Incentive Spirometry in Routine Management of COPD Patients
Study Details
Study Description
Brief Summary
The incentive spirometer is a device that encourages patients, with visual and other positive feedback, to maximally inflate their lungs and sustain that inflation. However, its efficacy in patients with COPD has been little documented especially in diaphragmatic function. This study tried to assess the role of incentive spirometry on Spirometric functions, Sonographic diaphragmatic function, and the scale of dyspnea in COPD patients with exacerbation and with follow-up of these parameters after 2 months.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
Forty COPD patients were admitted with an acute exacerbation and the patients were divided randomly into 2 equal groups: the first used the incentive spirometer together with medical treatment (according to GOLD guidelines) for 2 months and the second received only medical treatment for 2 months. All participants, on admission, underwent assessment of mMRC dyspnea scale, spirometry, arterial blood gases, and diaphragmatic ultrasound. Then, a follow-up of the participants was done after 2 months with the same parameters and a comparison between both groups was done.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: group 1 participants would use incentive spirometry for 2 months together with ordinary medical treatment |
Device: incentive spirometry
It is flow-oriented that has 3 chambers, (600, 900, and 1200 cc/s) and it has a mouthpiece and a ball in each chamber. After a quiet exhalation, each participant was instructed to take slow full inspirations and to keep as long as he can for at least 5 seconds, then he slowly expires. The device is used every hour at least 5 to 10 times in the session during wake time.
|
| No Intervention: group 2 participants would receive only ordinary medical treatment for 2 months |
Outcome Measures
Primary Outcome Measures
- assessing the change in baseline diaphragmatic excursion in cm [2 months]
assessing the change from Baseline diaphragmatic excursion (in cm) using ultrasound to 2 months
- assessing the change in baseline percentage of diaphragmatic thickness fraction [2 months]
assessing the change from baseline percentage of diaphragmatic thickness fraction (%) using ultrasound to 2 months
- assessing the change in baseline forced vital capacity percentage of predicted [2 months]
assessing the change from baseline forced vital capacity percentage of predicted (%) using spirometry to 2 months
- assessing the change in baseline forced expiratory volume in 1st second/forced vital capacity percentage (%) [2 months]
assessing the change from baseline forced expiratory volume in 1st second/forced vital capacity percentage (%) using spirometry to 2 months
- assessing the change in baseline peak expiratory flow rate percentage [2 months]
assessing the change from baseline peak expiratory flow rate percentage (%) using spirometry to 2 months
- change in arterial blood gases [2 months]
assessment the change in baseline PaO2 and PaCO2 (in mmHg) to 2 months
- assessing the change in mMRC dysnea scale [2 months]
assessing the change in the severity of dyspnea by mMRC dysnea scale from baseline to 2 months. It is 5 statements giving grades from 0 to 4 with the higher the degree, the more severe the shortness of breath in patients with COPD
Eligibility Criteria
Criteria
Inclusion Criteria:
-
confirmed cases of COPD according to the criteria GOLD
-
age more than 40 years
Exclusion Criteria:
-
bad acoustic window by ultrasound
-
other chronic respiratory diseases
-
lung malignancy
-
recent major surgery
-
inability to complete or perform the study
-
patient refusal
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Amal A. El-Koa | Cairo | Egypt |
Sponsors and Collaborators
- Menoufia University
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
- AARC (American Association for Respiratory Care) clinical practice guideline. Incentive spirometry. Respir Care. 1991 Dec;36(12):1402-5. No abstract available.
- Barakat S, Michele G, George P, Nicole V, Guy A. Outpatient pulmonary rehabilitation in patients with chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2008;3(1):155-62. doi: 10.2147/copd.s2126.
- Casaburi R, Porszasz J, Burns MR, Carithers ER, Chang RS, Cooper CB. Physiologic benefits of exercise training in rehabilitation of patients with severe chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1997 May;155(5):1541-51. doi: 10.1164/ajrccm.155.5.9154855.
- Cheng YY, Lin SY, Hsu CY, Fu PK. Respiratory Muscle Training Can Improve Cognition, Lung Function, and Diaphragmatic Thickness Fraction in Male and Non-Obese Patients with Chronic Obstructive Pulmonary Disease: A Prospective Study. J Pers Med. 2022 Mar 16;12(3):475. doi: 10.3390/jpm12030475.
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- GBD Chronic Respiratory Disease Collaborators. Prevalence and attributable health burden of chronic respiratory diseases, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet Respir Med. 2020 Jun;8(6):585-596. doi: 10.1016/S2213-2600(20)30105-3.
- Petrovic M, Reiter M, Zipko H, Pohl W, Wanke T. Effects of inspiratory muscle training on dynamic hyperinflation in patients with COPD. Int J Chron Obstruct Pulmon Dis. 2012;7:797-805. doi: 10.2147/COPD.S23784. Epub 2012 Nov 30.
- Scherer TA, Spengler CM, Owassapian D, Imhof E, Boutellier U. Respiratory muscle endurance training in chronic obstructive pulmonary disease: impact on exercise capacity, dyspnea, and quality of life. Am J Respir Crit Care Med. 2000 Nov;162(5):1709-14. doi: 10.1164/ajrccm.162.5.9912026.
- Stock MC, Downs JB, Gauer PK, Alster JM, Imrey PB. Prevention of postoperative pulmonary complications with CPAP, incentive spirometry, and conservative therapy. Chest. 1985 Feb;87(2):151-7. doi: 10.1378/chest.87.2.151.
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