From hospital pilots to studies at home: the clinical, feasibility and co-creation work of Breathing Games since 2014, done with children, families, young adults and care teams in seven countries. None of these studies is a randomised trial: they cover development and feasibility, not yet the evaluation of efficacy.
Each bar is the period of a study; the colour is its type. The label gives the number of the study.
Schematic map, not to scale: the numbers mark the four countries where most studies, game jams and exchanges took place, and the cards list the hospitals, partners and funders.
Multi-country test of a game (X1)
In 2023-2024 a game was also tested in Italy, Belgium, South Korea and Syria; these partners are not on the map.
- Belgium : CHU Tivoli
- Syria : Université de Lattaquié
- South Korea : Seoul National University Hospital · Korea University · Yonsei University · Karl Polanyi Institute Asia — Funders : Yonsei University · CityPreneurs
E1 Clinical study 05-07.2014
Pilot of games for PEP physiotherapy
CHU Sainte-Justine, Montréal · Canada
First test of games during PEP physiotherapy, with a questionnaire before and after, no control group.
- Participants
- 10 children with cystic fibrosis
- Games and sensors
- PEP Hero, Globule, Ange-Gardien
- Funding
- No funding reported
- Publication
- Abstract or poster only · J Cyst Fibros 2015
E4 Feasibility study 08.2015-09.2016
Feasibility pre-study: from cystic fibrosis to asthma
HE-Arc (HES-SO), Neuchâtel · Switzerland
A randomised trial is impossible in cystic fibrosis (about fifty eligible young people in French-speaking Switzerland), hence the shift to asthma; project judged feasible, funding remaining the challenge.
- Participants
- Clinicians of French-speaking Switzerland consulted
- Funding
- Fonds d'impulsion HE-Arc 48 400 CHF
- Publication
- Not published yet · Acfas 2016
E5 Clinical study 2019-2020
Acceptability of games for asthma education
CHU Sainte-Justine, Montréal · Canada
Games judged acceptable; knowledge transfer, role-play and playing together help self-management.
- Participants
- 5 children with asthma and 6 parents
- Games and sensors
- Asthma Heroes, Asthmonautes, LungLauncher, Bloïd
- Funding
- IRSC / CIHR 22 530 CAD; Centre de promotion de la santé, CHU Sainte-Justine 770 CAD; Centre de promotion de la santé, CHU Sainte-Justine 2 000 CAD (in kind)
- Publication
- Published · JMIR Pediatr Parent 2022
E6 Clinical study 11.2019
Controller validated against spirometry
CHU Sainte-Justine, Montréal · CHU de Québec – Université Laval · Canada
Good correlation with spirometry (r = 0.83), mean bias −36.4 L/min; over three quarters would use the game at home.
- Participants
- 158 children aged 8 to 15
- Games and sensors
- TikiFlow + Spirotroller
- Funding
- IRSC / CIHR; Pneumologie, CHU Sainte-Justine 1 500 CAD; Pneumologie, CHU Sainte-Justine 2 500 CAD (in kind)
- Publication
- Published · JMIR Serious Games 2021
E7 Co-creation game jam 03 + 10.2019
Game jams with young adults with cystic fibrosis
Hôpital Necker-Enfants malades (AP-HP), Paris · France
Two prototypes co-created in two-day game jams; participants' feedback all positive.
- Participants
- 10 young adults aged 16 to 24 with cystic fibrosis
- Games and sensors
- Rise, Dichosim
- Funding
- Fonds FHF (Fédération hospitalière de France) 54 000 EUR
- Publication
- Abstract or poster only · Réseau Mère-Enfant de la Francophonie, Lyon 2021
B1 Co-creation game jam 13-17.10.2019
Game jam with older adults with COPD
Besançon · France
Five-day co-creation game jam with older adults with COPD, hosted with the Arc-en-ciel foundation.
- Participants
- Older adults with COPD
- Funding
- Fonds FHF; Arc-en-ciel 1 750 CHF (in kind)
- Publication
- Not published yet
P1 Exchange or public test 27.09.2019
Public test of games with IRIB-CNR
Notte europea dei ricercatori, Palermo · Italy
Exhibition and public test of games with the Palermo institute of biomedical research (IRIB-CNR).
- Participants
- Public of the European Researchers' Night
- Funding
- No funding reported
- Publication
- Not published yet
X1 Exchange or public test 2016-2021
Exploratory exchanges to adapt a game
IRIB-CNR Palermo · Seoul National University Hospital · University of Lattakia · CHU Tivoli · Italy, South Korea, Syria, Belgium
Italy, South Korea, Syria and Belgium; a GARD 2021 poster gathers part of the team.
- Participants
- Clinical and research teams in four countries
- Funding
- No funding reported
- Publication
- Not published yet · GARD 2021
Third clinical study with Asthma Heroes and a sensor
CHU Sainte-Justine, Montréal · Canada
Asthma Heroes used with a breathing sensor by children hospitalised after an asthma attack; 15 of the 30 children test breathing exercises in parallel.
- Participants
- 30 children aged 10 to 15 hospitalised after an asthma attack
- Games and sensors
- Asthma Heroes
- Funding
- No funding reported
- Publication
- Not published yet
E8 Clinical study 2023-2025
Home PEP physiotherapy with a game, participatory action research
CHU Sainte-Justine, Montréal · Canada
Very positive family experience; self-reported PEP adherence up 12.8 % (p = 0.04). Single arm: the effect remains to be tested in controlled studies.
- Participants
- 30 children aged 6 to 17 with cystic fibrosis; 17 complete the home test
- Games and sensors
- PEP Master, CHU PEP tools + Organic Controller (L)
- Funding
- Inven_T & Université de Montréal 100 000 CAD; Sensorica, CHU Sainte-Justine, Vivre avec la fibrose kystique 89 000 CAD (in kind)
- Publication
- Accepted, in review · ERJ 2025