SpiroPlay, a Suite of Breathing Games for Spirometry by Kids & Experts

Abstract

We have built and implemented a set of metaphors for breathing games by involving children and experts. These games are made to facilitate prevention of asthma exacerbation via regular monitoring of children with asthma through spirometry at home. To instruct and trigger children to execute the (unsupervised) spirometry correctly, we have created interactive metaphors that respond in real-time to the child's inhalation and exhalation. Eleven metaphors have been developed in detail. Three metaphors have been fully implemented based on current guidelines for spirometry and were tested with 30 asthmatic children. Each includes multi-target incentives, responding to three different target values (inhalation, peak expiration, and complete exhalation). We postulate that the metaphors should use separate goals for these targets, have independent responses, and allow to also go beyond expected values for each of these targets. From the selected metaphors, most children preferred a dragon breathing fire and a soccer player kicking a ball into a goal as a metaphor; least liked were blowing seeds of a dandelion and applying lotion to a dog to grow its hair. Based on this project we discuss the potential and benefits of a suite-of-games approach: multiple games that each can be selected and adapted depending on personal capabilities and interests. CCS CONCEPTS• Human-centered computing → Empirical studies in ubiquitous and mobile computing; User studies.

Virtual Reality for Pulmonary Rehabilitation: Comprehensive Review

“…Of the 32 studies, 24 involved healthy individuals [ 6 , 8 , 10 , 24 , 26 , 28 - 38 , 40 , 41 , 43 - 48 ], 1 involved individuals at high risk of developing anxiety disorders [ 39 ], 1 involved patients with lung cancer [ 7 ], 1 involved patients with pneumonia [ 49 ], 2 involved patients with COPD [ 27 , 42 ], 2 involved patients with COVID-19 [ 49 , 50 ], and 1 involved patients with asthma [ 5 ]. The breathing exercises were mostly related to breathing therapy (9/32) [ 5 , 6 , 10 , 25 , 27 , 33 , 48 , 49 , 54 ] and anxiety management (13/32) [ 8 , 28 , 29 , 32 , 34 , 36 , 37 , 39 - 41 , 43 - 45 ]. Most of the reviewed papers based their research on pilot (16/32) or control studies (11/32), while some of the papers (4/32) only described the design and development processes of their systems.…”

“…Further, VR allows users to have full control over the environment they are exposed to. In combination with the use of biosensing technology, which provides acoustic, visual, and biofeedback guidance, VR users are offered the ability to consciously and self-effectively control and monitor their respiratory rate (RR) [ 2 , 5 , 12 ].…”

“…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:…”

Development and Testing of a Data Capture Device for Use With Clinical Incentive Spirometers: Testing and Usability Study

“…Gamification of medical interventions is an exciting concept for improving medical care adherence. Breathing games for the incentive spirometer is a familiar idea, with one group brainstorming a suite of games for asthmatics focusing on breathing metaphors as incentives for spirometer use [ 26 ], while others developed video games to incentivize breathing exercises and peak expiratory flow using digital flowmeters [ 18 , 27 ]. There exists an abandoned patent around the use of the incentive spirometer as a game controller [ 28 ] and an active patent around use of the flowmeter in video games [ 29 ], further supporting the popularity of the idea.…”

Co-creation of a Serious Game About Radiotherapy: Participatory Action Research Study With Children Treated for Cancer

“…Using text as the means of learning in a serious game proved to have a roughly similar outcome as learning through game mechanics, as when using the latter, the player could misinterpret the message if they did not understand it correctly [ 35 ]. The use of metaphors to help children understand medical instructions in games has previously been tested, and the results show that children prefer different metaphors for practice [ 36 ]. In the current game, each medical phenomenon was explained by a single corresponding metaphor.…”