Pilot Trial of Spirometer Games for Airway Clearance Practice in Cystic Fibrosis.

BACKGROUND: Many children with cystic fibrosis (CF) adhere poorly to airway clearance techniques (ACTs), and would rather play video games that challenge their dexterity and visual tracking skills. We developed gaming technology that encourages forced expiratory maneuvers. OBJECTIVE: Following inter...

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Published in:Respiratory Care Vol. 57; no. 8; pp. 1278 - 1285
Main Authors: Bingham, Peter M., Lahiri, Thomas, Ashikaga, Taka
Format: pictorial research tables/charts randomized controlled trial Journal Article
Published: Mary Ann Liebert, Inc. Aug2012
Online Access:View this record in EBSCOhost
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      dt: Aug2012
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      pub: Mary Ann Liebert, Inc.
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        atl: Pilot Trial of Spirometer Games for Airway Clearance Practice in Cystic Fibrosis.
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        au:
          Bingham, Peter M.
          Lahiri, Thomas
          Ashikaga, Taka
        affil: Department of Neurology, University of Vermont, Burlington, Vermont
      sug:
        subj:
          Cystic Fibrosis Therapy
          Respiratory Therapy Methods
          Spirometry Methods
          Therapy, Computer Assisted Methods
          Video Games
          Spirometry Equipment and Supplies
          Lung Diseases, Obstructive Therapy
          Product Development Methods
          Human
          Pilot Studies
          Respiratory Function Tests
          Forced Expiratory Flow Rates
          T-Tests
          Descriptive Statistics
          Interviews
          Forced Expiratory Volume
          Child
          Vital Capacity
          Patient Compliance
          Motivation
          Funding Source
          Vermont
          Software
          Crossover Design
          Randomized Controlled Trials
          Outcomes (Health Care)
          Single-Blind Studies
          Calibration
          Outcome Assessment
          Paired T-Tests
          Pearson's Correlation Coefficient
          Male
          Female
          Severity of Illness
          Child: 6-12 years
          Male
          Female
      ab: BACKGROUND: Many children with cystic fibrosis (CF) adhere poorly to airway clearance techniques (ACTs), and would rather play video games that challenge their dexterity and visual tracking skills. We developed gaming technology that encourages forced expiratory maneuvers. OBJECTIVE: Following interviews regarding recreational activities and subjects' practice of ACTs, we conducted a pilot trial of spirometer games in 13 adolescents with CF, to test the hypothesis that games could increase subjects' engagement with forced expiratory breathing maneuvers and improve pulmonary function tests (PFTs). METHODS: After baseline PFTs, subjects were provided with digital spirometers and computers set up as "game only" or "control" devices. After the first of 2 periods (each > 2 weeks), the computer was set-up for the alternate condition for period 2. The t test and non-parametric correlation analyses examined use, number of expiratory high flow events (HFEs), and change in PFTs, identifying trends at P ≤ .1, significance at P < .05. RESULTS: Interviews disclosed minimal awareness of ACTs among our pediatric CF patients. Subjects used games and control software a similar percentage of days during the game (26%) and control periods (32%). There was a trend toward more minutes with the game versus control setup (P = .07), though HFE count did not differ between the 2 conditions (P = .71). Game play showed no overall effect on FEV1, though correlation analysis showed a modest relation between minutes of play and change in FEV1 from baseline (r = 0.50, P = .09). The game period showed a trend to increased vital capacity (P = .05). CONCLUSIONS: Spirometer games elicit forced expiratory breath maneuvers in pediatric CF patients. Improvement in PFTs may be due to improved test performance technique, though improved obstructive/restrictive lung function due to game play cannot be excluded. A formal clinical trial of this approach is planned.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        randomized controlled trial
        Journal Article
      ougenre: Article
    language: English
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