A Gamified Mobile Application for Lung Re‑Expansion Therapy: A Preclinical User Experience Evaluation (Preprint)

Background: Lung re?expansion therapies are essential for preventing pulmonary complications but are frequently affected by
low adherence due to their repetitive nature and limited supervision outside clinical settings. Gamification has shown potential to
enhance engagement in rehabilitation and digital health interventions; however, its application to respiratory physiotherapy
remains underexplored.
Objective: This study evaluates user experience, enjoyment, and engagement with a gamified mobile application designed to
support lung re-expansion therapy in a preclinical, non-patient setting.
Methods: A gamified mobile application integrating a digital spirometer was developed to guide deep?inspiration exercises
through game mechanics and feedback. Twelve non?patient users completed a structured evaluation using an adapted
questionnaire derived from the Game Experience Questionnaire and Player Experience of Need Satisfaction instruments.
Enjoyment?related indicators, including engagement, perceived control, clarity of instructions, challenge, frustration, and overall
experience were assessed alongside descriptive performance metrics.
Results: Participants reported high levels of engagement, perceived performance, clarity of instructions, and overall experience,
alongside low levels of stress and frustration. Correlation analyses revealed strong associations between engagement and clarity
of instructions, and between perceived performance and overall experience. Qualitative feedback identified technical
synchronization and customization complexity as primary sources of frustration.
Conclusions: The gamified application delivered a positive user experience and supported key enjoyment indicators associated
with engagement, thereby establishing an experiential foundation relevant to adherence in subsequent patient?centered
evaluations. This preclinical study identifies usability strengths and limitations that inform further system refinement and future
patient?centered research.