The Incentive Spirometer

Uses of the Incentive Spirometer (IS)

It is thought that the IS is used to reduce the risk of post-operative pulmonary complications (PPCs) by increasing total lung inflation, tidal volume, and vital capacity.

What Does the Evidence Say?:

  • The most current evidence DOES NOT support the use of incentive spirometry for any patient as a first line intervention to prevent or decrease risk of PPCs or improve pulmonary function.
  • Other devices such as Threshold®IMT and PEP (Acapella) have shown greater effect in reducing PPCs, hospital LOS, and pulmonary function.
  • Early mobilization, Diaphragmatic breathing exercises, and active cycle of breathing have also been shown to decrease risk of PPCs better than IS with no benefit of addition of IS to these interventions.
  • Post-CABG and post-abdominal surgeries of all kinds were the primary populations studied with highest level evidence. Moderate level evidence in the same persuasion was given for post-trauma and cancer patients. Current evidence also reports poor compliance with IS performance.
  • The IS has not been shown to be effective for patients being treated for COVID-19 (WCPT, 2020 – see resources page)

Is there anyone who can benefit from IS?

  • Patients with recent rib fracture(s) until they can tolerate increased intensity of training. – Low Level Evidence
  • Pre-operative training for very deconditioned patients until more intense training is tolerated. – Moderate Level Evidence

So what the heck do I do with it?

  • Assessment of improvement of vital capacity when used before and after an intervention (i.e. PEP, IMT, diaphragmatic breathing) – Moderate Level
  • May help regulate the normal cough mechanism – Low Level Evidence

image


Does your hospital issue an IS or an IMT to every patient after an operation? Let me know in the comments!

More from the Pulmonary Rehab Toolbox…

Postural Drainage

We’ve all seen that dreaded picture in our textbooks… All the human figures laying in so many different positions with pillows and tables tilted all over… and I very clearly remember thinking, “How on earth am I supposed to remember all of those?” Well, good news. You really don’t have to. It’s great if youContinue reading “Postural Drainage”

Spilling the Box of Pearls: All the Tips on Supplemental Oxygen Management

In my recent post on COPD management, I mentioned that there are some really important parts of supplemental oxygen management that you need to be aware of and consider in your practice. If you are assisting patients who utilize supplemental oxygen regularly, you need to keep these things in mind. You also may be workingContinue reading “Spilling the Box of Pearls: All the Tips on Supplemental Oxygen Management”

Chronic Disease Part 2: Chronic Obstructive Pulmonary Disease (COPD)

This is part 2 in a multi-part series on the role of Rehab Providers in the management of chronic disease. Don’t forget to check out Part 1: Heart Failure! Chronic Obstructive Pulmonary Disease is a widely diagnosed disease of the lungs that includes the diagnoses of emphysema and chronic bronchitis. COPD can be caused byContinue reading “Chronic Disease Part 2: Chronic Obstructive Pulmonary Disease (COPD)”

Loading…

Something went wrong. Please refresh the page and/or try again.

Follow @DoctorBthePT on Twitter for regular updates!

References:

  • Tyson, A.F., Kendig, C.E., Madebi, C. (2015). The Effect of Incentive Spirometry on Postoperative Pulmonary Function Following Laparotomy: A Randomized Clinical Trial. Jama Surgery. 150(3):229-236. doi:10.1001/jamasurg.2014.1846
  • Katsura, M., Kuriyama, A., Takeshima, T., Fukuhara, S., Furukawa, T. (2015) Preoperative inspiratory muscle training for postoperative pulmonary complications in adults undergoing cardiac and major abdominal surgery. Cochrane Database of Systematic Reviews. http://doi.org//10/1002/14651858.CD010356.pub2

2 thoughts on “The Incentive Spirometer

  1. It’s hard to fathom all the changes in the way we treat patients as opposed to what we learned when I was a young nurse. Esp, with IS.

    Like

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: