Incentive spirometry and breath stacking: effects on the inspiratory capacity of individuals submitted to abdominal surgery

Background: Respiratory complications are the main causes of increased morbidity and mortality in individuals who undergo upper abdominal surgery. The effi cacy of physical therapy procedures needs clarifi cation, and it is necessary to know which therapeutic approaches are the best ones to implement. Objective: To compare the inspiratory volume during the breath stacking maneuver with the volume during incentive spirometry, in abdominal surgery patients. Methods: Twelve patients, on their fi rst postoperative day, were instructed to take a deep breath through the VoldyneTM incentive spirometer and to make successive inspiratory efforts using a facemask that had been adapted for performing the breath stacking maneuver. Each technique was performed fi ve times according to the randomization. Before the operation, the patients performed a spirometric test. They were also assessed and instructed about the procedures. A WrightTM ventilometer allowed inspiratory capacity to be recorded. Results: The inspiratory capacity during breath stacking was signifi cantly higher than during incentive spirometry, both before and after the operation. There was a signifi cant reduction in volumes after the surgical procedure, independent of the technique performed. Conclusions: The breath stacking technique was shown to be effective. This technique was better than incentive spirometry for generating and sustaining inspiratory volumes. Since no adverse effects have been described, this technique can probably be used safely and effectively, particularly in uncooperative patients.