infections; Lung Diseases; Respiratory Tract Diseases

Results Point of Contact

• Title: Dr. Sarvari Yellapragada
• Organization: MD Anderson

svyellapragada@mdanderson.org

832 207 3053

Study Officials

• Sarvari V Yellapragada, MD

  Michael E. DeBakey VA Medical Center, Houston, TX

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: FED
• Responsible Party: SPONSOR

Model Details: COVID-19 patients or PUI (persons under investigation) admitted to the MEDVAMC (n=60), with an anticipated length of stay of at least 3 days will be recruited. Participants will be randomized (n=1:1) to either intervention (IG) or control (CG) groups. Both groups will receive standard of care. IG will additionally receive Tele-Exergame MP therapy. Tele-Exergame sessions will range from 3-10 minutes based on patient ability and completed twice daily. They will complete assessments at baseline and at one-month post-hospital discharge.

Study Record Dates

• First Submitted: January 12, 2021
• First Posted: February 8, 2021
• Study Start: July 5, 2021
• Primary Completion: December 31, 2023
• Study Completion: December 31, 2023
• Last Updated: August 5, 2026
• Results First Posted: August 5, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)