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Mera N, Wilches Luna EC, Benavides-Cordoba V. Comparative analysis of pulmonary ventilation distribution between low-cost and branded incentive spirometers using electrical impedance tomography in healthy adults: Study protocol. PLoS One 2024; 19:e0302476. [PMID: 38709742 PMCID: PMC11073695 DOI: 10.1371/journal.pone.0302476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 03/28/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND The Incentive Spirometer (IS) increases lung volume and improves gas exchange by visually stimulating patients to take slow, deep breaths. It prevents respiratory complications and treats postoperative atelectasis in patients undergoing abdominal, thoracic, and neurosurgical procedures. Its effectiveness has been validated in studies that support improved lung capacities and volumes in individuals with respiratory complications, postoperative thoracic surgery, upper abdominal surgery, and bariatric surgery. The modified Pachón incentive spirometer (MPIS) is a cost-effective alternative to branded IS. It is crucial to validate whether the MPIS distributes ventilation as effectively as commercial devices do. Ventilation distribution will be measured using electrical impedance tomography. OBJECTIVE The aim is to compare the distribution of pulmonary ventilation between the MPIS and another commercial IS in healthy adults using electrical impedance tomography. METHODS A crossover clinical trial is proposed to evaluate the measurement of pulmonary ventilation distribution using EIT in a sample of healthy adults. All participants will use a commercial flow IS and the MPIS, with the order of assignment randomized. This research will use electrical impedance tomography to validate the operation of the MPIS. CONCLUSIONS This study protocol will compare two incentive spirometers' impact on pulmonary ventilation, potentially endorsing the adoption of a cost-effective device to enhance accessibility for targeted populations. TRIAL REGISTRATION The study was registered in ClinicalTrials.gov (NTC05532748).
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Novel Real-Time OEP Phase Angle Feedback System for Dysfunctional Breathing Pattern Training-An Acute Intervention Study. SENSORS 2021; 21:s21113714. [PMID: 34073590 PMCID: PMC8199249 DOI: 10.3390/s21113714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/19/2021] [Accepted: 05/25/2021] [Indexed: 11/25/2022]
Abstract
Dysfunctional breathing patterns (DBP) can have an impact on an individual’s quality of life and/or exercise performance. Breathing retraining is considered to be the first line of treatment to correct breathing pattern, for example, reducing ribcage versus abdominal movement asynchrony. Optoelectronic plethysmography (OEP) is a non-invasive 3D motion capture technique that measures the movement of the chest wall. The purpose of this study was to investigate if the use of a newly developed real-time OEP phase angle and volume feedback system, as an acute breathing retraining intervention, could result in a greater reduction of phase angle values (i.e., an improvement in movement synchrony) when compared to real-time OEP volume feedback alone. Eighteen individuals with a DBP performed an incremental cycle test with OEP measuring chest wall movement. Participants were randomly assigned to either the control group, which included the volume-based OEP feedback or to the experimental group, which included both the volume-based and phase angle OEP feedback. Participants then repeated the same cycle test using the real-time OEP feedback. The phase angle between the ribcage versus abdomen (RcAbPhase), between the pulmonary ribcage and the combined abdominal ribcage and abdomen (RCpAbPhase), and between the abdomen and the shoulders (AbSPhase) were calculated during both cycle tests. Significant increases in RcAbPhase (pre: −2.89°, post: −1.39°, p < 0.01), RCpAbPhase (pre: −2.00°, post: −0.50°, p < 0.01), and AbSPhase (pre: −2.60°, post: −0.72°, p < 0.01) were found post-intervention in the experimental group. This indicates that the experimental group demonstrated improved synchrony in their breathing pattern and therefore, reverting towards a healthy breathing pattern. This study shows for the first time that dysfunctional breathing patterns can be acutely improved with real-time OEP phase angle feedback and provides interesting insight into the feasibility of using this novel feedback system for breathing pattern retraining in individuals with DBP.
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Mendes LPDS, Borges LF, Mendonça L, Montemezzo D, Ribeiro-Samora GA, Parreira VF. Incentive spirometer: Aspects of the clinical practice of physical therapists from Minas Gerais working with patients with respiratory dysfunction. Braz J Phys Ther 2021; 25:632-640. [PMID: 34023212 DOI: 10.1016/j.bjpt.2021.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 03/15/2021] [Accepted: 04/03/2021] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND Incentive spirometers (ISs) are clinical devices used in respiratory physical therapy to increase alveolar ventilation and functional residual capacity. OBJECTIVES To investigate factors that influence physical therapists from Minas Gerais in selecting a type of IS and the scientific background behind the use of ISs by physical therapists who work with patients with respiratory dysfunctions. METHODS Physical therapists from 13 hospital and non-hospital institutions (public/private) completed a self-administered questionnaire based on the current evidence on ISs. RESULTS Indications and contraindications of ISs are not fully understood by most of the 168 physical therapists who completed the questionnaire. Volume-oriented IS was preferred over flow-oriented IS. However, only half of the physical therapists have a scientific background to justify the choice of one IS type rather than the other. CONCLUSIONS Most physical therapists from Minas Gerais do not fully understand the indications and contraindications for ISs. Despite physical therapists stating their preference for volume-oriented IS, this choice is not necessarily based on current scientific evidence. The development of strategies to bring physical therapists closer to evidence-based practice is necessary to ensure best patient care.
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Affiliation(s)
| | - Larissa Faria Borges
- Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - LetÃcia Mendonça
- Department of Physical Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Dayane Montemezzo
- Department of Physical Therapy from the Centre of Health Sciences and Sports, Universidade do Estado de Santa Catarina, Florianópolis, SC, Brazil
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El Banna EH, El Hadidy EI, Ali WM. Effect of respiratory therapy on pulmonary functions in children with cerebral palsy: a systematic review. BULLETIN OF FACULTY OF PHYSICAL THERAPY 2020. [DOI: 10.1186/s43161-020-00016-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Children with cerebral palsy (CP) are at risk for respiratory dysfunction. Early initiation of pulmonary rehabilitation in addition to conventional physical therapy may result in improvement and maintenance of chest mobility and respiratory function. However, empirical support for respiratory therapy is limited. The aim of the review was to assess the evidence of the effectiveness of respiratory therapy on pulmonary functions in children with CP.
Methods
Four electronic databases (PubMed, Cochrane Library, Physiotherapy Evidence Database (PEDro), and Google Scholar) were searched till December 2019 using predefined terms by two independent reviewers. Randomized controlled trials published in English were included if they met the following criteria: population—children with different types of CP of both sex, aged up to 18 years; intervention—respiratory therapy; outcomes—pulmonary functions. Eight studies with 235 participants only met the inclusion criteria and were included in this review. Predefined data were tabulated using American Academy for Cerebral Palsy and Developmental Medicine by two reviewers and verified by a third reviewer. Methodological quality was assessed using rating system of quality assessment and PEDro scale; also, levels of evidence adopted from modified Sacket’s scale were used for each outcome.
Results
The quality of studies ranged from excellent (one study) to good (five studies) and fair (two studies). The results showed level 1 (six studies) and level 2 (two studies) on modified Sacket’s scale for level of evidence. Lack of allocation concealment and blinding was the major risk of bias in the included studies.
Conclusions
Meta-analysis revealed significant difference in the improvement of vital capacity, peak expiratory flow, and forced expiratory volume at 1 s in favor of the study groups. However, there is a need for high-quality studies to draw a clear conclusion.
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Mendes LP, Teixeira LS, da Cruz LJ, Vieira DS, Parreira VF. Sustained maximal inspiration has similar effects compared to incentive spirometers. Respir Physiol Neurobiol 2019; 261:67-74. [DOI: 10.1016/j.resp.2019.01.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 12/31/2018] [Accepted: 01/14/2019] [Indexed: 10/27/2022]
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Ubolsakka-Jones C, Tasangkar W, Jones DA. Comparison of breathing patterns, pressure, volume, and flow characteristics of three breathing techniques to encourage lung inflation in healthy older people. Physiother Theory Pract 2018; 35:1283-1291. [PMID: 29799307 DOI: 10.1080/09593985.2018.1477890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Background: It is important to encourage lung inflation to prevent postsurgical pulmonary complications and we compared three breathing techniques that place different emphasis on inspiratory flow and breath-holding. Methods: Fourteen healthy older people (69 ± 3.6 yrs) used diaphragmatic breathing (DB), Triflo II (TF), and a water pressure threshold device (BreatheMAX; BM) in a randomized and balanced crossover design. Outcome measures were inspiratory flow and pressure, inspiratory time (Ti), tidal volume (Vt), and breathing frequency. Results: Inspiratory flow with TF was significantly faster than DB and BM (p < 0.001: 0.96 ± 0.1; 0.43 ± 0.20 and 0.28 ± 0.1 L.s-1, respectively) and pressures greater (p < 0.001: -1.3 ± 0.6, -5.5 ± 1.2 and -2.8 ± 3.6 cm H2O). However, Ti was shorter (TF, 1.16 ± 0.21s; DB, 3.31 ± 0.97 s, p < 0.001; BM, 5.53 ± 1.92 s, p < 0.001), resulting in smaller Vt (TF, 1.12 ± 0.29 L; DB, 1.28 ± 0.29L, p = 0.003; BM, 1.37 ± 0.43L, p = 0.016). Breathing frequency was faster with TF compared to DB and BM (p < 0.001). Conclusions: Substantial lung inflation could be achieved with any of the above-mentioned methods, although Vt was smaller with TF and the high inspiratory flow with this method may not inflate the lower lung. The high pressures and rapid breathing with TF could increase the sense of effort. Trials are needed to determine the clinical value of the different breathing exercises.
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Affiliation(s)
- Chulee Ubolsakka-Jones
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Wiraporn Tasangkar
- Physical Therapy Department, Bumrungrad International Hospital, Bangkok, Thailand
| | - David A Jones
- School of Health Care Sciences, Manchester Metropolitan University, Manchester, United Kingdom
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Breath-stacking and incentive spirometry in Parkinson's disease: Randomized crossover clinical trial. Respir Physiol Neurobiol 2018; 255:11-16. [PMID: 29727719 DOI: 10.1016/j.resp.2018.04.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 04/20/2018] [Accepted: 04/30/2018] [Indexed: 11/21/2022]
Abstract
Patients with Parkinson's disease often exhibit respiratory disorders and there are no Respiratory Therapy protocols which are suggested as interventions in Parkinson's patients. The aim of this study is to evaluate the effects of Breathing-Stacking (BS) and incentive spirometer (IS) techniques in volume variations of the chest wall in patients with Parkinson's Disease (PD). 14 patients with mild-moderate PD were included in this randomized cross-over study. Volume variations of the chest wall were assessed before, immediately after, then 15 and 30 min after BS and IS performance by optoelectronic plethysmography. Tidal volume (VT) and minute ventilation (MV) significantly increased after BS and IS techniques (p < 0.05). There was greater involvement of pulmonary and abdominal compartments after IS. The results suggest that these re-expansion techniques can be performed to immediately improve volume.
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Rodrigues MA, Ferreira LM, de Carvalho Calvi EN, Nahas FX. Preoperative Respiratory Physiotherapy in Abdominoplasty Patients. Aesthet Surg J 2018; 38:291-299. [PMID: 29040352 DOI: 10.1093/asj/sjx121] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND After abdominoplasty, patients experience decreased ventilatory function and increased intra-abdominal pressure (IAP). Breathing exercises are used during the pre- and postoperative periods of several abdominal surgeries to prevent or minimize postoperative complications. OBJECTIVES The aim of this study was to assess the effect of preoperative respiratory physiotherapy on the outcome of abdominoplasty patients. METHODS Thirty-three patients were divided into 2 groups. The control group (n = 18) received no preoperative intervention. The intervention group (n = 15) performed breathing exercises during the preoperative period, including incentive spirometry, diaphragmatic breathing, shortened expiration, and sustained maximal inspiration. Respiratory physiotherapy started one week before surgery. Breathing exercises were performed daily. They were performed 3 times weekly in the presence of a physiotherapist and patients were instructed to carry on the exercises at home on days without physiotherapy sessions for three sets of 20 repetitions each. Patients were assessed by spirometry and IAP measurements. RESULTS No significant difference in spirometry was found between groups. However, patients in the intervention group had lower IAP at the start of surgery and at all time points (P = 0.010) compared with controls. CONCLUSIONS Preoperative respiratory physiotherapy had no impact on spirometry, but may have contributed to reduce IAP intraoperatively. LEVEL OF EVIDENCE 2
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Pereira MC, Porras DC, Lunardi AC, da Silva CCBM, Barbosa RCC, Cardenas LZ, Pletsch R, Ferreira JG, de Castro I, de Carvalho CRF, Caruso P, de Carvalho CRR, de Albuquerque ALP. Thoracoabdominal asynchrony: Two methods in healthy, COPD, and interstitial lung disease patients. PLoS One 2017; 12:e0182417. [PMID: 28767680 PMCID: PMC5540557 DOI: 10.1371/journal.pone.0182417] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 07/18/2017] [Indexed: 11/18/2022] Open
Abstract
Background Thoracoabdominal asynchrony is the nonparallel motion of the ribcage and abdomen. It is estimated by using respiratory inductive plethysmography and, recently, using optoelectronic plethysmography; however the agreement of measurements between these 2 techniques is unknown. Therefore, the present study compared respiratory inductive plethysmography with optoelectronic plethysmography for measuring thoracoabdominal asynchrony to see if the measurements were similar or different. Methods 27 individuals (9 healthy subjects, 9 patients with interstitial lung disease, and 9 with chronic obstructive pulmonary disease performed 2 cycle ergometer tests with respiratory inductive plethysmography or optoelectronic plethysmography in a random order. Thoracoabdominal asynchrony was evaluated at rest, and at 50% and 75% of maximal workload between the superior ribcage and abdomen using a phase angle. Results Thoracoabdominal asynchrony values were very similar in both approaches not only at rest but also with exercise, with no statistical difference. There was a good correlation between the methods and the Phase angle values were within the limits of agreement in the Bland-Altman analysis. Conclusion Thoracoabdominal asynchrony measured by optoelectronic plethysmography and respiratory inductive plethysmography results in similar values and has a satisfactory agreement at rest and even for different exercise intensities in these groups.
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Affiliation(s)
- Mayra Caleffi Pereira
- Pulmonary Division, Heart Institute (Incor), Hospital das ClÃnicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- SÃrio-Libanês Teaching and Research Institute, São Paulo, Brazil
| | - Desiderio Cano Porras
- Department of Physical Therapy, Hospital das ClÃnicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Adriana Claudia Lunardi
- Department of Physical Therapy, Hospital das ClÃnicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | - Renata Cléia Claudino Barbosa
- Department of Physical Therapy, Hospital das ClÃnicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - LetÃcia Zumpano Cardenas
- Pulmonary Division, Heart Institute (Incor), Hospital das ClÃnicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Renata Pletsch
- Pulmonary Division, Heart Institute (Incor), Hospital das ClÃnicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Jeferson George Ferreira
- Pulmonary Division, Heart Institute (Incor), Hospital das ClÃnicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Isac de Castro
- SÃrio-Libanês Teaching and Research Institute, São Paulo, Brazil
| | | | - Pedro Caruso
- Pulmonary Division, Heart Institute (Incor), Hospital das ClÃnicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Carlos Roberto Ribeiro de Carvalho
- Pulmonary Division, Heart Institute (Incor), Hospital das ClÃnicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - André Luis Pereira de Albuquerque
- Pulmonary Division, Heart Institute (Incor), Hospital das ClÃnicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- SÃrio-Libanês Teaching and Research Institute, São Paulo, Brazil
- * E-mail:
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Fernandes SCDS, Santos RSD, Giovanetti EA, Taniguchi C, Silva CSDM, Eid RAC, Timenetsky KT, Carnieli-Cazati D. Impact of respiratory therapy in vital capacity and functionality of patients undergoing abdominal surgery. EINSTEIN-SAO PAULO 2016; 14:202-7. [PMID: 27462894 PMCID: PMC4943354 DOI: 10.1590/s1679-45082016ao3398] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 05/06/2016] [Indexed: 01/09/2023] Open
Abstract
Objective To evaluate the vital capacity after two chest therapy techniques in patients undergoing abdominal surgical. Methods A prospective randomized study carried out with patients admitted to the Intensive Care Unit after abdominal surgery. We checked vital capacity, muscular strength using the Medical Research Council scale, and functionality with the Functional Independence Measure the first time the patient was breathing spontaneously (D1), and also upon discharge from the Intensive Care Unit (Ddis). Between D1 and Ddis, respiratory therapy was carried out according to the randomized group. Results We included 38 patients, 20 randomized to Positive Intermittent Pressure Group and 18 to Volumetric Incentive Spirometer Group. There was no significant gain related to vital capacity of D1 and Ddis of Positive Intermittent Pressure Group (mean 1,410mL±547.2 versus 1,809mL±692.3; p=0.979), as in the Volumetric Incentive Spirometer Group (1,408.3mL±419.1 versus 1,838.8mL±621.3; p=0.889). We observed a significant improvement in vital capacity in D1 (p<0.001) and Ddis (p<0.001) and in the Functional Independence Measure (p<0.001) after respiratory therapy. The vital capacity improvement was not associated with gain of muscle strength. Conclusion Chest therapy, with positive pressure and volumetric incentive spirometer, was effective in improving vital capacity of patients submitted to abdominal surgery.
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Mohan V, Ahmad NB, Tambi NB. Effect of respiratory exercises on neck pain patients: A pilot study. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.poamed.2016.01.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Cancelliero-Gaiad KM, Ike D, Pantoni CBF, Borghi-Silva A, Costa D. Respiratory pattern of diaphragmatic breathing and pilates breathing in COPD subjects. Braz J Phys Ther 2014; 18:291-9. [PMID: 25075999 PMCID: PMC4183256 DOI: 10.1590/bjpt-rbf.2014.0042] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Accepted: 10/23/2013] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND: Diaphragmatic breathing (DB) is widely used in pulmonary rehabilitation (PR) of
patients with chronic obstructive pulmonary disease (COPD), however it has been
little studied in the scientific literature. The Pilates breathing (PB) method has
also been used in the rehabilitation area and has been little studied in the
scientific literature and in COPD. OBJECTIVES: To compare ventilatory parameters during DB and PB in COPD patients and healthy
adults. METHOD: Fifteen COPD patients (COPD group) and fifteen healthy patients (healthy group)
performed three types of respiration: natural breathing (NB), DB, and PB, with the
respiratory pattern being analyzed by respiratory inductive plethysmography. The
parameters of time, volume, and thoracoabdominal coordination were evaluated.
After the Shapiro-Wilk normality test, ANOVA was applied followed by Tukey's test
(intragroup analysis) and Student's t-test (intergroup analysis; p<0.05). RESULTS: DB promoted increase in respiratory volumes, times, and SpO2 as well
as decrease in respiratory rate in both groups. PB increased respiratory volumes
in healthy group, with no additional benefits of respiratory pattern in the COPD
group. With respect to thoracoabdominal coordination, both groups presented higher
asynchrony during DB, with a greater increase in the healthy group. CONCLUSIONS: DB showed positive effects such as increase in lung volumes, respiratory motion,
and SpO2 and reduction in respiratory rate. Although there were no
changes in volume and time measurements during PB in COPD, this breathing pattern
increased volumes in the healthy subjects and increased oxygenation in both
groups. In this context, the acute benefits of DB are emphasized as a supporting
treatment in respiratory rehabilitation programs.
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Affiliation(s)
| | - Daniela Ike
- Universidade Federal de São Carlos (UFSCar), São Carlos, SP, Brazil
| | | | | | - Dirceu Costa
- Universidade Federal de São Carlos (UFSCar), São Carlos, SP, Brazil
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França DC, Camargos PAM, Martins JA, Abreu MCS, Avelar e Araújo GH, Parreira VF. Feasibility and reproducibility of spirometry and inductance plethysmography in healthy Brazilian preschoolers. Pediatr Pulmonol 2013; 48:716-24. [PMID: 23281215 DOI: 10.1002/ppul.22743] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2011] [Accepted: 08/22/2012] [Indexed: 11/08/2022]
Abstract
RATIONALE Preschoolers show peculiarities that reinforce the importance of assessing their pulmonary function. However, there are few data on the success rate and between-occasions reproducibility of pulmonary function tests in preschoolers, particularly in the Brazilian population. OBJECTIVE To assess the success rate and between-occasions reproducibility of the variables obtained by spirometry and respiratory inductive plethysmography in healthy children aged 4-6 years. METHODS Breathing pattern was assessed by plethysmography (tidal volume-V(T), respiratory rate-f, inspiratory duty cycle-Ti/Ttot, mean respiratory flow-V(T)/Ti, displacement of the rib cage-RC and phase relation during the total breath-PhRTB) and spirometry (forced vital capacity-FVC, forced expiratory volume in 0.5 sec-FEV0.5 and forced expiratory volume in first second-FEV1) in 47 healthy children, aged 4-6 years. To evaluate between-occasions reproducibility, 10 children (according to the sample size calculation) were reassessed after 3 weeks. Between-occasions reproducibility was evaluated by paired t-test, considering significant P < 0.05, Intraclass Correlation Coefficient (ICC) and coefficient of variation of method error (CV(ME)). RESULTS The results showed an 83% success rate for spirometry and a 98% success rate for plethysmography. Regarding reproducibility, there were no significant differences between the variables of any test. Spirometry ICC was above 0.80 and the CV(ME) was lower than 10%. The plethysmography ICC was between 0.61 and 0.95, and the CV(ME) was between 2% and 31%. CONCLUSIONS These results suggest a high success rate in performing the pulmonary function tests and good between-occasions reproducibility for spirometry and plethysmography in healthy preschoolers.
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Affiliation(s)
- Danielle C França
- Federal University of Minas Gerais, Graduation Program in Science Rehabilitation, Belo Horizonte, Brazil
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Santos TV, Ruas G, Sande de Souza LAP, Volpe MS. Influence of forward leaning and incentive spirometry on inspired volumes and inspiratory electromyographic activity during breathing exercises in healthy subjects. J Electromyogr Kinesiol 2012; 22:961-7. [DOI: 10.1016/j.jelekin.2012.05.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2011] [Revised: 05/06/2012] [Accepted: 05/07/2012] [Indexed: 01/18/2023] Open
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Matos CMP, Moraes KS, França DC, Tomich GM, Farah MW, Dias RC, Parreira VF. Changes in breathing pattern and thoracoabdominal motion after bariatric surgery: a longitudinal study. Respir Physiol Neurobiol 2012; 181:143-7. [PMID: 22415065 DOI: 10.1016/j.resp.2012.02.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Revised: 01/20/2012] [Accepted: 02/26/2012] [Indexed: 11/25/2022]
Abstract
This study evaluated the breathing pattern of 30 obese patients [32 ± 9 years old; body mass index (BMI): 42.72 ± 4.10 kg/m(2)] before and after bariatric surgery and compared them with 30 control individuals (31 ± 8 years old, BMI: 21.99 ± 2.22 kg/m(2)). Measurements were performed using calibrated respiratory inductive plethysmography. Six months after bariatric surgery, obese patients exhibited a significant reduction in tidal volume (V(T)), minute ventilation (V(E)) and inspiratory duty cycle (T(I)/T(TOT)) compared with pre-surgical values. The control group had a higher breathing frequency, V(E) and phase angle (PhAng). There were no significant differences in V(T)/T(I), percentage of rib cage motion (%RC) or abdominal motion (%AB). Obese patients exhibited changes in their breathing pattern and asynchrony after bariatric surgery without any changes in thoracoabdominal motion. Certain aspects of the breathing pattern of obese patients became more similar to those of the controls after surgery.
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Affiliation(s)
- Clarissa M P Matos
- Rehabilitation Science Graduation Program, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Dias CM, Vieira RDO, Oliveira JF, Lopes AJ, Menezes SLSD, Guimarães FS. Three physiotherapy protocols: effects on pulmonary volumes after cardiac surgery. J Bras Pneumol 2011; 37:54-60. [PMID: 21390432 DOI: 10.1590/s1806-37132011000100009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2010] [Accepted: 09/10/2010] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate inspiratory volume in patients undergoing cardiac surgery and to determine the effects that incentive spirometry (IS) and the breath stacking (BS) technique have on the recovery of FVC in such patients. METHODS A prospective, controlled, randomized clinical trial involving 35 patients undergoing cardiac surgery at the Hospital de Força Aérea do Galeão (HFAG, Galeão Air Force Hospital), in the city of Rio de Janeiro, Brazil. The patients, all of whom performed mobilization and cough procedures, were randomly divided into three groups: exercise control (EC), performing only the abovementioned procedures; IS, performing the abovementioned procedures and instructed to take long breaths using an incentive spirometer; and BS, performing the abovementioned procedures, together with successive inspiratory efforts using a facial mask coupled to a unidirectional valve. Forced spirometry was carried out in the preoperative period and on postoperative days 1 to 5. During the maneuvers, inspiratory volume was measured in the IS and BS groups. RESULTS On postoperative day 1, FVC significantly decreased in all groups (EC: 87.1 vs. 32.0%; IS: 75.3 vs. 29.5%; and BS: 81.9 vs. 33.2%; p < 0.001 for all), as did inspiratory volume in the IS and BS groups (2.29 vs. 0.82 L; and 2.56 vs. 1.34 L, respectively; p < 0.001 for both). Between postoperative days 1 and 5, FVC partially normalized in all groups (EC: 32.0 vs. 51.3%; IS: 29.5 vs. 46.7%; and BS: 33.3 vs. 54.3%; p < 0.001 for all). During the postoperative period, inspiratory volume was significantly higher in the BS group than in the IS group. CONCLUSIONS The three protocols were equivalent concerning the recovery of FVC on the first five postoperative days. When compared with IS, the BS technique promoted higher inspiratory volumes in this sample of postoperative cardiac patients.
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Affiliation(s)
- Cristina Márcia Dias
- Centro Universitário Augusto Motta-UNISUAM, Augusto Motta University Center- Department of Physiotherapy, Hospital de Força Aérea do Galeão-HFAG, Galeão Air Force Hospital-Rio de Janeiro, Brazil.
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Bruton A, Garrod R, Thomas M. Respiratory physiotherapy: towards a clearer definition of terminology. Physiotherapy 2011; 97:345-9. [PMID: 22051592 DOI: 10.1016/j.physio.2010.12.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2010] [Accepted: 12/24/2010] [Indexed: 11/26/2022]
Abstract
Interventions used in clinical practice and research need to be described in sufficient detail to permit accurate replication. Since words and phrases can change their meaning over time, it is important that authors choose their words carefully and define anything which might be ambiguous. 'Breathing exercises' is a phrase which covers a multitude of therapeutic approaches. Recent randomised controlled trials have established the value of teaching patients with asthma to retrain their breathing. However, the descriptions of the breathing interventions are generally inadequate. This problem stems partly from a degree of confusion surrounding terms such as 'diaphragmatic breathing' which has been variously interpreted. A more structured approach to reporting such interventions is proposed. This approach will help to avoid confusion, and will permit the transfer of those interventions found to be effective in research trials into routine clinical practice.
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Affiliation(s)
- Anne Bruton
- Highfield Campus, University of Southampton, Southampton SO17 1BJ, UK.
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