Breathe: A Game to Motivate the Adherence of Breathing Exercises

Background and Purpose. Breathing often becomes impaired or difficult after surgeries or in the presence of disease or injury. Breathing exercises are imperative to ensure the health of lungs. Despite this, patient adherence with breathing exercise regimes is not commonly assessed. There is a need for breathing exercise programs that will stimulate motivation, the lack of which is often associated with exercise. Typically, breathing exercises must be performed at regular intervals throughout the day while recovering from surgery or undertaking cycles of prophylactic breathing exercises. Furthermore, there is a need for a device that will provide quantitative measures of patient progress and adherence. An incentive spirometer apparatus measures the volume of air inspired and expired, and provides visual feedback while performing breathing exercises. The development of a game-based incentive spirometry system aims to overcome the typical exercise inertia to motivate patients to perform breathing exercises and to provide individualized challenge levels and quantitative measurement of progress and adherence. Method/Model Description and Evaluation. This research involves an interdisciplinary team of physical therapists, game designers, engineers, and computer scientists. The iterative game-design process was used to develop 6 prototype games. The games underwent a series of user tests. Two game prototypes underwent further refinement and user testing with a sample of physical therapists and people with disabilities. Game usability was assessed and feedback was provided on the incentive spirometry device, game play, system goals, and potential improvements. Outcomes. Initial assessment of the prototype system indicated that both physical therapists and potential users enjoyed the incentive spirometry game and encouraged further development. The potential end users indicated their excitement about the concept of using games for breathing exercises and look forward to the completed game. Discussion and Conclusions. Following further refinement and development, the game-based breathing system will be assessed for effectiveness in improving patient adherence and reducing pulmonary complications, compared to standard treatment techniques. The integration of medical devices with video game technologies offers great potential to improve assessment and treatment tools and patient adherence with physical therapy.