Can the gamification of chest physiotherapy improve the treatment of respiratory conditions?

The mainstay treatment for bronchiectasis and cystic fibrosis, two conditions primarily affecting the lungs, is chest physiotherapy to remove excess mucus from the airways. This is critical as the mucus causes coughing, shortness of breath, restricts activities and creates a fertile ground for infections. In turn, this results in progressive lung scarring, dramatically reducing quality of life for these children.

When unwell, chest physiotherapy is required up to three times a day, a huge undertaking for a child or adolescent. Adherence is challenging, and worsens in the teenage years. And like any routine practice, whether it be dieting, taking medication, or working out, it is hard to maintain. Adherence to chest physiotherapy is no different as the treatment is time-consuming and boring.

Dr Cass Byrnes is an expert in respiratory illness. She encounters children and young people every week who have these chronic lung conditions. They are life-limiting and restrict normal activities; so anything that can be done to improve treatment, or adherence to treatment, is an important step-forward. Dr Byrnes’ idea for improving adherence to treatment is to make it fun.

Together with Dr Christof at the University of Auckland, Hamed Minaeizaeim at the Auckland Bioengineering Institute, Dr Byrnes and her team are developing a novel, but to date clinically untrialled, software prototype that turns chest physiotherapy into a game – known as gamification. There is increasing evidence that gamification of treatments improves adherence because treatment is no longer perceived as a chore.

Dr Byrnes and her team will trial the device, known as BreatheHero, in 20 children for three months. The results (clinical, adherence, and feedback from the children themselves) will inform larger studies which will determine if BreatheHero is successful in improving adherence to physiotherapy, and more importantly, whether the quality of life and health for these children is improved.

The success of such a unique intervention would have wide-reaching impacts on those children with cystic fibrosis, bronchiectasis, as well as other respiratory problems requiring regular chest physiotherapy.