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Background: Chest expansion measurements are used to evaluate the patient's baseline status, treatment effectiveness, and progression of respiratory diseases with regards to chest wall mobility and respiratory muscle function. It is important to know the reference values of chest expansion of healthy adult Indian population for precise interpretation. Aim:To determine reference values of chest expansion for healthy adult Indian population. Methodology:Total 576 healthy adults participated in this observational study which was carried out at teaching institute and community in Pune city, India. Participants were apparently healthy and non smoking individuals who are recruited by purposive sampling technique. Data was obtained by measuring chest expansion with participants in standing position, elbows slightly flexed so that the hands rested on hips. Chest was exposed and with the help of an non stretchable inch tape the chest expansion was measured at three levels that is 2 nd intercostal space(ICS), 4 th intercostal space, and zyphoid process.Statistical Analysis: Data was analyzed with descriptive and inferential statistics. Level of significance was set at 0.05 -level.Results: 576 Participants were recruited for the study.293 were females and 283 were males. The mean age of female participants was 38.43 years (SD=16.52 years) , and the mean age of males were 39.99 years (SD= 17.13 years). Results showed that in female participants mean expansion at 2 nd ICS was 2.22 inches (SD=0.76 inches), at 4 th ICS was 2.22 inches (SD=0.73 inches) and at zyphoid process level was 2.27 inches (SD=0.78 inches) while in male participants mean expansion at 2 nd ICS was 2.76 inches (SD=0.90 inches), at 4 th ICS was 2.71 inches (SD=0.82 inches) and at zyphoid process level was 2.99 inches (SD=0.87 inches). Chest expansion in male participants' at all three levels was significantly higher than female participants. There was statistically significant difference between chest expansion at 2 nd , 4 th ICS and zyphoid process level in males but there was no such difference found in females. It was also observed that there was age-wise reduction in chest expansion in both males and females. Conclusion:It was concluded that male chest expansion was significantly higher than female participants. Study has provided the preliminary baseline for the chest expansion measurements obtained from healthy adult Indian population.

Background: The 2 types of incentive spirometers (flow and volume-oriented) prescribed after cardiac surgery demonstrate a difference in the pattern of breathing, diaphragm mobility, pulmonary function test. Limited research is available on effect of incentive spirometer on hemodynamic parameters. Purpose: To provide hemodynamic perspective for preference of a specific type of incentive spirometer after cardiac surgery. Method: Ideal method of performing breathing on their prescribed incentive spirometer was explained. On 2nd day post surgery, heart rate, respiratory rate, oxygen saturation and blood pressure were noted immediately before and after performing 8 breaths on incentive spirometer. Results: The intergroup comparison i.e., difference between changes caused by flow and volume-oriented incentive spirometers are statistically insignificant. The intra group comparison, the changes in hemodynamic parameters by flow and volume-oriented incentive spirometers are statistically insignificant, except for heart rate with flow-oriented incentive spirometers showed statistically significant increase. Conclusions: There is no difference in the impact of flow oriented and volume-oriented Incentive spirometers on hemodynamic parameters in post cardiac surgery patients. KEY WORDS: Incentive spirometer, Cardiac surgery, Heart rate, Blood pressure, Respiratory Rate, Oxygen saturation.

Background: Variation in the position of the body influences the orientation and length of the muscle. The ability of the respiratory muscles to generate force depends upon its length. There is a dearth of literature about the effect of pressures generated by the respiratory muscles due to the different sitting positions. Purpose of the study: Due to the importance of body positioning in the optimization of breathing exercises, a need was felt to compare maximal respiratory pressures of the respiratory muscles in different sitting positions and identify a suitable position in which respiratory muscles work the best. Participants: Total 144 participants were included in the study according to the inclusion and exclusion criteria. Participants were divided into age groups of 18-40years, 41-60years and 60years and above. Equal representation was given to sample number and gender in each group. Method: MIP and MEP were measured in three different sitting positions i.e. upright sitting position, forward leaning position and semi fowlers position by using the Micro RPM (Micro Medical/Care Fusion, Kent, United Kingdom). The best of the three measurements was taken. Results: There is a significant difference in the values of MIP and MEP in different sitting positions in all the age groups with p-value < 0.05. In each age group it was found that the values of MIP was better in upright sitting position as compared to forward leaning position (p-value <0.01) with no difference found in the values of MIP between the upright sitting position and semi-fowlers position (p-value > 0.05). The values for MEP was found to be increased in forward leaning position as compared to upright sitting position and semi-fowlers position p-value <0.05 Conclusion: The present study concluded that, there is a significant influence of different sitting positions on the maximal respiratory pressures in healthy individuals of various age groups. Implication: The results of this study can be used to make a good clinical decision about which sitting position should be adapted while giving the various types of breathing exercises to the patient. KEY WORDS: Maximal respiratory pressures, MIP, MEP, body positioning, sitting positions, breathing exercises.