https://orcid.org/0000-0003-1944-0519
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Abstract
The assessment and training of respiratory muscles are two essential tasks for indirect screening of status and improvement of lung function, respectively, especially in times of COVID-19. To perform both tasks, we have designed an innovative handheld mouth pressure biofeedback system for assessment and personalized game-based training of respiratory muscle strength. Thirty recovered COVID-19 patients were involved in an across-ages pilot study to evaluate their respiratory muscle strength and the system’s usability, and eight of the thirty patients were involved in a home inspiratory training program of 3 weeks to assess its effectiveness. Results revealed that participants rated the system’s overall usability as excellent (91.3 ± 6.4) and consistently performed respiratory cycles along with the game-based training program in terms of mouth pressure. Furthermore, patients involved in the home training program showed a 40% increase in their Maximal Inspiratory Pressure (Pimax). These results indicate that the proposed system stands for a proper healthcare solution for the initial diagnosis of respiratory muscle dysfunction or disease and for guiding the correct performance of tailored and consecutive threshold load breathing cycles playfully and engagingly. Furthermore, it stands for an attractive and personalized biofeedback solution to promote adherence to at-home therapy. Finally, it can be used to investigate new and effective training protocols that improve respiratory muscle performance.
Acknowledgements
Authors acknowledge support from CREE-Coahuila, especially to MD Nadia Catalina de la Peña-Martínez, Director of CREE-DIF, in Saltillo, Coah., Mexico, who oversaw and supervised patients participation in its Pulmonary Rehabilitation Department.
Disclosure statement
Authors confirm that neither associations nor perceived conflicts of interest nor competing financial interest exist.
Notes
1 Definition approved in May 18 2008, by the Association for Applied Psychophysiology and Biofeedback (AAPB), the Biofeedback Certification International Alliance (BCIA), and the International Society for Neurofeedback and Research (ISNR).
2 This one-time calibration stands for a byproduct of our design that uses simultaneously a differential and an absolute low-cost, but medical grade, sensors to facilitate usability in different locations or moving it from one place to another.
3 Positive pressure values would be measured when using a PEP threshold valve for expiratory muscles training from abdominal muscles.
Additional information
Funding
Notes on contributors
N. Garcia-Hernandez
N. Garcia-Hernandez is a researcher at the Center for Research and Advanced Studies of Mexico (CINVESTAV-Saltillo). She received Ph.D. degree from the University of Genova, Italy and Italian Institute of Technology (IIT). Her research interests include games for health, biomechanical modeling, rehabilitation robotics and haptics.
I. Muñoz-Pepi
I. Muñoz-Pepi is a PhD student candidate at the Department of Robotics and Advanced Manufacturing of the Center for Research and Advanced Studies of Mexico (CINVESTAV). His research interests include rehabilitation robotics, neuromusculoskeletal modeling and simulation, and optimal control of human movement.
F. Villafranca-Martinez
F. Villafranca-Martinez is a PhD student candidate at the Department of Robotics and Advanced Manufacturing of the Center for Research and Advanced Studies of Mexico (CINVESTAV). His research interests include games for health and robotics.
V. Parra-Vega
V. Parra-Vega is a full-profesor at the Department of Robotics and Advanced Manufacturing of the Center for Research and Advanced Studies of Mexico (CINVESTAV-Saltillo).