Abstract
The aging process is characterized by physiological and functional modifications that impair pulmonary function. Incentive spirometry (IS) has been widely used in clinical practice for lung expansion; however, the effects of volumetric IS (VIS) and flow-oriented IS (FIS) on chest wall volumes, inspiratory muscular activity and thoracoabdominal synchrony in elderly are poorly understood.
Objective: To compare the effects of VIS and FIS on chest wall volumes and thoracoabdominal synchrony, as well as on inspiratory muscular activity, in elderly subjects and in normal healthy adult subjects.
Methods: Sixteen elderly subjects (9 women, 70.6 ± 3.9 yrs, 23.8 ± 2.5 kg/m2) and sixteen normal healthy adults (8 women, 25.9 ± 4.3 yrs, 23.6 ± 2.4 kg/m2) performed quiet breathing, VIS and FIS (randomized sequence). Chest wall kinematics (optoelectronic plethysmography) and inspiratory muscular activity (surface electromyography) were assessed simultaneously. Synchrony between the superior thorax and abdominal motion was calculated (phase angle). ANOVA with the post hoc test of Holm-Sidak was used, and the significance level was set at 5%.
Results: In the elderly, both types of IS increased chest wall volumes similarly while in normal healthy adult subjects VIS induced greater chest wall volume than FIS. In addition, FIS and VIS triggered similar lower thoracoabdominal synchrony in elderly while in normal healthy adults FIS induced lower synchrony than VIS. At last, FIS required augmented muscular activity in elderly subjects to promote an increase in chest wall volumes.
Conclusion: We conclude that performance during the use of incentive spirometer is influenced by age. We also present differences between elderly and normal healthy adult subjects in response to this therapy that should be considered in clinical practice.
- breathing exercises
- physical therapy modalities
- incentive spirometry
- elderly
- respiratory mechanics
- eletromyography
- chest wall
- biomechanics
- lung volume measurements
Footnotes
- Correspondence should be addressed to: Celso R. F. Carvalho Department of Physical Therapy, School of Medicine of University of Sao Paulo R. Cipotanea 51, Sao Paulo, SP-Brazil Zip Code: 05360-160, Phone: +55 11 3091-7451, E-mail: cscarval{at}usp.br
No financial or other potential conflicts of interest exist in this study.
Financial Support: grants #2010/50120-4 and #2010/19196-4, São Paulo Research Foundation (FAPESP)
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