Bubble Breather - A Breathing Exercise Game to Support Pneumonia Rehabilitation and Recovery

Tabor, Aaron; Pradantyo, Reyhan; Sadprasid, Book; Birk, Max V.; Scheme, Erik; Bateman, Scott

doi:10.1145/3383668.3419921

Cited by 17 publications

(25 citation statements)

References 14 publications

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“…Nowadays, individuals may explore and seek the assistance of professional coaches or use advanced devices that are specially designed for the purpose of breathing; however, these means often have a high cost and are time-consuming [ 5 , 7 ]. VR technology, on the other hand, is becoming one of the most accessible and low-cost solutions in the health care domain for breathing interventions [ 8 , 11 ]. Further, VR allows users to have full control over the environment they are exposed to.…”

Section: Introductionmentioning

confidence: 99%

“…In this literature review, we introduce state-of-the-art VR technologies relevant to pulmonary rehabilitation and breathing exercises by analyzing recent related articles on the subject. Owing to the lack of studies related to breathing gaming exercises, for this review, we only examined and evaluated 32 available studies from the last decade [ 5 - 8 , 10 , 24 - 50 ]. Evidence from related empirical and experimental studies that comprised several types of breathing exercises and patterns was systematically reviewed to address the following research questions:…”

Section: Introductionmentioning

confidence: 99%

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Virtual Reality for Pulmonary Rehabilitation: Comprehensive Review

Pittara¹,

Matsangidou²,

Petkov³

et al. 2023

JMIR Rehabil Assist Technol

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Background Pulmonary rehabilitation is a vital component of comprehensive care for patients with respiratory conditions, such as lung cancer, chronic obstructive pulmonary disease, and asthma, and those recovering from respiratory diseases like COVID-19. It aims to enhance patients’ functional ability and quality of life, and reduce symptoms, such as stress, anxiety, and chronic pain. Virtual reality is a novel technology that offers new opportunities for customized implementation and self-control of pulmonary rehabilitation through patient engagement. Objective This review focused on all types of virtual reality technologies (nonimmersive, semi-immersive, and fully immersive) that witnessed significant development and were released in the field of pulmonary rehabilitation, including breathing exercises, biofeedback systems, virtual environments for exercise, and educational models. Methods The review screened 7 electronic libraries from 2010 to 2023. The libraries were ACM Digital Library, Google Scholar, IEEE Xplore, MEDLINE, PubMed, Sage, and ScienceDirect. Thematic analysis was used as an additional methodology to classify our findings based on themes. The themes were virtual reality training, interaction, types of virtual environments, effectiveness, feasibility, design strategies, limitations, and future directions. Results A total of 2319 articles were identified, and after a detailed screening process, 32 studies were reviewed. Based on the findings of all the studies that were reviewed (29 with a positive label and 3 with a neutral label), virtual reality can be an effective solution for pulmonary rehabilitation in patients with lung cancer, chronic obstructive pulmonary disease, and asthma, and in individuals and children who are dealing with mental health–related disorders, such as anxiety. The outcomes indicated that virtual reality is a reliable and feasible solution for pulmonary rehabilitation. Interventions can provide immersive experiences to patients and offer tailored and engaging rehabilitation that promotes improved functional outcomes of pulmonary rehabilitation, breathing body awareness, and relaxation breathing techniques. Conclusions The identified studies on virtual reality in pulmonary rehabilitation showed that virtual reality holds great promise for improving the outcomes and experiences of patients. The immersive and interactive nature of virtual reality interventions offers a new dimension to traditional rehabilitation approaches, providing personalized exercises and addressing psychological well-being. However, additional research is needed to establish standardized protocols, identify the most effective strategies, and evaluate long-term benefits. As virtual reality technology continues to advance, it has the potential to revolutionize pulmonary rehabilitation and significantly improve the lives of patients with chronic lung diseases.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Virtual Reality for Pulmonary Rehabilitation: Comprehensive Review

Pittara¹,

Matsangidou²,

Petkov³

et al. 2023

JMIR Rehabil Assist Technol

View full text Add to dashboard Cite

show abstract

“…Breathing exercises, such as diaphragmatic and labial breathing and positive expiratory pressure (PEP), which can be performed individually or in combination, are another important intervention in the treatment of COPD. Breathing exercises may be recommended for patients with dyspnoea who are unable to exercise because they offer significant benefits in managing shortness of breath (Scichilone et al, 2006; Tabor et al, 2020). Typically, a device is used when these exercises are performed using PEP.…”

Section: Introductionmentioning

confidence: 99%

Breathing better: A tech‐monitored study of positive expiratory pressure and reading aloud for chronic obstructive pulmonary disease

Özden,

Parlar Kılıç

2023

Int J of Nursing Practice

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BackgroundBreathing exercises, such as diaphragmatic breathing and positive expiratory pressure (PEP), relieve breathlessness in people with chronic obstructive pulmonary disease (COPD).AimThis study aimed to investigate the effects of breathing exercises with PEP and reading aloud on vital signs, fatigue level, severity of dyspnoea and respiratory function parameters in patients with COPD.DesignThe study followed a randomized controlled trial of COPD patients from a single hospital in eastern Turkey.MethodsThe study included 103 patients who were randomly assigned to receive pre‐reading exercises, breathing exercises with a PEP device or no intervention for 8 weeks.ResultsThe use of a PEP device improved oxygen saturation, forced expiratory volume in 1 s (FEV1) and FEV1/forced vital capacity (FVC) values and reduced fatigue and dyspnoea severity. Reading aloud lowered the mean arterial pressure and reduced fatigue and dyspnoea severity.ConclusionThe study concludes that PEP devices and reading aloud can improve respiratory function in patients with COPD. Additionally, reading aloud is an accessible, easy‐to‐implement and economically feasible method for treating COPD symptoms.

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“…The problem of nonadherence and lacking engagement is present in various domains, and different works hypothesize gamification as a potential solution [ 18 , 19 ]. In addition, for breathing training, various mobile [ 20 - 22 ], desktop [ 23 ], and virtual reality [ 24 , 25 ] applications that use some gameful elements have been conceptualized and developed. However, many apps are not interactive and do not include biofeedback during training, which is surprising as research indicates increased effectiveness of breathing training when biofeedback is used [ 26 - 29 ].…”

Section: Introductionmentioning

confidence: 99%

“…Nevertheless, breathing training apps exist that include biofeedback mechanisms based on heart rate variability (HRV) [ 30 ] or breathing [ 21 - 23 , 31 ]. Although HRV-based biofeedback offers feedback on the biosignal often targeted by breathing training [ 32 ], it only provides deferred feedback.…”

Section: Introductionmentioning

confidence: 99%

Breathing as an Input Modality in a Gameful Breathing Training App (Breeze 2): Development and Evaluation Study

Lukic¹,

Teepe²,

Fleisch³

et al. 2022

JMIR Serious Games

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Background Slow-paced breathing training can have positive effects on physiological and psychological well-being. Unfortunately, use statistics indicate that adherence to breathing training apps is low. Recent work suggests that gameful breathing training may help overcome this challenge. Objective This study aimed to introduce and evaluate the gameful breathing training app Breeze 2 and its novel real-time breathing detection algorithm that enables the interactive components of the app. Methods We developed the breathing detection algorithm by using deep transfer learning to detect inhalation, exhalation, and nonbreathing sounds (including silence). An additional heuristic prolongs detected exhalations to stabilize the algorithm’s predictions. We evaluated Breeze 2 with 30 participants (women: n=14, 47%; age: mean 29.77, SD 7.33 years). Participants performed breathing training with Breeze 2 in 2 sessions with and without headphones. They answered questions regarding user engagement (User Engagement Scale Short Form [UES-SF]), perceived effectiveness (PE), perceived relaxation effectiveness, and perceived breathing detection accuracy. We used Wilcoxon signed-rank tests to compare the UES-SF, PE, and perceived relaxation effectiveness scores with neutral scores. Furthermore, we correlated perceived breathing detection accuracy with actual multi-class balanced accuracy to determine whether participants could perceive the actual breathing detection performance. We also conducted a repeated-measure ANOVA to investigate breathing detection differences in balanced accuracy with and without the heuristic and when classifying data captured from headphones and smartphone microphones. The analysis controlled for potential between-subject effects of the participants’ sex. Results Our results show scores that were significantly higher than neutral scores for the UES-SF (W=459; P<.001), PE (W=465; P<.001), and perceived relaxation effectiveness (W=358; P<.001). Perceived breathing detection accuracy correlated significantly with the actual multi-class balanced accuracy (r=0.51; P<.001). Furthermore, we found that the heuristic significantly improved the breathing detection balanced accuracy (F1,25=6.23; P=.02) and that detection performed better on data captured from smartphone microphones than than on data from headphones (F1,25=17.61; P<.001). We did not observe any significant between-subject effects of sex. Breathing detection without the heuristic reached a multi-class balanced accuracy of 74% on the collected audio recordings. Conclusions Most participants (28/30, 93%) perceived Breeze 2 as engaging and effective. Furthermore, breathing detection worked well for most participants, as indicated by the perceived detection accuracy and actual detection accuracy. In future work, we aim to use the collected breathing sounds to improve breathing detection with regard to its stability and performance. We also plan to use Breeze 2 as an intervention tool in various studies targeting the prevention and management of noncommunicable diseases.

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Bubble Breather - A Breathing Exercise Game to Support Pneumonia Rehabilitation and Recovery

Cited by 17 publications

References 14 publications

Virtual Reality for Pulmonary Rehabilitation: Comprehensive Review

Virtual Reality for Pulmonary Rehabilitation: Comprehensive Review

Breathing better: A tech‐monitored study of positive expiratory pressure and reading aloud for chronic obstructive pulmonary disease

Breathing as an Input Modality in a Gameful Breathing Training App (Breeze 2): Development and Evaluation Study

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