UBICU: A Gamified Respiratory Incentive System for Pulmonary Re-Expansion

Pulmonary complications can arise due to trauma, postoperative conditions, or as sequelae of diseases such as COVID-19. To help patients restore lung functionality, most undergo lung re-expansion physiotherapy using a Respiratory Incentive Spirometer. However, currently available Respiratory Incentive Spirometers do not allow for quantitative tracking of performance during inspiration exercises, require physiotherapist supervision to ensure exercise quality, and show low treatment adherence. To address these limitations, we developed UBICU, an assistive product for lung re-expansion physiotherapy. UBICU includes a flow measurement device, an app with a video game interface to motivate exercise performance, and cloud-based software for the remote prescription and evaluation of physiotherapy. We conducted a quasi-experimental study with a sample of 30 healthy individuals, aged 18 to 65 years and balanced by age and sex. We assessed pulmonary ventilation distribution before, during, and after using two flow respiratory incentive spirometers, UBICU and TriFlo, with electrical impedance tomography. Our findings indicate that UBICU provides accurate and reliable measurements of pulmonary ventilation distribution, showing statistically significant improvements after use (p < 0.01), validating its effectiveness as a respiratory incentive spirometer. To evaluate the usability of the video game component, we conducted a perception survey, achieving an acceptance rating above 5 on a scale of 0 to 6. Notably, UBICU was shown to favor lung re-expansion more effectively than the traditional TriFlo mechanical system.