BrightHearts Research, 2011…

The BrightHearts Research project is investigating the application of George Khut’s heart-rate controlled artworks  for use during medical procedures – as a biofeedback assisted relaxation-training app to help manage the pain and anxiety experienced by children who undergo recurrent painful procedures, such as injections for Botulinim (‘Botox’) treatments, Baclofen pump changes, central line changes, and lumbar punctures.

The BrightHearts app (iOS only) is available as a free download from the Apple App Store – for use in conjunction with a range of consumer heart rate sensors that use the Bluetooth 4.0 heart rate protocol.

The recurrent nature of these procedures can result in a build-up of anticipatory anxiety, causing significant distress to the children, exacerbating the perceived intensity of the painful stimulus during treatment, and further complicating veinipuncture procedures in cases of extreme vasoconstriction. If left un-addressed, the intense distress and anxiety experienced during these procedures can lead to avoidance behaviours that may stay with them into adulthood. .

Children using the BrightHearts App before and during anxiety provoking procedures are rewarded with sounds and visuals that respond to decreases in heart rate over different periods of time i.e. changes that they can influence with their breathing, and longer-term changes that require relaxation. The patterns change according to the patient’s changing pulse rate. Children learn to relax and slow down their heart rate.

The BrightHearts approach combines standard distraction methods with the principals of biofeedback relaxation training – focusing children’s attention away from their object of their anxiety and fear, and helping them to develop skills for observing and regulating their response during painful procedures. The app provides a distraction and helps children gain a greater sense of control over their own body.

The BrightHearts App is designed to work with Heart Rate sensors that use the Bluetooth Heart Rate standardsensors i.e. MIO Alpha, Link etc., Polar H7, and is available for purchase from the Apple iTunes Store.

Research Findings

In a pilot study published by Pain Practice, BrightHearts was found to help most young patients cope better with the pain and anxiety of procedures.

“BrightHearts taps into children’s interest in devices like smartphones and tablets,” said Dr. Morrow. “Biofeedback is a modality that we hope will empower children and help them to manage their pain and anxiety without the need for medications.”

The patient cohort for the study underwent one of three medical procedures: peripheral blood collection, botulinum toxin injection, or intravenous cannula insertion. The researchers observed or received feedback from patients, parents, and healthcare professionals, while satisfaction from these three parties was measured through surveys.

The study shows that 83 percent of patients said that they found the relaxation app helpful and would use it again, all of the parents and 96 percent of healthcare professionals also said they would use BrightHearts again. Sixty-four percent of the clinicians said it allowed them to perform the procedure more easily.

Clinical trials of the BrightHearts app are still underway with patients at the Children’s Hospital at Westmead, Kid Rehab.

Credits

George Khut: interaction concept, interaction programming (Max-MSP), production management

Dr Angie Morrow: Staff specialist, Kids Rehab, chief investigator – acute pain management; hospital and research office liason

Trent Brooks: iOS Development, 2014-2019

Jason McDermott: iOS Development. 2011-2014

Andy Nicholson (Infinite Recursion): iOS Development 2012-2013

Angelo Fraietta (Smart Controller): custom pulse-sensor interface

Frank Maguire: sensor electronics and hardware design

Ben Cloyd and Melissa Yogui-Watanabe: research assistants, Kids Rehab.

Caroline Dale: Qualitative researcher – children’s experiences of recurrent painful procedures

Tuan Mahn Vu, Lukas Blödorn, Christoph Eibisberger, and Monette Tan (Final Year Students – Extreme Programming Workshop, UTS Faculty of Engineering and IT): Heart Rate Variability Analysis software

Acknowledgements  

BrightHearts has been supported by the James N. Kirby Foundation (medical grant);  the Australian Network for Art and Technology; the Children’s Hospital at Westmead, Kids Rehab, and the Australian Government through the Australia Council for the Arts, its arts funding and advisory body. Special thanks to UTS Interaction Design and Human Practices Lab (IDHuP), and UTS DAB Interactivation Studio