AMS Spring 2023

3D Printing Helps UCL and Microsoft Research Gamify Cystic Fibrosis Breathing Treatment


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I have never been much of a video gamer, but I’m a little obsessed with playing Angry Birds on my phone. There aren’t a lot of high stakes in that game – it’s mindless enough, but if I’m able to break my previous high score, I’ll admit to getting a little excited. So here’s an interesting question – how much more would I play Angry Birds if it offered a very specific health benefit? The physiotherapy department at University College London (UCL) has partnered with Microsoft Research to develop computer games that will motivate kids with cystic fibrosis (CF) to complete necessary breathing exercises that will help clear their chest and lungs.

According to Cystic Fibrosis Trust, the genetic condition CF affects about 10,800 people in the UK, and about 100,000 around the world. The life-threatening disease is caused by a defective gene, and causes the internal organs, especially the digestive system and lungs, to become clogged with thick, sticky mucus. This results in chronic infections, lung inflammation, and difficulty digesting food, as the necessary digestion enzymes can’t always reach the stomach through the mucus; this is referred to as pancreatic insufficiency, and people with CF often need to take many pills each day that help them digest food.

We have seen 3D printing technology used to make a more discreet dispenser for people with CF to carry around their variety of pills, in one application of the technology to help in easing self-care. At the recent Createch2017 event, part of London Tech Week, Haiyan Zhang, the innovation director at Microsoft Research, talked about Microsoft’s partnership with UCL, and explained that the culmination of the work is something called Project Fizzyo.

Because of the increased build-up of thick mucus secretions, CF patients are much more susceptible to lung infections than the average person, and have to take necessary precautions to make sure they’re not exposed to bacteria or harmful bugs. In addition to inhaling medication, people with CF also need to undergo chest physiotherapy (different breathing techniques) to open their airways and thin out the mucus in order to keep the chest clear. Fizzyo, which was featured in December’s Big Life Fix BBC documentary about tech experts taking on challenges that face real people, takes traditional airway clearance devices and adds a wireless, chipped electronic sensor into the mouthpiece of the device. As the user exhales, the sensor sends out electronic signals that control computer games on a tablet.

Morgan and Aiden Coxhead, who have CF, use the prototype chipped airway clearance devices [Image: Chartered Society of Physiotherapy]

Zhang worked with Morgan and Aiden Coxhead, two teens from Cornwall with CF, during the BBC program. While both Morgan and Aiden are required to undergo thirty minutes of airway clearance exercise each day to help loosen up the mucus in their lungs, another important part of their daily life is computer gaming.

At the Createch2017 event, Zhang said, “I started creating a sensor which attaches to a traditional physiotherapy device and turns the children’s breath into controls for a video game. 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.”

UCL’s physiotherapy staff, including course director Eleanor Main and senior teaching fellow and research fellow Sarah Rand, helped Zhang develop the device. According to Professor Main, the BBC documentary showed one early prototype; there have been three additional designs to help produce an electronic sensor that’s able to fit multiple airway clearance devices, and is easier to clean after.

One of the important parts of the Fizzyo project is data collection, which could help educate and inform clinicians about airway clearance compliance, and just how effective these devices are.

“This is potentially a way for us to collect data we have never seen before. 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,” explained Rand.

Five members of UCL’s computer science department are working on software that will deliver data to the cloud, while two members of the electrical engineering department are hard at work on firmware for the electronic chip; the two teams are expected to complete their work by this September.

[Image: Professor Eleanor Main via Twitter]

Professor Main said, “If all of that is working perfectly, then the attachments will be 3D printed, and then we will mould and manufacture 100 of these devices.”

3D printing technology is useful for manufacturing custom attachments for multiple objects, like GoPro mounts and a drone exoskeleton attachment.

Over a period of 4-6 months, children will test out the 100 Fizzyo airway clearance devices with 3D printed attachments, but without the use of the fun computer games. After that first period of testing, the computer games will be introduced, and UCL will then analyze the data from both testing periods to “assess how gaming affects compliance with airway clearance treatment.”

“The boys in Cornwall are quite obsessed with computer games, so it was a way in for them. But is it a way in for everyone? We don’t know this yet,” said Professor Main. “And more importantly, would any change or improvement in compliance be accompanied by better clinical outcomes.”

While Cystic Fibrosis Week ended on Sunday, you can still help make a difference by contributing to Project Fizzyo on GitHub. Discuss in the Cystic Fibrosis forum at

[Source: Chartered Society of Physiotherapy]


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