Effect of volume-oriented versus flow-oriented incentive spirometry on chest wall volumes, inspiratory muscle activity, and thoracoabdominal synchrony in the elderly

Effect of volume-oriented versus flow-oriented incentive spirometry on chest wall volumes, inspiratory muscle activity, and thoracoabdominal synchrony in the elderly

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,...

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Bibliographic Details
Published in:Respiratory care Vol. 59; no. 3; pp. 420 - 426
Main Authors: Lunardi, Adriana C, Porras, Desiderio C, Barbosa, Renata Cc, Paisani, Denise M, Marques da Silva, Cibele C B, Tanaka, Clarice, Carvalho, Celso R F
Format: Journal Article
Language:English
Published: United States Daedalus Enterprises, Inc 01-03-2014
Subjects:
Adult
Aged
Breathing Exercises
Electromyography
Female
Humans
Male
Methods
Physiological aspects
Physiological research
Pulmonary function tests
Pulmonary ventilation
Respiratory Mechanics - physiology
Respiratory Muscles - physiology
Spirometry - methods
Thoracic Wall
Young Adult
elderly
electromyography
respiratory mechanics
chest wall
physical therapy
biomechanics
incentive spirometry
lung volumes
breathing exercises
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Summary: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. 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). 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. Incentive spirometry performance is influenced by age, and the differences between elderly and healthy adults response should be considered in clinical practice.
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ISSN:0020-1324
1943-3654
DOI:10.4187/respcare.02665