AARC Clinical Practice Guideline: INCENTIVE SPIROMETRY (1991). Respir Care, 36, 1402-5
www.rcjournal.com/cpgs/ispircpg.html


Agostini P, Singh S (2009) Incentive spirometry following thoracic surgery: what should we be doing? Physiotherapy, 95, 2, 76-82
• postoperative physiotherapy regimes, with or without incentive spirometry, are effective following thoracic surgery compared with no physiotherapy.

Baker WL et al (1990) Breath-stacking increases the depth and duration of chest expansion by incentive spirometry. Am Rev Resp Dis, 141, 343-6


Bellet PS et al (1995) Incentive spirometry to prevent acute pulmonary complications in sickle cell disease. New Eng J Med, 333, 699-703

Chureemas G, Kovindha A (1992) The use of sustained maximal inspiration (SMI) to improve respiratory function in spinal cord injury. J Thai Rehabil, 2, 1, 20-25
www.rehabmed.or.th/royal/rc_thai/admin/newsletter/files/Vol2_No1_4.pdf
• incentive spirometry improves vital capacity


Chuter TAM et al 1989) Effect of incentive spirometry on diaphragmatic function after surgery. Surgery, 105, 488-93
• IS fails to increase diaphragmatic movement in postoperative patients


Crowe JM et al (1994) The effectiveness of incentive spirometry for the postoperative patient. Physiother Canada, 46, 2 (suppl)
• IS is ineffective when used in addition to ‘pulmonary physiotherapy’


Dull JL, Dull WL (1983) Are maximal inspiratory breathing exercises or incentive spirometry better than early mobilization after cardiopulmonary bypass? Phys Ther, 63, 655-9
• IS, when used in addition to early mobilisation, offers no advantage over early mobilisation alone


Gosselink R et al (2000) Incentive spirometry does not enhance recovery after thoracic surgery. Crit Care Med, 28, 679-83
www.ccmjournal.com/pt/re/ccm/abstract.00003246-200003000-00013.htm;jsessionid=DOLjRI8Y5ndT9lhuVm2OYxWuZZa1YITpfzx2j5g2WI7WKvDCA7si!-365670234!-949856145!9001!-1
• routine use of IS after thoracic surgery seems to be ineffective, but could be beneficial in high-risk patients.


Grant-Paterson L (1985) Incentive spirometry: an adjunct to physiotherapy. Physiotherapy Canada, 37, 388-93


Hall JC et al (1991) Incentive spirometry versus routine chest physiotherapy for prevention of pulmonary complications after abdominal surgery. Lancet, 337, 953-6
• IS and ‘chest physiotherapy’ are of equal efficacy


Krastins (1982) An evaluation of incentive spirometry in the management of pulmonary complications after cardiac surgery in a pediatric population. Crit Care Med, 10, 525-8


Melendez JA (1992) Postthoracotomy respiratory muscle mechanics during incentive spirometry using respiratory inductance plethysmography. Chest, 101, 432-36


Stock (1985) Prevention of postoperative pulmonary complications with CPAP, incentive spirometry and conservative therapy. Chest, 87, 151-7
• no evidence of effectiveness of incentive spirometry


Wattie J (1998) Incentive spirometry following CABG. Physiotherapy, 84, 508-514


Weindler J, Kiefer RT (2001). The efficacy of postoperative incentive is influenced by the device-specific imposed work of breathing. Chest, 119, 1858-64
www.chestjournal.org/cgi/content/full/119/6/1858?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&volume=119&firstpage=1858&resourcetype=HWCIT
• some devices (e.g. Mediflo) impose a greater inspiratory work of breathing than others (e.g. Coach).
• the former did not affect the maximal inspired volume of patients with severely impaired respiratory function, but did reduce the maximal inspired volume in patients who had moderately impaired respiratory function.



AARC = American Association for Respiratory Care
CABG = coronary artery bypass graft
IS = incentive spirometry