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Study design flowchart of the 16-month study per participant. Participant assessment visits are in shaded boxes. ACTs and physical activity are recorded daily using electronically chipped devices (a bespoke ACT sensor and a Fitbit activity tracker). The specially developed Fizzyo app, as well as syncing ACT data throughout the 16 months, gives participant feedback in months 2–14 and ACT-driven gaming is available in months 4–12. ACT, airway clearance technique; CF, cystic fibrosis.
