Hi Vanilla. I don't find the appearance useful. As simple as it seems I find it complex. Explaining to a patient to inhale to raise the ball or piston doesn't do much to encourage patient use. I notice that patient don't used as prescribed during their admission. I've also seen nurse struggle to teach or explain how to use the device. I would definitely change the appearance that would be a more simplified version then what it is. I think the incentive spirometer is an essential tool that needs to be updated in some way to improve compliance.