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

Abstract

BACKGROUND: Aging causes physiological and functional changes that impair pulmonary function. Incentive spirometry is widely used for lung expansion, but the effects of volume-oriented incentive spirometry (VIS) versus flow-oriented incentive spirometry (FIS) on chest wall volumes, inspiratory muscle activity, and thoracoabdominal synchrony in the elderly are poorly understood. We compared VIS and FIS in elderly subjects and healthy adult subjects. METHODS: Sixteen elderly subjects (9 women, mean ؎ SD age 70.6 ؎ 3.9 y, mean ؎ SD body mass index 23.8 ؎ 2.5 kg/ m 2 ) and 16 healthy adults (8 women, mean ؎ age 25.9 ؎ 4.3 y, mean ؎ body mass index 23.6 ؎ 2.4 kg/ m 2 ) performed quiet breathing, VIS, and FIS in randomized sequence. Chest wall kinematics (via optoelectronic plethysmography) and inspiratory muscle activity (via surface electromyography) were assessed simultaneously. Synchrony between the superior thorax and abdominal motion was calculated (phase angle). RESULTS: In the elderly subjects both types of incentive spirometry increased chest wall volumes similarly, whereas in the healthy adult subjects VIS increased the chest wall volume more than did FIS. FIS and VIS triggered similar lower thoracoabdominal synchrony in the elderly subjects, whereas in the healthy adults FIS induced lower synchrony than did VIS. FIS required more muscle activity in the elderly subjects to create an increase in chest wall volume. CONCLUSIONS: Incentive spirometry performance is influenced by age, and the differences between elderly and healthy adults response should be considered in clinical practice.

Systematic Review of Inspiratory Muscle Training After Cerebrovascular Accident

“…Three articles were found that included information about spirometers. 10,12,22 In these articles, respiratory muscle training, performed using threshold pressure load in inspiratory muscles, was included. 23 A meta-analysis of the data from the randomized clinical trials was included in this review and is presented in Figure 1.…”

“…22 There are 2 types of spirometers: volume and flow. 12 The incentive volume spirometer provides an increase in thoracic expansion and reduces asymmetries of these expansions.…”

Fonoterapia vocal e fisioterapia respiratória com idosos saudáveis: revisão de literatura

“…Another study 37 compared the effects of incentive spirometry flow (RESPIRON®) and volume (Voldyne®) on lung volumes, thoracoabdominal mobility and inspiratory muscle activity in the elderly people and in healthy adults, evaluated by plethysmography and electromyography, concluding that both the spirometers have similar effects in lung volumes and thoracoabdominal mobility, however, the spirometer flow requires greater respiratory muscle activity. A current study 38 with 48 healthy elderly subjects randomized into group therapy with RESPIRON® and the other therapy group with Voldyne® presented an increase in some variables, such as: respiratory muscle strength, lung function (spirometry values) and thoracoabdominal mobility in both groups by approving these devices as good allies of respiratory therapy.…”

Efeitos do exercício muscular respiratório na biomecânica da deglutição de indivíduos normais

“…Among these, we can highlight the Respiron® IS, which emphasizes the deep inspiration up to total lung capacity, providing visual feedback 7,8 . This type of IS facilitates deep breathing, stimulates high inspired volumes and prevents lung hypoventilation 6,9,10 .…”

“…The exercises with IS are a simple and safe way to perform breathing training, aiming at the improvement of lung volumes and at the prevention of respiratory complications in children, adults and elderly people 7 .…”