3D printed device ‘gamifies’ airway clearing exercises for young cystic fibrosis patients

Physiotherapists from University College London (UCL) in the UK are working with Microsoft to develop partially 3D printed tools for children with cystic fibrosis (CF). The tools form part of a computer-game-style strategy help young CF sufferers increase their breathing capacity. A hereditary disorder that affects the exocrine glands, causing thick and obstructive mucus, CF is most common in Northern Europe, where around one in 3,000 newborns are affected. Patients with CF often suffer blockages in pancreatic ducts, intestines, and bronchi, and are susceptible to respiratory infections and other problems. There is currently no known cure for the condition. Fortunately, there are certain techniques and practices for mitigating the negative effects of CF for patients. Airway clearance techniques (ACTs), for example, are practiced by patients in order to loosen thick, sticky mucus so that it can be cleared from the lungs by coughing. There are even special devices that patients can use to encourage the draining of the mucus. UCL’s physiotherapy department is currently working with Microsoft to develop a modern ACT treatment for CF, one that encourages young people suffering from the condition to effectively carry out the practice with fun incentives. The “Fizzyo project” was presented by Haiyan Zhang, innovation director at Microsoft Research, during the Createch 2017 event on June 13 in London. The project, which makes use of 3D printing and other modern technologies, takes conventional airway clearance devices and inserts a wireless chipped electronic sensor into the mouthpiece. As the user of the device exhales, the sensor sends electronic signals that function as input signals for a computer game being displayed on a tablet. “I started creating a sensor which attaches to a traditional physiotherapy device and turns the children’s breath into controls for a video game,” Zhang told attendees at Createch. “It’s a sensor that uses existing equipment and allows you to play video games in the day-to-day treatment. From a prototype, we were able to turn this into self-contained devices that the kids can use day in day out with their treatment.” Zhang’s research was recently the subject of a BBC documentary called “Big Life Fix.” In the program, Zhang attempted to use her device with two teenage video game-lovers in Cornwall who have CF. Sarah Rand, a senior teaching fellow and research fellow at UCL, believes the breathing device could help CF researchers understand more about the condition—particularly regarding how much the practice of airway clearance actually helps CF patients “This is potentially a way for us to collect data we have never seen before,” Rand said. “We have been prescribing the same treatment for a number of years and there is no way for us to look and see whether treatments are the right ones for individuals and how they correlate to other outcomes. And that is what we are trying to do with this.” The UCL and Microsoft researchers working on the breathing device have already reeled off several iterations, but are still working to find the perfect version. Two members of the university’s electrical engineering department are currently writing firmware for the electronic chip, while five members of the computer science department are writing software that will deliver collected data to the cloud. The work of both of these teams is expected to be complete by September. If both the electronic chip and software are up to scratch by that time, the team will mold and manufacture 100 of the new devices. 3D printed attachments will also be utilized. A group of children will use the partially 3D printed devices over a period of 4-6 months, first carrying out their airway clearance exercises without using computer games. After that period, computer games will be introduced. UCL’s academics will analyze the data to assess from both periods to see how gaming affects compliance with airway clearance treatment. They hope this will let them examine how well certain CF patients react to airway clearance. “The boys in Cornwall are quite obsessed with computer games, so it was a way in for them,” said Professor Eleanor Main, physiotherapy course director at UCL. “But is it a way in for everyone? We don’t know this yet.” Last year, Zhang organized a “hackathon” in London that encouraged tech wizards to develop games that could be played using a CF airway clearance device. With Microsoft on board with the project, these games could soon become much more advanced and potentially far more effective for CF patients.