Effect of Expiration Muscle Exercise Using Positive Expiratory Pressure in Chronic Obstructive Pulmonary Disease

In this COVID-19 pandemic era, it is important to obtain objective expiratory muscle strength measurement in Chronic Obstructive Pulmonary Disease patients (COPD).

Comparative efficacy of inspiratory, expiratory and combined respiratory muscle training on the pulmonary functions and chest expansion in acute stroke survivors

Background: Respiratory muscle strength can be reduced in patients diagnosed with stroke, which reasonably justifies the use of respiratory muscle training in this population. This study determines the comparative efficacy of inspiratory, expiratory, and combined respiratory muscle training on the pulmonary functions and chest expansion in acute stroke survivors. Method: Forty-five acute stroke survivors (15 in each group) completed all protocols of the study. Participants were randomly assigned to any one of three groups. In addition to the conventional exercise therapy, participants received any one of the three respiratory muscle training protocols (inspiratory muscle training, expiratory muscle training or combined respiratory muscle training). Chest expansion was assessed using tape measure and pulmonary function parameters were assessed using a spirometer. Results: Paired t-test analysis showed significant improvements in the chest expansion and the pulmonary function parameters following training in each group. One-way ANOVA showed significant improvements in the pulmonary function parameters across the three groups but not in the chest expansion with p - value = 0.405. Least significant difference (LSD), post-hoc analysis shows that the significant difference for FEV1, FVC and FEV1/FVC lies between inspiratory muscle training group and expiratory muscle training group. Conclusion: When the three training methods were compared, it was found that expiratory muscle training was the most beneficial in improving the pulmonary functions and chest expansion in acute stroke survivors.

Respiratory characteristics in patients with major burn injury and smoke inhalation

This study aimed to evaluate pulmonary function measurements and respiratory muscle parameters in patients with major burn injury and smoke inhalation. The inclusion criteria included patients who were diagnosed with a smoke inhalation burn or a major burn of more than 20% of total body surface area (TBSA). All subjects underwent a pulmonary function test, respiratory muscle strength test, peak cough flow and fluoroscopic diaphragmatic movement measurement, and six-minute walk test before starting pulmonary rehabilitation. Evaluations were conducted on the 88 th days after the injury, the average time of admission to the Department of the Rehabilitation Medicine for burn rehabilitation after the completion of the acute treatment. The average degree of burns of the total 67 patients was 34.6% TBSA. All parameters in the patient group were significantly lower than the healthy controls, and a mild restrictive pattern of impairment with a reduction in diffusing capacity and more reduced expiratory muscle, than inspiratory muscle strength were observed. Peak cough flow, respiratory muscle strength, and forced vital capacity in the patient group with inhalation burn were significantly lower than in those without inhalation burn. The conditions of the majority of patients with major burn and inhalation injury were consistent with restrictive impairment and significant reduction in diffusion capacity. The patients had expiratory muscle weakness, decreased diaphragmatic movement, and exercise capacity impairment.

Efficacy of Incentive Spirometry in Expiratory Muscle Training Following Abdominal Surgery

BACKGROUND: Incentive spirometry is a device which helps in the improvement of lung function after abdominal surgery. It motivates the patients by giving visual feedback about their lung volumes. It is one of the less expensive and user-friendlydevices. Incentive spirometry facilitates the patients to take slow deep breath and there by producing a sustained maximal inspiration (SMI) that mainly helps in the prevention of atelectasis. But it is a common practice for physiotherapists to teach the patients to do expiratory exercise by reversing the incentive spirometer. The simplest way to measure the maximal inspiratory and expiratory pressures is by respiratory pressure meter in cmH2o. OBJECTIVE: To find out the efficacy of incentive spirometer in improving the expiratory muscle strength following abdominal surgery. METHODOLOGY: Quasi-Experimental study. PROCEDURE: 30 subjects were conveniently selected based on inclusion and exclusion criteria and allotted to group A (n=15) and group B (n= 15). Both groups were trained for inspiratory muscle and group A was also trained for expiratory muscle using incentive spirometry. OUTCOME MEASURES: Maximal inspiratory pressure (MIP), Maximal expiratory pressure (MEP). RESULT: This study shows that the mean MIP value have improved from 2nd to 7th postoperative day, but it is not statistically significant (P>0.05). The mean MEP values shows statistically significant (P<0.05) improvement from second to 7th postoperative day in group A when compared to group B. CONCLUSION:This study concludes that there is significant improvement in the expiratory muscle strength along with inspiratory muscle strength by training with the Incentive spirometry in the upside down and upright positions respectively.