Acute effects of three pulmonary reexpansion modalities on thoracoabdominal motion of healthy subjects: Randomized crossover study

Abstract

BackgroundChest physiotherapy can be an alternative to increase lung volumes through pulmonary expansion therapies, but there is still inconsistency in the literature in order to determine which device can promote a greater volume increase at the expense of a better ventilatory pattern. Therefore, the aim of this study was to evaluate and compare the chest wall kinematics of healthy subjects submitted to the use of three different devices for pulmonary reexpansion.MethodsChest wall compartmental and operational volumes, breathing pattern and thoracoabdominal asynchrony were evaluated in 12 healthy individuals through optoelectronic plethysmography during quiet breathing, pulmonary reexpansion and recovery. Three different devices (volume-oriented incentive spirometer–IS-v; positive expiratory pressure–PEP; and incentive spirometer volume and pressure oriented–IS-vp) were administered in a random order with at least 48h between the devices.ResultsA greater volume variation in the chest wall and its compartments was observed when the IS-vp was used in comparison with the other devices (p<0.05). Furthermore, the IS-vp mobilizes a greater amount of volume accompanied by greater synchronism between the compartments when compared to IS-v (p <0.05).ConclusionThe IS-vp may be able to increase total and compartmental chest wall volumes, as well as improve synchrony among compartments when compared to IS-v and PEP devices, thus constituting an important tool for treating patients with restrictive ventilatory pattern.

Maneuvers and strategies in respiratory physical therapy: time to revisit the evidence

“…Respiratory physical therapy has always sought to prove the efficiency of techniques, 1 - 3 such as chest vibration/percussion and changes in inspiratory/expiratory flow, in bronchial hygiene. However, this has failed to be proven because of methodological differences among the studies and the fact that these techniques depend on being properly performed by the physical therapist, as well as, in many cases, on the collaboration of the patients.…”