Volume Rather Than Flow Incentive Spirometry Is Effective in Improving Chest Wall Expansion and Abdominal Displacement Using Optoelectronic Plethysmography

Abstract

. All subjects performed 8 quiet breaths and 8 deep breaths with FIS and VIS, in a randomized order. We measured thoracoabdominal chest wall, upper and lower rib-cage, and abdominal volumes with optoelectronic plethysmography, and the muscle activity of the sternocleidomastoid and superior and inferior intercostal muscles with electromyography. RESULTS: VIS increased chest wall volume more than did FIS (P ‫؍‬ .007) and induced a larger increase in the upper and lower rib-cages and abdomen (156%, 91%, and 151%, respectively, P < .001). By contrast, FIS induced more activity in the accessory muscles of respiration than did VIS (P < .001). CONCLUSIONS: VIS promotes a greater increase in chest wall volume, with a larger abdominal contribution and lower respiratory muscle activity, than does FIS in healthy adults.

Effect of Volume-Oriented Versus Flow-Oriented Incentive Spirometry on Chest Wall Volumes, Inspiratory Muscle Activity, and Thoracoabdominal Synchrony in the Elderly

“…1,25 FIS and VIS induced similar volumes and displacement in all the thoracoabdominal compartments in the elderly, whereas in the adult subjects VIS induced greater abdominal displacement than did FIS. 10,11 Contrary to the findings of previous studies, our adult subjects did not have higher sternocleidomastoid activity during FIS. 10,11 The difference between our results and those studies might be due to differences in how the subjects were advised to perform incentive spirometry, or to different EMG electrode positioning.…”

“…10,11 Contrary to the findings of previous studies, our adult subjects did not have higher sternocleidomastoid activity during FIS. 10,11 The difference between our results and those studies might be due to differences in how the subjects were advised to perform incentive spirometry, or to different EMG electrode positioning. In our study the electrode positioning was standardized and the same researcher oriented all the subjects similarly.…”

“…In healthy adults, previous studies have reported that VIS induced greater chest wall expansion and abdominal displacement 10,11,19 and lower inspiratory muscle activity 9,11,20 and work of breathing 21,22 than FIS. However, to the best of our knowledge the advice to use incentive spirometry has never been investigated in elderly subjects.…”

“…These maneuvers increase transpulmonary pressure and therefore increase chest-wall volume. 9 Parreira et al 10 and Paisani et al 11 showed that VIS promotes a greater chest wall volume with a larger abdominal contribution than does FIS in healthy adult subjects. In addition, Chang et al (2010) 7 and Parreira et al (2005) 10 suggested that the inspiratory flow, rather than the type of incentive spirometry, determines the breathing pattern and the respiratory muscle activation in this population.…”

Acute Effects of Volume-Oriented Incentive Spirometry on Chest Wall Volumes in Patients After a Stroke

“…Literature suggests this type of incentive spirometer prevents pulmonary complications and also improves chest wall volumes compared with flow-oriented devices. [4][5][6][7][8][9] The volume-oriented incentive spirometer has the advantage of being inexpensive and portable, thus making it ideal for home rehabilitation in stroke patients. However, the possible beneficial effects on chest wall motion are still unknown.…”