Use of lung expansion techniques on drained and non-drained pleural effusion: survey with 232 physiotherapists

Abstract

Introduction: Techniques for lung expansion seem to benefit patients with drained and undrained pleural effusion, but there is a lack of evidence to indicate which technique is best in each situation. Currently, the therapeutic choices of respiratory physiotherapists serving this population are not known. Objective: To know which lung expansion techniques are chosen by chest physiotherapists who assist patients with drained and non-drained pleural effusion. Method: Through the announcement of the Federal Council, 232 physiotherapists who work in hospitals in Brazil were questioned about which techniques they apply to patients with drained and non-drained effusion. Results: Initially, 512 were questioned but 232 (45.3%) answered. The physiotherapists associate more than one technique of lung expansion in both types of patients, besides walking. Deep breathing is the most used technique in patients with drained (92%) and non-drained (77%) pleural effusion. Positive pressure exercises in the airways are chosen by 60% of the physiotherapists to treat patients with drained pleural effusion and by 34% to treat patients with non-drained pleural effusion. Yet the incentive spirometry are used with 66% of patients with drained pleural effusion and 42% with non-drained ones. Conclusion: Deep breathing is the most applied lung expansion technique in the treatment of patients with drained and non-drained pleural effusion by chest physiotherapists. In addition, there is association between greatest degree and time of professional performance and the chosen techniques.

A Combat Journey With Pulmonary Rehabilitation and Palliative Care in a Patient With Pleural Effusion, Secondary to Metaplastic Breast Carcinoma

“…Deep breathing, incentive spirometry, and positive pressure exercises were all effective lung expansion techniques employed in patients who had drained pleural effusions [11]. Chest mobility exercises improve chest wall, trunk, and shoulder mobility, even focusing on depth of inspiration.…”

“…The primary interventions for rehabilitating patients with deteriorating health status due to respiratory problems include patient education, airway clearance procedures, breathing strategies, and a graded exercise training program [ 10 ]. Deep breathing, incentive spirometry, and positive pressure exercises were all effective lung expansion techniques employed in patients who had drained pleural effusions [ 11 ]. Chest mobility exercises improve chest wall, trunk, and shoulder mobility, even focusing on depth of inspiration.…”

Current developments and future directions in respiratory physiotherapy

“…Deep breathing exercises and lung expansion techniques have been widely used to prevent complications in different chronic respiratory diseases and after surgical procedures [55][56][57][58]. However, their efficacy remains uncertain.…”

“…Deep breathing exercises are based on producing an active inspiration with a breath hold, permitting a maximum and slow breath, before a passive expiration. This technique can be applied in patients with drained and undrained pleural effusions; a survey has found that it is the most commonly used technique in these patients [56]. Deep breathing exercises have been evaluated in patients after upper abdominal surgery in a randomised control trial; results show that neither thoracoabdominal mechanics nor pulmonary complications were modified using this technique [58].…”

Effect of incentive spirometry after cardiac surgery: protocol for a systematic review

“…Several publications have suggested that IS is ineffective [8,10]. Nevertheless, nearly 42% of physiotherapists keep using IS after thoracic surgical procedures [11]. In contrast, some studies have shown that when IS is adequately used, it may lead to beneficial outcomes [12,13].…”