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A multisensory pelvic floor muscle training game

Until recently it was believed that using pelvic floor muscles to control objects in computer games was complete science fiction. Now, after some years, when we have thousands of women exercising using a intravaginal device connected to a mobile phone, the said vision is no longer anything outlandish. How did computer games, associated mostly with entertainment, become a common element of pelvic floor physiotherapy?

Why is it difficult for us to keep exercising regularly?

The barriers that prevent young moms after childbirth or pre-menopausal women from taking up treatment are known and described in much detail. They include e.g. lack of time, fear of talking to the physician or physiotherapist, fear of having to come to terms with dysfunctions and limited physical activity, often having to commute to the practice to work out, or monotony of exercises provided in an analog format (e.g. a sheet of paper). In addition, the reconstruction of muscles in accordance with the principles of biomechanics requires 3 to 9 – or even 12 – months of involvement and regular exercise. It is no different in the case of men. But in their case, the problem is even bigger because of a complete lack of education and prevention in this area.

Serious games in medicine

Serious games have been successfully used in rehabilitation for many years now. The term “serious games” means that such games are note designed for entertainment but for other specific purposes, e.g. for education, therapy, rehabilitation. The new PelviFly Boost solution runs on UNITY (the most popular game engine in the world). The intravaginal probe (kGoal) and the exercise saddle (Boost) act as manometric (pressure) sensors that analyze muscle activity (contraction/relaxation), and the mobile app presents this activity in the form of an engaging game. This is a perfect example of biofeedback. What’s more, the tasks you need to perform become obstacles you need to navigate through, sharp and gentle turns, or starts to collect.  All this is served in a dynamically changing setting, which makes you completely forget that you actually exercise your pelvic floor muscles when you play the game.

How it works – in a nutshell.

When you contract your muscles, the car makes a turn at the left edge. When you relax your muscles, it starts going along the outer edge. Avoiding obstacles requires you to use more strength when contracting your muscles or to maintain your muscles activated for a few seconds, and collecting stars requires you to relax your muscles quickly and move the car to the other side of the road. Sounds interesting?

Now rotate your phone.

When you play the game, you get tips and information on how to perform the tasks correctly. How much strength to use, how long to keep the muscles contracted, when to relax, or whether the relaxation is total. There is a special meter, like a car tachometer, that shows you the force you apply to control your pelvic floor muscles. The algorithms monitor and analyze the course of your training all the time, prompting you if you exercise correctly. There is also an indication of the driver’s skill level displayed in the bottom left corner. If your level of muscle control, strength, or endurance is not sufficient, you won’t be able to cover the in-game route without running onto the curb or crashing into the barriers placed on the road. This means that the brand-new car you get into to play the game may take a solid beating.

Is the in-app training adapted to my parameters?

Your first task before you take the driver’s seat will be to perform a pelvic floor muscle test using the app and a dedicated device. The test consists of a few simple tasks, i.e. contracting the muscles gently, contracting the muscles as much as you’re able to, performing quick muscle activations, and relaxing. This will enable a special algorithm to analyze the condition of your muscles and define the input parameters. They are the basis on which the in-game routes and the difficulty level are set. You can perform this test on your own at home or under the supervision of a physiotherapist in their practice.

Personalized training programs

There are many different in-game routes. They are designed to enable the player to perform specific tasks and focus on specific activities. Long turns require constant muscle activation at a set level, e.g. for 10 or 20 seconds, which improves muscle endurance. Straight routes with obstacles require quick response and instant relaxation, which supports muscle control and teaches quick activation. Long straight sections combined with fixed-level vibration offer maximum relaxation.

What mechanisms supporting training effectiveness are applied in the game?

The PelviFly Boost rehabilitation game offers exercises affecting a number of senses. The feedback on pelvic floor muscle activity is provided through animation, sound, vibration, and touch. The touchscreen technology is an innovation incorporated into PelviFly games. When performing an exercise using pelvic floor muscles, the player needs to simultaneously react to the objects appearing on the screen and touch them with fingers. This will make the muscles learn the right automatic response and able to control the movement of the car and perform the set task while distracted by additional stimuli. Not to worry. These more challenging exercises will become available once you master the basics.

Ready to take care of your health by going for a ride?

The app will be available in App Store and Google Play on 17 November 2021 – when the Boost device is officially unveiled. If you already own or are planning to buy an external Boost training device, the new PelviFly Boost app will work and connect with it free of charge. It doesn’t include any paid plans and doesn’t require you to link your bank card with it. There is no limit on the quantity of exercises. You are free to use the app as much as you want.

What if I already work out using the latest version of the app and the kGoal device?

We have some great news for you. After you purchase a special license (plugin), the new PelviFly Boost app will connect to your intravaginal device, and once you perform the muscle test, the training regimens will adapt to your individual parameters. The in-game race routes and the tasks to perform are based on similar mechanisms to those adopted in the PelviFly&KegelNinja so you’ll surely manage.

At the first stage after the official unveiling of the PelviFly Boost app, it will not be possible to exercise under the permanent supervision of a specialist (current CARE plan) and the physiotherapist will not be able to view your results. Our suggestion for the users of the PelviFly&KegelNinja app is to keep training using the latest version of the app because it makes it possible to work closely with the selected medical specialist, who is then able to modify the adopted training plans and track and analyze the progress made. The new PelviFly Boost app is recommended mainly to those who exercise for prevention or who have experience with training using an intravaginal probe. The new app will add variety to the plans already followed.

So, hop in behind the wheel, fasten your seatbelt, and off we go!