SilverFit Flow: Breathing exercices

Flow Malou

With the SilverFit Flow, the patient performs various breathing exercises through games. These motivates the patient to keep doing the exercises longer and to repeat them more often.

The exercises are performed under supervision of a therapist or independently, and can be practiced by one patient several times a day.

The training data and scores are recorded by the system, so that the progress is noticeable.

For a demonstration of our SilverFit Flow, without any obligation, please contact us.

SilverFit Flow Speerwerpen

How does it work?

While performing the exercise, goals must be achieved by breathing in and out through a spirometer. The spirometer is a medical product and measures the inhaled and exhaled volume. The values ​​are passed on to the SilverFit Flow, which then controls the exercise.

In the future (expected fall 2020) it is also possible to set a resistance on the spirometer. In this way, the patient can perform respiratory strength training.


Importance of breathing training

Shortness of breath (Dyspnea) is a common complaint in people with lung disease, including patients with Chronic Obstructive Pulmonary Disease (COPD) and asthma. Artificial respiration can also lead to breathing problems at the intensive care unit.

Breathing exercises are an important part of the treatment of these patient groups (Snoeck-Stroband et al. 2015, Gosselink et al. 2011a). Breathing exercises can relieve difficult breathing and ensure that the patient regains control over breathing.

Breathing training can be supervised by a physical therapist, occupational therapist, respiratory therapist or speech therapist.

Motivational games

Regular breathing training is often perceived by patients as boring and repetitive. The SilverFit Flow offers breathing exercises through games. This motivates the patient to keep doing the exercises longer and more regularly.

How to use the SilverFit Flow?

The SilverFit Flow can be supplied on a laptop or added as a module on the SilverFit 3D.

A therapist integrates the SilverFit Flow exercices and games into his treatment protocol, and under his supervision. After guidance from the therapist, the patient experiences how the exercises can be performed independently.

More practice moments can be realized through independent use, with some exercises to be performed every hour.  This contributes positively to the recovery.

Application options

During a treatment: therapists can use the SilverFit Flow to support the treatment of the patient.

From the patient's hospital bed: the spirometer is (via bluetooth - expected spring 2020) linked to the laptop. This allows the patient to perform exercises remotely from the laptop, for example from the hospital bed.

In different departments: the SilverFit Flow is offered on a laptop, making it easy to move the system between different departments.

SilverFit Flow Paraplu

Just like the other SilverFit systems, the SilverFit Flow is developped with exercises. The current exercises on the SilverFit Flow are games with the aim of:

- Increasing the strength of inspiratory muscle by breathing in as much volume as possible. It is also possible to set a minimum and maximum permitted inspiratory flow, so the patient can learn to breathe in a controlled way.

- Increasing the strength of the expiratory muscle by exhaling with maximum force.

- Improving the breathing rhythm by breathing at a specific pace.

- Training respiratory strength through an adjustable resistance (expected fall 2020).

Javelin throw

The patient exhales with maximum force. The greater the expiratory power, the further the hunter throws the spear.

Star path

The patient collects as many stars as possible by breathing in and out at a certain rhythm.

The diamond mine

The patient breathes in as much volume as possible. When breathing in, the vacuum cleaner sucks up the diamonds. Limits can be set so that the patient must stay between a minimum and maximum flow.

The benefits of the SilverFit Flow compared to regular breathing training:

- Visualizations ensure that the patient understands the breathing exercise well and can perform it effectively.

- The patient is motivated to practice thanks to the interactive exercises.

- Multiple practice moments per day due to independent use.

- Both the therapist and the patient gain insight into the patient's progress.

- The patient with impaired cognitive function and / or mild to moderate mental disability is easily involved in the exercises.

A 52-year-old COPD patient performed the "Diamond Mine" game during a SilverFit Flow test session. The game was set precisely in such a way that the patient did not always achieve the highest score. This made her try hard. The patient indicated that the exercises in the form of a game was motivating and fun, and that it challenged her to perform better.

SilverFit Flow Diamantmijn

SilverFit Flow Systeem

The SilverFit Flow offers breathing exercises through games to motivate patients to keep doing the exercises longer and to repeat them more regularly.

Standard Components


The SilverFit Flow consists of a laptop with a 17-inch screen, spirometer and 50 replaceable mouth filters.


The SilverFit Flow software includes all exercises through games and decision aid. The SilverFit Flow can also be supplied as a module on the SilverFit 3D. The software is CE certified as a medical device.

Installation and assistance

On-site installation, training of all potential users, 1 year warranty on hardware and software and 1 year on-site assistance with any problems.


Extra filters

Replaceable mouth filters for the spirometer to ensure hygiene. You can order this from SilverFit.

Service agreement

Additions to the software, (accredited) floor training for all users at your location, fast on-site service in the event of problems and free access to the SilverFit training sessions and user meetings.

SilverFit Flow Spirometer

SilverFit Flow Wetenschap

Better respiration gas exchange

Viera et al. (2014) have shown that breathing exercises (including sighs and maximum inhalation) increase the tidal volume and decrease the respiratory rate compared to these resting values. This results in a better respiration gas exchange. This is important, among other things, for patients with COPD and patients who have a reduced gulp volume and an increased breathing rate after artificial respiration.

Positive effect on dyspnea & quality of life

Dyspnea (shortness of breath) is common in people with COPD, regardless of the severity of the disease. Many of the interventions for people with COPD are aimed at reducing this symptom. Breathing exercises are physical therapy interventions. Long Alliance Netherlands describes that they have a proven beneficial effect on dyspnea and on the quality of life. During the breathing exercises, the patient is encouraged and motivated to also use the learnt techniques in daily life. Adopting these techniques in daily life reduces anxiety and motivates people with COPD to exercise more (Long Alliance Netherlands, 2016).

Exercises recommended with COPD

The KNGF (Koninklijk Nederlands Genootschap voor Fysiotherapy) recommends inspiratory muscle strength training for COPD patients with pronounced inspiratory muscle weakness, fatigue and complaints of shortness of breath in daily life. Clinical experiences support the KNGF recommendation. Breathing exercises, including active expiration as well as slow and deep breathing, are recommended to reduce hyperinflation and improve gas exchange (KNGF, 2017).

Borge et al. (2014) have looked at various systematic reviews about the effect of respiratory muscle strength training on various symptoms within people with COPD. Five systematic reviews were examined, two of which were of high quality. Based on this, it was concluded that respiratory muscle strength training has a positive effect on shortness of breath, fatigue and quality of life in people with COPD. The results can be seen in the table below.

Flow Borge table EN

Exercising after artificial respiration is also important

Bissett et al. (2016) looked at the effect of inspiratory muscle strength training on patients after having been on ventilation for a long period of time. Inspirational muscle strength and quality of life increased significantly more in the group of patients who performed inspiratory muscle strength training (IST group) than in patients from a control group.

Flow Bissett graph EN


Bissett, B. M., Leditschke, I. A., Neeman, T., Boots, R., & Paratz, J. (2016). Inspiratory muscle training to enhance recovery from mechanical ventilation: a randomized trial. Thorax, 71, 812-819.

Borge, C.R., Hagen, K. B., Mengshoel, A. M., Omenaas, E., Moum, T., & Wahl, A. K. (2014). Effects of controlled breathing exercises and respiratory muscle training in people with chronic obstructive pulmonary disease: results from evaluating the quality of evidence in systematic reviews. BMC Pulmonary Medicine, 14, 184.

Geddes, E. L., O'Brien, K., Reid, W. D., Brooks, D., & Crowe, J. (2008). Inspiratory muscle training in adults with chronic obstructive pulmonary disease: an update of a systematic review. Respiratory Medicine, 102, 1715-1729.

Gosselink, R., Clerckx, B., Robbeets, C., Vanhullebusch, T., Vanpee, G., & Segers, J. (2011a). Physiotherapy in the intensive care unit. Netherlands Journal of Critical Care, 15 (2), 66-75.

Gosselink, R., De, V. J., Van den Heuvel, S. P., Segers, J., Decramer, M., & Kwakkel, G. (2011b). Impact of inspiratory muscle training in patients with COPD: what is the evidence? European Respiratory Journal, 37, 416-425.

KNGF (2017). KNGF guideline, Chronic obstructive pulmonary diseases.

Long Alliance Netherlands (2016). COPD care standard.

O'Brien, K., Geddes, E. L., Reid, W. D., Brooks, D., & Crowe, J. (2008). Inspiratory muscle training compared to other rehabilitation interventions in chronic obstructive pulmonary disease: a systematic review update. Journal of Cardiopulmonary Rehabilitation and Prevention, 28, 128-141.

Shoemaker, M.J., Donker, S., & Lapoe, A. (2009). Inspiratory muscle training in patients with chronic obstructive pulmonary disease: the state of the evidence. Cardiopulmonary Physical Therapy Journal, 20, 5-15.

Snoeck-Stroband, J. B., Schermer, T. R. J. Van Schayck, C. P., Muris, J. W., Van der Molen, T., In 't Veen, J. C. C. M.,Tuut M.K. (2015). NHG Standard COPD (Third Review). General Practitioner and Science, 58 (4), 198-211.

Thomas, M. J., Simpson, J., Riley, R., & Grant, E. (2010). The impact of home-based physiotherapy interventions on breathlessness during activities or daily living in severe COPD: a systematic review. Physiotherapy, 96, 108-119.

Vieira, D.S.R., Mendes, L.P.S., Elmiro, N.S., Velloso, M., Britto, R.R., & Parreira, V.F. (2014). Breathing exercises: influence on breathing patterns and thoracic abdominal motion in healthy subjects. Brazilian Journal of Physical Therapy, 18 (6), 544-552