• Denise de Moraes Paisani, Adriana Claudia Lunardi, Cibele Cristine Berto Marques da Silva, Desiderio Cano Porras, Clarice Tanaka, and Celso Ricardo Fernandes Carvalho.
• Department of Physical Therapy, School of Medicine, University of São Paulo, São Paulo, Brazil.
• Respir Care. 2013 Aug 1;58(8):1360-6.

BackgroundIncentive 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.ObjectiveTo compare the effects of VIS and FIS on thoracoabdominal mechanics and respiratory muscle activity in healthy volunteers.MethodsThis cross-sectional trial assessed 20 subjects (12 female, ages 20-40 years, body mass index 20-30 kg/m(2)). 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.ResultsVIS 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).ConclusionsVIS promotes a greater increase in chest wall volume, with a larger abdominal contribution and lower respiratory muscle activity, than does FIS in healthy adults.

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