Project Fizzyo - making essential physiotherapy fun!

Feature -

As the Trust unveils the second round of Clinical Excellence and Innovation Awards, supporting ground-breaking projects in clinical care, we hear from PhD student Helen Douglas, who is part of the Project Fizzyo team supported through an award to Great Ormond Street Hospital.

Minigolf Madness

What is Project Fizzyo?

The aims of Project Fizzyo are simple – firstly, to make airway clearance treatments more engaging and fun for children with cystic fibrosis. The hope is that if children start to enjoy doing the routine and burdensome physiotherapy treatments, and do them more regularly, then they will stay well for longer. Project Fizzyo uses wireless chipped electronic sensors inside airway clearance devices. The sensor detects breathing and converts each breath into an electronic signal, which in turn controls computer games on a tablet. Children will be able to use their breathing treatments to drive a car, play mini golf or collect coins, among many other gaming options being developed!   

Secondly, Project Fizzyo aims to use data, collected passively via the chipped sensors, to understand more about the relationship between routine airway clearance, exercise behaviours and health outcomes. One of the best things about Project Fizzyo is that a lot of useful data can be collected without any extra effort from children with CF and their families, but in order to make sense of this data we will need the help of a data scientist – more about that in a bit. 

How has the project evolved?

As part of the 2016 BBC 2 television series ‘The Big Life Fix’, Haiyan Zhang, Innovation Director at Microsoft, was asked to try and help Vicky Coxhead and her two teenage sons Aidan and Morgan who both have cystic fibrosis. As is often the way, the boys hated doing their airway clearance and Vicky battled every day to ensure they completed their treatment. Haiyan, along with creative design technologist Greg Saul and some help from CF physiotherapists and researchers at UCL, developed a prototype sensor and games to make airway clearance more fun, and the two teenagers have been using them ever since. Vicky has said that for the first time ever her boys want to do their physio, and are putting in much more effort, so it is more effective.

But it didn’t stop there! Project Fizzyo was born when the teams at Microsoft and UCL decided to collaborate in taking the project further. The initial sensor design has been modified several times to produce an insert that will fit a range of airway clearance devices and is easier to clean. The team is growing and, led by Professor Eleanor Main, involves the physiotherapy, computer science, and electrical and electronic engineering departments at UCL. There are now an additional seven UCL students working on exciting projects developing the necessary technology. Lee Stott, CTO of Academic Engagements at Microsoft UK, has organised four large hackathons where volunteer designers and engineers create new video games to work with the sensor – apparently game variety is key! 

Image from Dragon Doom, a Project Fizzyo game

And, having made such a difference to her family’s life, Vicky nominated the project for an award in AbilityNet’s 2017 Tech4Good Awards. AbilityNet is a charity that works to change the lives of people with disabilities by helping them to use digital technology at work, at home or in education. Its Tech4Good Awards recognise and celebrate technology innovation that can improve lives. To our enormous delight Project Fizzyo was the 2017 Digital Health Category winner!

Where is it headed?

The reception that Project Fizzyo has received so far is overwhelming. The children and families that have been consulted at each stage of development have been so delighted and keen to be involved. The Digital Health Tech4Good award is also wonderful independent affirmation of the value of this work that we are so passionate about. And the response on social media has been wonderful. Tweets from people in the CF community have been so positive, and reflecting what we suspected… adults are interested in using this too!

Once the device and technology is fully developed we will run a small pilot study towards the end of this year, with just a few families. This is to check that everything works effectively: the sensor sends the signals to a specially developed app, and then to a secure cloud; the cloud receives and processes the signals, and the sensor and games work as anticipated!

Once we have ironed out any glitches that emerge during the pilot study, we will then run a larger trial with children and young people at Great Ormond Street Hospital early in 2018. Thanks to the support of the Cystic Fibrosis Trust through the Clinical Excellence and Innovation Awards, 100 families will be given an airway clearance sensor, a tablet and a wearable activity tracker to use continuously at home for 14 months, while carrying on with their normal treatments and exercise – there is no additional burden to their care. At the same time we will collect what we think is the largest ever continuous activity and exercise dataset in children and young people with cystic fibrosis.  

We will compare airway clearance and exercise behaviours with clinical outcomes at each stage and, will examine what factors and behaviour patterns have the biggest impact on health in children and young people with cystic fibrosis. 

The Trust’s innovation grant will provide funding for a data scientist to help us model different ways of interrogating the ‘big data’ to find sensible answers to our ‘big questions’. We want to be able to tell children and their families with more certainty how often they need to do treatments, and what the minimum effective dose is in order to keep them well. We want to be able to tell them what airway clearance device is the best to use, and when doing physical activity or exercise is more important than doing airway clearance. We also want to understand whether gaming during treatments will provide sustained benefits in terms of adherence with treatments and improved clinical outcomes. Most importantly we want to find out if there are ways in which we can better prescribe personalised physiotherapy treatments based on individual clinical profiles, rather than depend on blanket ‘twice a day’ airway clearance advice. Exciting times ahead, watch this space...

You can help fund inspiring projects like this and make a difference to people with cystic fibrosis right now – make a donation today.

*Pictured: Two of the games developed for Project Fizzyo.

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