RT Journal Article SR Electronic T1 Volume Rather Than Flow Incentive Spirometry Is Effective in Improving Chest Wall Expansion and Abdominal Displacement Using Optoelectronic Plethysmography JF Respiratory Care FD American Association for Respiratory Care SP 1360 OP 1366 DO 10.4187/respcare.02037 VO 58 IS 8 A1 Denise de Moraes Paisani A1 Adriana Claudia Lunardi A1 Cibele Cristine Berto Marques da Silva A1 Desiderio Cano Porras A1 Clarice Tanaka A1 Celso Ricardo Fernandes Carvalho YR 2013 UL http://rc.rcjournal.com/content/58/8/1360.abstract AB BACKGROUND: Incentive spirometers are widely used in clinical practice and classified as flow-oriented (FIS) and volume-oriented (VIS). Until recently the respiratory inductive plethysmography used to evaluate the effects of incentive spirometry on chest wall mechanics presented limitations, which may explain why the impact of VIS and FIS remains poorly known. OBJECTIVE: To compare the effects of VIS and FIS on thoracoabdominal mechanics and respiratory muscle activity in healthy volunteers. METHODS: This cross-sectional trial assessed 20 subjects (12 female, ages 20–40 years, body mass index 20–30 kg/m2). All subjects performed 8 quiet breaths and 8 deep breaths with FIS and VIS, in a randomized order. We measured thoracoabdominal chest wall, upper and lower rib-cage, and abdominal volumes with optoelectronic plethysmography, and the muscle activity of the sternocleidomastoid and superior and inferior intercostal muscles with electromyography. RESULTS: VIS increased chest wall volume more than did FIS (P = .007) and induced a larger increase in the upper and lower rib-cages and abdomen (156%, 91%, and 151%, respectively, P < .001). By contrast, FIS induced more activity in the accessory muscles of respiration than did VIS (P < .001). CONCLUSIONS: VIS promotes a greater increase in chest wall volume, with a larger abdominal contribution and lower respiratory muscle activity, than does FIS in healthy adults.