Impact of Playful Visual Feedback Coaching on Mechanical In-Exsufflation Learning in Children: A Randomized Trial

Aims Mechanical insufflation-exsufflation (MI-E) is effective for pediatric airway clearance. A novel coaching module using playful visual feedback is available, but its learning efficacy is unknown. This study investigated whether adding the module to physiotherapist guidance improves learning speed.Methods In this randomized controlled trial, healthy children aged 6–10 years, naive to MI-E, were assigned to a coaching group with the coaching module plus physiotherapist guidance or a control group (physiotherapist guidance only). Learning was assessed over two sessions by the number of sets to achieve success and visual analog scales (VAS) for playfulness and ease of learning.Results Twenty children were included in the final analysis (9 girls, 11 boys; mean age 9.0 ± 1.3 years), including 11 in the coaching group and 9 in the control group. The coaching group required significantly fewer sets in session one (2.3 ± 1.1 vs 4.1 ± 1.9; p = 0.01), but not during the second session. VAS scores showed no significant differences.Conclusion Playful visual feedback can accelerate initial MI-E learning in children, offering a promising strategy for early training. Further research is needed to evaluate long-term outcomes and home-based implementation.