Effects of breathing exercises on breathing pattern and thoracoabdominal motion after gastroplasty

Abstract

Objective: To evaluate breathing pattern and thoracoabdominal motion during breathing exercises. Methods: Twenty-four patients with class II or III obesity (18 women; 6 men) were studied on the second postoperative day after gastroplasty. The mean age was 37 ± 11 years, and the mean BMI was 44 ± 3 kg/m 2 . Diaphragmatic breathing, incentive spirometry with a flow-oriented device and incentive spirometry with a volume-oriented device were performed in random order. Respiratory inductive plethysmography was used in order to measure respiratory variables and thoracoabdominal motion. Results: Comparisons among the three exercises showed significant differences: tidal volume was higher during incentive spirometry (with the flow-oriented device or with the volume-oriented device) than during diaphragmatic breathing; the respiratory rate was lower during incentive spirometry with the volume-oriented device than during incentive spirometry with the flow-oriented device; and minute ventilation was higher during incentive spirometry (with the flow-oriented device or with the volume-oriented device) than during diaphragmatic breathing. Rib cage motion did not vary during breathing exercises, although there was an increase in thoracoabdominal asynchrony, especially during incentive spirometry with the flow-oriented device. Conclusions: Among the breathing exercises evaluated, incentive spirometry with the volume-oriented device provided the best results, because it allowed slower, deeper inhalation.Keywords: Breathing exercises; Physical therapy (Specialty); Bariatric surgery; Obesity, morbid. ResumoObjetivo: Avaliar o padrão respiratório e o movimento toracoabdominal durante exercícios respiratórios. Métodos: Vinte e quatro pacientes com obesidade de nível II e III (18 mulheres; 6 homens) foram estudados no segundo dia pós-operatório após gastroplastia. A média de idade era de 37 ± 11 anos, e a média de IMC era de 44 ± 3 kg/m 2 . Exercício diafragmático, espirometria de incentivo orientada a fluxo e espirometria de incentivo orientada a volume foram realizados em ordem aleatória. A pletismografia respiratória indutiva foi utilizada para avaliar variáveis do padrão respiratório e do movimento toracoabdominal. Resultados: As comparações entre os exercícios demonstraram diferenças significativas: maior volume corrente durante a espirometria de incentivo orientada a fluxo ou orientada a volume (vs. exercício diafragmático), menor frequência respiratória durante a espirometria de incentivo orientada a volume (vs. espirometria de incentivo orientada a fluxo), e maior ventilação minuto durante a espirometria de incentivo orientada a fluxo ou orientada a volume (vs. exercício diafragmático). O movimento toracoabdominal não foi modificado durante os exercícios respiratórios e houve um aumento na assincronia toracoabdominal, especialmente durante a espirometria de incentivo orientada a fluxo. Conclusões: Entre os exercícios respiratórios avaliados, a espirometria de incentivo orientado a volume forneceu os melhores resultado...

Feasibility and reproducibility of spirometry and inductance plethysmography in healthy Brazilian preschoolers

“…This is a noninvasive method that requires little effort from the individual. The measures are based on changes in the cross‐sectional area of the chest wall and are captured by two bands of inductance,16 one positioned in the axilla and the other placed in the umbilical line, according to established criteria 10, 17, 18. The devices provide breath waveform sampling at 50 points/sec.…”

Três protocolos fisioterapêuticos: efeitos sobre os volumes pulmonares após cirurgia cardíaca

“…(9) Therefore, the duration of the BS maneuvers was greater than was that of IS. According to various authors, the effectiveness of a lung-expansion maneuver might be influenced as much by its duration as by the maximal volume achieved.…”

“…Therefore, if SpO 2 dropped to < 90%, the intervention was interrupted and oxygen therapy recommenced. (9,10) All of the procedures were performed under the supervision of a member of the hospital physical therapy staff participating in the study. Forced spirometry was carried out in the preoperative period and from postoperative days 1 to 5, with a Pony Fx ® spirometer (Cosmed, Rome, Italy).…”

Influence of forward leaning and incentive spirometry on inspired volumes and inspiratory electromyographic activity during breathing exercises in healthy subjects

“…The explanation is that a slow inspiration contributes to generate a laminar inspiratory flow, resulting in a more uniform distribution of air through the parenchyma, what theoretically augments pulmonary expansion (Tomich et al, 2007(Tomich et al, , 2010. Conversely, a high inspiratory flow would impair air distribution, especially to peripheral areas of pulmonary parenchyma.…”

“…Since 1980's, IS became widely used in the postoperative of thoracic and abdominal surgeries for the prevention and treatment of pulmonary complications (O'Donohue, 1985). Several studies have been conducted to evaluate its efficacy and to compare this technique with other treatment programs (Dias et al, 2011;Tomich et al, 2010). However, until today there are some controversies regarding IS benefits in relation to BE performed without it or even related to the device type used, volume or flow-oriented (Agostini et al, 2008).…”