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Virtual respiratory therapy delivered through a smartphone app: A mixed-methods randomised usability study

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posted on 2022-11-07, 23:03 authored by Clarence A Baxter, Julie-Anne Carroll, B Keogh, Corneel VandelanotteCorneel Vandelanotte
Introduction A new smartphone app (QUT Inspire) has been developed to detect inspiratory sound and deliver virtual incentive spirometry (ISy), a respiratory therapy technique used in postoperative recuperation, management of some chronic conditions and with potential applications in SARS-CoV-2 rehabilitation. The aim of this study was to compare the usability of this new app with a clinical ISy device as measured by effectiveness, efficiency and satisfaction. Methods In this mixed-methods randomised usability study, healthy volunteers (aged 39.2±12.2 years, n=24) compared inspirations using the QUT Inspire app and a Triflo II clinical ISy device. A post-Test questionnaire and a semi-structured interview explored dimensions of usability regarding the new app. Results The duration of inspirations performed using the QUT Inspire app (7.3±2.0 s) were comparable with use of the Triflo II ISy device (7.5±2.3 s). No artefacts arising from the order of device testing were identified. App users held their phones adjacent but not proximal to their mouths (13.6±6.4 cm), notwithstanding instructions to keep the phone less than 5 cm away for optimal breath sound detection. The use of onscreen text or video instructional materials did not result in a significant reduction in this distance. Participants reported clear preferences for the app (100%, n=24) to motivate persistence with repeated inspirations. App gamification features such as a timer (75%, n=18) and breath counter (83.3%, n=20) were well regarded. Analysis of semi-structured interviews identified four main themes arising from this study: visual reward from responsive app animations, clinical look and feel influencing credibility, perceived effort affecting engagement and selective adoption of gamification features. Conclusion This study demonstrates that a virtual ISy app can be effective, efficient and have high satisfaction. Improvements informed by this research include use of additional phone sensors to optimise sound detection and minimising the distance that phones are held from the user's mouth. Further research in randomised controlled trials are needed to evaluate performance of this app in clinical contexts where ISy is currently employed.

History

Volume

9

Issue

1

Start Page

1

End Page

8

Number of Pages

8

eISSN

2052-4439

ISSN

2052-4439

Publisher

BMJ

Publisher License

CC BY-NC

Additional Rights

CC BY-NC 4.0

Language

en

Peer Reviewed

  • Yes

Open Access

  • Yes

Acceptance Date

2022-06-21

External Author Affiliations

Queensland University of Technology;

Author Research Institute

  • Appleton Institute

Era Eligible

  • Yes

Medium

Print

Journal

BMJ Open Respiratory Research

Article Number

e001221