Flower Breath - English

Visual feedback for Positive Expiration Presure (PEP) Devices

Many young people suffering from respiratory problems must perform daily physiotherapy for airway clearance with a PEP medical device

By breathing out with a moderate force through a resistance, a positive pressure is generated in the airways, helping to keep them open. This positive pressure allows airflow to get beneath the areas of mucus obstruction and move the mucus toward the larger airways, where it can be coughed out.

Initally developped for The Flutter® VRP1 the software is also compatible with other PEP devices.

Children with CF (Cystic fibrosis) are required to perform these exercises for at least 5 minutes 2-3 times each day. For young patients and their caregivers, these are tedious and discouraging exercises.

Researchers have looked for ways to introduce visual feedback and game dynamics into these exercises in order to increase their effectiveness and make the therapy less monotonous. The first solution developed was a free PC program. (http://flower-for-all.org/)

In 2010, the Defitech foundation was introduced to the Flutter and the visualization software by Mr Q. de Halleux, the Chief Physiotherapist of the Pediatric Unit at CHUV. He stressed the importance of these exercises and the positive impact the visual feedback provided on the quality of the breathing exercises.

With the rapid development of smart phone, Defitech decided to, take the software developed for PC’s and bring it to mobile devices. The concept developed uses a microphone connected to the mobile device to measure and analyze the sound on the PEP device. To ensure ease of use and consistency across devices Defitech chose to develop our application for iOS devices.

Download from iTunes

Flower breath - our goals

Give visual feedback of PEP device usage on iOS devices (iPod, iPhone iPad)

  • Keep the work open and free.
  • Reach the maximum number of patients.
  • Build a software base other can improve upon with games and activities.
  • Set up a system allowing patients to easily share the results of breathing exercises with their therapists


  • The program works on all iPod models, iPhone and iPad with iOs4.0.
  • System requires an headphones with a microphone (included with the iPhone) CHF 29 .- from Apple.
  • The software is free and can be downloded from the AppStore.

In September 2011, an iPod with headphones cost: Switzerland CHF209 (€ 199 in France) (United States $ 199)

Project Status

  • The software is functional and we have already done the initial tests with young patients.
  • We have incorporated the feedback physiotherapists gave on earlier models.
  • The source code is available on github.com

Software Features

  • Detection of vibration frequencies using the library FLAPI
  • Visual feedback corresponding to the frequencies of vibration.
  • Audio feedback.
  • Ability to create user profiles and create custom calibrations and settings.
  • Visualization of results
  • Ability to share results in HTML and CSV for spreadsheets.
  • Gamification. For example, a volcano based game where a successful exercise causes an eruption.
  • Available in English, German and French.



Durations settings



Results (details)

Volcano Game

Volcano Game - in course

Volcano Game - done

Download from iTunes

Usage and set-up ....

Limitations and requests

The software contains a single simple game. However, it has real utility for regular users of PEP devices. The next step for the project is to gather the necessary feedback to improve future releases. The source code is completely open, and we are trying to make it simple for programmers around the world to help in the development.

Computer science students: The development of a mini-game for the Flower breath is a great research project.

Contributions of graphics and language translations are also critical to the project. Contact the development team: info @ defitech ch ** Developers' page **

This software is distributed under the LGPL and is free. The source code is available upon request or on github.com

The project Breath Flower, is originaly a joint initiative from Brigitte Bouzin, Vincent Chritin, Eric Van Lancker, Romain Labbé and Phillip Trotter

Although used in a therapeutic context there is no medical guarantee for the software.

Defitech Foundation is not affiliated and has no contractual relationship with the company producing PEP devices.