Incentive spirometry (IS) is a widely-used method of preventing or treating lung collapse (atelectasis) and improving airway clearance after surgery or a lung illness, such as pneumonia. It is also helpful in exercising the lungs in conditions like cystic fibrosis or chronic obstructive pulmonary disease (COPD).

Also known as sustained maximal inspiration (SMI), incentive spirometry is performed using a device that gives visual feedback when the patient inhales at a set volume or flow and sustains the inflation for at least 5 seconds. The device is variously called lung exerciser or manual incentive spirometer.

How to use

• The patient holds the spirometer in an upright position and exhales normally.
• Then she places her lips tightly around the mouthpiece.
• She inhales slowly to raise the ball (flow-oriented IS) or piston/plate (volume-oriented IS) in the chamber up to the set target.
• At maximum inhalation, she removes the mouthpiece, holds her breath for 5 seconds, and then normally exhales.

Usually, 10-15 breaths should be taken with the spirometer every 1-2 hours.

Research-backed Evidence of IS Efficacy

• Thomas & McIntosh (1994) reported that IS and deep breathing exercises were more effective than no physical therapy intervention in preventing lung complications after surgery.
• Kotani et. al. (2015) found improvements in pulmonary function and respiratory motion after 2 weeks of training with an incentive spirometer.
• Goni-Viguriaet al. (2018) published a literature review which concluded that combined respiratory physiotherapy, including incentive spirometry, was best to prevent and treat lung complications in patients.
• Basoglu et. al. (2005)found that the use of incentive spirometry in patients with COPD helped improve arterial blood gases and health-related quality of life.
• Heydari et. al. (2015)reported that incentive spirometry was an effective component of a pulmonary rehabilitation program in COPD patients.
• Weiner et. al. (1997) published a report which concluded that lung functions were significantly increased when incentive spirometry and specific inspiratory muscle training are used before and after surgery.

IS as a predictive tool for lung health

A 1997 study noted that incentive spirometry can be used to predict patients at risk for lung cancer, heart attacks, and stroke. Patients with abnormal spirometric findings can be warned that their airways have begun to be obstructed, which may push them to quit smoking. The study recommends that primary care providers can and should perform this noninvasive test regularly.

Incentive spirometry is designed to imitate natural yawning or sighing by encouraging the patient to take deep, slow, long breaths. The action reduces pleural pressure, boosts increased lung expansion, and improves respiratory gas exchange function. When this form of lung exercise is repeated regularly, lung collapse may be prevented or even reversed.

Doctors recommend that incentive spirometry be used as part of respiratory therapy after surgery along with deep breathing exercises, directed coughing, optimal analgesia, and early mobilization.

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