Comparisons between chest trunk mobilization with sustained maximum inspiration and flow incentive spirometry on chest expansion, respiratory muscle strength, and functional exercise capacity in patients undergoing video-assisted thoracoscopic surgery

Abstract

IntroductionChest trunk mobilization with sustained maximum inspiration (SMI) and flow incentive spirometry (flow IS) are breathing techniques that mostly apply to patients undergoing video-assisted thoracoscopic surgery (VATS). The purpose of this study was to determine the effects of chest trunk mobilization with SMI and flow IS on chest expansion, respiratory muscle strength, and functional exercise capacity in patients undergoing VATS.MethodsSixty VATS patients were randomly allocated into chest trunk mobilization with SMI (<i>n</i> = 30) and flow IS (<i>n</i> = 30) groups. Each group performed a physical therapy program preoperatively and 4 days post-operatively. Chest expansion at upper, middle, and lower levels, inspiratory and expiratory muscle strengths, and functional exercise capacity were determined at pre- and post-VATS.ResultsIn both groups, chest expansion at all levels, expiratory muscle strength, and distance of the 6MWT significantly increased (<i>p</i> < 0.05) post-operatively compared to pre-operative assessments, although there was no significant difference between groups. In addition, inspiratory muscle strength significantly improved from baseline in both groups (<i>p</i> < 0.05), but the flow IS group showed a greater increase than the chest trunk mobilization with the SMI group (78.17 ± 24.16 and 65.57 ± 20.39 cmH2O, respectively, <i>p</i> < 0.05).ConclusionsChest trunk mobilization with SMI and flow IS can improve chest expansion at all levels, as well as respiratory muscle strength and the distance of the 6MWT. However, flow IS enhances inspiratory muscle strength to a greater extent than chest trunk mobilization with SMI. Ultimately, both techniques can be applied effectively in patients undergoing VATS.