TY - JOUR T1 - ACUTE EFFECTS OF VOLUME-ORIENTED INCENTIVE SPIROMETRY ON CHEST WALL VOLUMES IN PATIENTS AFTER STROKE JF - Respiratory Care DO - 10.4187/respcare.02651 SP - respcare.02651 AU - Íllia NDF Lima AU - Guilherme AF Fregonezi AU - Melo Rodrigo AU - Elis EA Cabral AU - Andrea Aliverti AU - Tânia F Campos AU - Gardênia MH Ferreira Y1 - 2013/11/12 UR - http://rc.rcjournal.com/content/early/2013/11/12/respcare.02651.abstract N2 - Background: The aim of the present study was to assess how volume-oriented incentive spirometry (IS) applied to patients after stroke modify total and compartmental chest wall volume variations, including right and left hemithorax compared to controls. Methods: 20 post-stroke patients (stroke group, SG) and 20 age-matched healthy subjects (control group, CG) were studied by optoelectronic plethysmography during spontaneous quiet breathing (QB), IS and in the recovery period after IS. Results: IS determined an increase of chest wall volume and its rib cage and abdominal compartments in both groups (p = 0.0008) and between the three instances (p < 0.0001). Compared to healthy control subjects, tidal volume of patients with stroke was 24.7%, 18% and 14.7% lower during QB, , IS and post-IS, respectively. In all the three conditions the contribution of the abdominal compartment to tidal volume was greater in the stroke patients (54.1, 43.2 and 48.9%) than controls (43.7, 40.8 and 46.1%, p = .039). In the vast majority of patients 13/20 and 18/20 during QB and IS, respectively), abdominal expansion led rib cage expansion during inspiration. A greater asymmetry between the right and left hemithoracic expansion occurred in stroke patients compared to controls but it decreased during IS (62.5% (p = 0.0023) QB; 19.7% IS; and 67.6% (p = 0.135) post-IS. Conclusions: IS promotes an increased expansion in all compartments of the chest wall and reduces the asymmetric expansion between right and left pulmonary rib cage and therefore it should be considered as a tool for rehabilitation. ER -