Inspiratory flow rate, not type of incentive spirometry device, influences chest wall motion in healthy individuals

Abstract

This study investigated the effect of flow rates and spirometer type on chest wall motion in healthy individuals. Twenty-one healthy volunteers completed breathing trials to either two times tidal volume (2xV_T) or inspiratory capacity (IC) at high, low, or natural flow rates, using a volume- or flow-oriented spirometer. The proportions of rib cage movement to tidal volume (%RC/V_T), chest wall diameters, and perceived level of exertion (RPE) were compared. Low and natural flow rates resulted in significantly lower %RC/V_T compared to high flow rate trials (p=0.001) at 2xV_T. Low flow trials also resulted in significantly less chest wall motion in the upper anteroposterior direction than high and natural flow rates (p<0.001). At IC, significantly greater movement occurred in the abdominal lateral direction during low flow compared to high and natural flow trials (both p<0.003). RPE was lower for the low flow trials compared to high flow trials at IC and 2xV_T (p<0.01). In healthy individuals, inspiratory flow (not device type) during incentive spirometry determines the resultant breathing pattern. High flow rates result in greater chest wall motion than low flow rates.