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Current Respiratory Medicine Reviews

Editor-in-Chief

ISSN (Print): 1573-398X
ISSN (Online): 1875-6387

Scoping Review

Effectiveness of Incentive Spirometry on Lung Function in Adult COVID- 19 in the Acute and Post-COVID-19 Phase: Exploratory Review

Author(s): Leonardo Arzayus-Patiño*, Valeria Perez-Hortua, Jaime Aguilar-Zambrano, Helberg Asencio-Santofimio and Esther Cecilia Wilches-Luna

Volume 19, Issue 3, 2023

Published on: 16 May, 2023

Page: [218 - 227] Pages: 10

DOI: 10.2174/1573398X19666230510142030

Price: $65

Abstract

Introduction: Respiratory incentive, an instrumental technique used to increase transpulmonary pressure, is indicated when patients present decreased volumes and capacities, a condition presented by patients with acute phase coronavirus infection and patients with pulmonary sequelae post COVID-19. Some studies recommend including respiratory incentives in managing COVID-19 patients because of its benefits and limited risk. The objective of this exploratory review was to describe and present the current evidence of the effectiveness of IR in improving pulmonary function in adult patients with acute and post COVID-19.

Methods: An exploratory review was performed. An extensive search was made in databases such as BVS (MEDLINE-LILLACS-IBECS), PubMed, OVID, Scielo, PEDro, and EBSCO, the checklist recommended by PRISMA was used and was based on the Johanna Briggs method (JGB), initially conceived by Arksey and O "Malley. To assess the quality of the studies, we used the PEDro Scale, which evaluates the methodological quality of the clinical designs.

Results: In this exploratory review, 4 studies published between 2019 and 2022 were identified related to the use of the respiratory incentive in COVID-19 and post COVID-19. The evidence reviewed identified that the respiratory incentive was used in the acute phase of the disease and post COVID-19, improvements in lung function such as FVC and FEV1, clinical parameters such as oxygen saturation, dyspnea and anxiety were obtained.

Conclusion: The studies identified in this review describe that IR favors the increase of FVC and FEV1, with occasional benefits in improving dyspnea and oxygen saturation.

Graphical Abstract

[1]
Silva CMS, Andrade AN, Nepomuceno B, et al. Evidence-based physiotherapy and functionality in adult and pediatric patients with COVID-19. J Hum Growth Dev 2021; 30(1): 148-55.
[http://dx.doi.org/10.7322/jhgd.v30.10086]
[2]
World Health Organization. COVID-19 clinical management: Living guidance, 25 January 2021. United States: PAHO 2021; p. 81.
[3]
Li Y, Wu J, Wang S, et al. Progression to fibrosing diffuse alveolar damage in a series of 30 minimally invasive autopsies with COVID‐19 pneumonia in Wuhan, China. Histopathology 2021; 78(4): 542-55.
[http://dx.doi.org/10.1111/his.14249] [PMID: 32926596]
[4]
Ahmed H, Patel K, Greenwood D, et al. Long-term clinical outcomes in survivors of severe acute respiratory syndrome and Middle East respiratory syndrome coronavirus outbreaks after hospitalisation or ICU admission: A systematic review and meta-analysis. J Rehabil Med 2020; 52(5): 0.
[http://dx.doi.org/10.2340/16501977-2694] [PMID: 32449782]
[5]
Costela-Ruiz VJ, Illescas-Montes R, Puerta-Puerta JM, Ruiz C, Melguizo-Rodríguez L. SARS-CoV-2 infection: The role of cytokines in COVID-19 disease. Cytokine Growth Factor Rev 2020; 54: 62-75.
[http://dx.doi.org/10.1016/j.cytogfr.2020.06.001] [PMID: 32513566]
[6]
McElvaney OJ, McEvoy NL, McElvaney OF, et al. Characterization of the inflammatory response to severe COVID-19 Illness. Am J Respir Crit Care Med 2020; 202(6): 812-21.
[http://dx.doi.org/10.1164/rccm.202005-1583OC] [PMID: 32584597]
[7]
Sun X, Wang T, Cai D, et al. Cytokine storm intervention in the early stages of COVID-19 pneumonia. Cytokine Growth Factor Rev 2020; 53: 38-42.
[http://dx.doi.org/10.1016/j.cytogfr.2020.04.002] [PMID: 32360420]
[8]
Ojo AS, Balogun SA, Williams OT, Ojo OS. Pulmonary fibrosis in COVID-19 survivors: Predictive factors and risk reduction strategies. Pulm Med 2020; 2020: 1-10.
[http://dx.doi.org/10.1155/2020/6175964] [PMID: 32850151]
[9]
George PM, Barratt SL, Condliffe R, et al. Respiratory follow-up of patients with COVID-19 pneumonia. Thorax 2020; 75(11): 1009-16.
[http://dx.doi.org/10.1136/thoraxjnl-2020-215314] [PMID: 32839287]
[10]
Alarcón-Rodríguez J, Fernández-Velilla M, Ureña-Vacas A, et al. Manejo y seguimiento radiológico del paciente post-COVID-19. Radiologia 2021; 63(3): 258-69.
[http://dx.doi.org/10.1016/j.rx.2021.02.003]
[11]
Carfì A, Bernabei R, Landi F. Persistent Symptoms in Patients After Acute COVID-19. JAMA 2020; 324(6): 603-5.
[http://dx.doi.org/10.1001/jama.2020.12603] [PMID: 32644129]
[12]
Mo X, Jian W, Su Z, et al. Abnormal pulmonary function in COVID-19 patients at time of hospital discharge. Eur Respir J 2020; 55(6): 2001217.
[http://dx.doi.org/10.1183/13993003.01217-2020] [PMID: 32381497]
[13]
Attaway AH, Scheraga RG, Bhimraj A, Biehl M, Hatipoğlu U. Severe COVID-19 pneumonia: Pathogenesis and clinical management. BMJ 2021; 372(436): n436.
[http://dx.doi.org/10.1136/bmj.n436] [PMID: 33692022]
[14]
Nalbandian A, Sehgal K, Gupta A, et al. Post-acute COVID-19 syndrome. Nat Med 2021; 27(4): 601-15.
[http://dx.doi.org/10.1038/s41591-021-01283-z] [PMID: 33753937]
[15]
Han X, Fan Y, Alwalid O, et al. Six-month Follow-up Chest CT Findings after Severe COVID-19 Pneumonia. Radiology 2021; 299(1): E177-86.
[http://dx.doi.org/10.1148/radiol.2021203153] [PMID: 33497317]
[16]
John AE, Joseph C, Jenkins G, Tatler AL. COVID‐19 and pulmonary fibrosis: A potential role for lung epithelial cells and fibroblasts. Immunol Rev 2021; 302(1): 228-40.
[http://dx.doi.org/10.1111/imr.12977] [PMID: 34028807]
[17]
Venkataraman T, Coleman CM, Frieman MB. Overactive Epidermal Growth Factor Receptor Signaling Leads to Increased Fibrosis after Severe Acute Respiratory Syndrome Coronavirus Infection. J Virol 2017; 91(12): e00182-17.
[http://dx.doi.org/10.1128/JVI.00182-17] [PMID: 28404843]
[18]
Combet M, Pavot A, Savale L, Humbert M, Monnet X. Rapid onset honeycombing fibrosis in spontaneously breathing patient with COVID-19. Eur Respir J 2020; 56(2): 2001808.
[http://dx.doi.org/10.1183/13993003.01808-2020] [PMID: 32631838]
[19]
Tale S, Ghosh S, Meitei SP, Kolli M, Garbhapu AK, Pudi S. Post-COVID-19 pneumonia pulmonary fibrosis. QJM 2020; 113(11): 837-8.
[http://dx.doi.org/10.1093/qjmed/hcaa255] [PMID: 32814978]
[20]
Nabahati M, Ebrahimpour S, Khaleghnejad Tabari R, Mehraeen R. Post-COVID-19 pulmonary fibrosis and its predictive factors: A prospective study. Egypt J Radiol Nucl Med 2021; 52(1): 248.
[http://dx.doi.org/10.1186/s43055-021-00632-9]
[21]
Garrigues E, Janvier P, Kherabi Y, et al. Post-discharge persistent symptoms and health-related quality of life after hospitalization for COVID-19. J Infect 2020; 81(6): e4-6.
[http://dx.doi.org/10.1016/j.jinf.2020.08.029] [PMID: 32853602]
[22]
Vijayakumar B, Tonkin J, Devaraj A, et al. CT Lung Abnormalities after COVID-19 at 3 Months and 1 Year after Hospital Discharge. Radiology 2022; 303(2): 444-54.
[http://dx.doi.org/10.1148/radiol.2021211746] [PMID: 34609195]
[23]
Zha L, Shen Y, Pan L, et al. Follow-up study on pulmonary function and radiological changes in critically ill patients with COVID-19. J Infect 2021; 82(1): 159-98.
[http://dx.doi.org/10.1016/j.jinf.2020.05.040] [PMID: 32473229]
[24]
Spruit MA, Singh SJ, Garvey C, et al. An official American Thoracic Society/European Respiratory Society statement: Key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med 2013; 188(8): e13-64.
[http://dx.doi.org/10.1164/rccm.201309-1634ST] [PMID: 24127811]
[25]
Yan X, Huang H, Wang C, et al. Follow-up study of pulmonary function among COVID-19 survivors 1 year after recovery. J Infect 2021; 83(3): 381-412.
[http://dx.doi.org/10.1016/j.jinf.2021.05.034] [PMID: 34062186]
[26]
Dan JM, Mateus J, Kato Y, Hastie KM, Yu ED, Faliti CE, et al. Immunological memory to SARS-CoV-2 assessed for up to 8 months after infection. Science 2021; 371(6529): eabf4063.
[http://dx.doi.org/10.1126/science.abf4063]
[27]
María CMD, Iglesias MM, Rialp G, Panesso MA, Guerrero MM, Ramos VV. Recommendations On Early Mobilization And Respiratory Rehabilitation. In COVID-19 From The Spanish Society Of Intensive And Critical Medicine And Coronary Units (Semicyuc) And The Spanish Society Of Rehabilitation And Physical Medicine (Sermef). SEMICYUC 2022. Available From:https://semicyuc.org/wp-content/uploads/2020/05/RECOMENDACIONES-SEMICYUCSERMEF.pdf
[28]
Wang TJ, Chau B, Lui M, Lam GT, Lin N, Humbert S. Physical medicine and rehabilitation and pulmonary rehabilitation for COVID-19. Am J Phys Med Rehabil 2020; 99(9): 769-74.
[http://dx.doi.org/10.1097/PHM.0000000000001505] [PMID: 32541352]
[29]
Zhao HM, Xie YX, Wang C. Recommendations for respiratory rehabilitation in adults with coronavirus disease 2019. Chin Med J 2020; 133(13): 1595-602.
[http://dx.doi.org/10.1097/CM9.0000000000000848] [PMID: 32251002]
[31]
Tobin MJ. Basing respiratory management of COVID-19 on physiological principles. Am J Respir Crit Care Med 2020; 201(11): 1319-20.
[http://dx.doi.org/10.1164/rccm.202004-1076ED] [PMID: 32281885]
[32]
Siddiq MAB, Rathore FA, Clegg D, Rasker JJ. Pulmonary Rehabilitation in COVID-19 patients: A scoping review of current practice and its application during the pandemic. Turk J Phys Med Rehabil 2020; 66(4): 480-94.
[http://dx.doi.org/10.5606/tftrd.2020.6889] [PMID: 33364571]
[33]
Miskovic A, Lumb AB. Postoperative pulmonary complications. Br J Anaesth 2017; 118(3): 317-34.
[http://dx.doi.org/10.1093/bja/aex002] [PMID: 28186222]
[34]
Batra A. Effect of incentive spirometry on recovery of Post-Operative Patients: Pre experimental study. Int J Nurs Educ 2020; 12(3): 1-5.
[http://dx.doi.org/10.37506/ijone.v12i2.3849]
[35]
Weiner P, Man A, Weiner M, et al. The effect of incentive spirometry and inspiratory muscle training on pulmonary function after lung resection. J Thorac Cardiovasc Surg 1997; 113(3): 552-7.
[http://dx.doi.org/10.1016/S0022-5223(97)70370-2] [PMID: 9081102]
[36]
Sum SK, Peng YC, Yin SY, et al. Using an incentive spirometer reduces pulmonary complications in patients with traumatic rib fractures: A randomized controlled trial. Trials 2019; 20(1): 797.
[http://dx.doi.org/10.1186/s13063-019-3943-x] [PMID: 31888765]
[37]
Overend TJ, Anderson CM, Lucy SD, Bhatia C, Jonsson BI, Timmermans C. The effect of incentive spirometry on postoperative pulmonary complications: A systematic review. Chest 2001; 120(3): 971-8.
[http://dx.doi.org/10.1378/chest.120.3.971] [PMID: 11555536]
[38]
Freitas ERFS, Soares BGO, Cardoso JR, Atallah ÁN. Incentive spirometry for preventing pulmonary complications after coronary artery bypass graft. Cochrane Libr 2012; 2021(4): CD004466.
[http://dx.doi.org/10.1002/14651858.CD004466.pub3] [PMID: 22972072]
[39]
Davies BL, MacLeod JP, Ogilvie HM. The efficacy of incentive spirometers in post-operative protocols for low-risk patients. Can J Nurs Res 1990; 22(4): 19-36.
[PMID: 2134642]
[40]
Thomas P, Baldwin C, Bissett B, et al. Physiotherapy management for COVID-19 in the acute hospital setting: Clinical practice recommendations. J Physiother 2020; 66(2): 73-82.
[http://dx.doi.org/10.1016/j.jphys.2020.03.011] [PMID: 32312646]
[41]
Tricco AC, Lillie E, Zarin W, et al. PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation. Ann Intern Med 2018; 169(7): 467-73.
[http://dx.doi.org/10.7326/M18-0850] [PMID: 30178033]
[42]
Verhagen AP, de Vet HCW, de Bie RA, et al. The Delphi List. J Clin Epidemiol 1998; 51(12): 1235-41.
[http://dx.doi.org/10.1016/S0895-4356(98)00131-0] [PMID: 10086815]
[43]
Srinivasan V, Kandakurti PK, Alagesan J, Kishore JT, Jenifer AS, Anitha A. Efficacy of pursed lip breathing with bhastrika pranayama vs incentive spirometry in rehabilitating post COVID 19 follow up-a randomized control study. Turk J Physiother Rehabil 2021; 32(3): 402-7.
[44]
Javaherian M, Shadmehr A, Keshtkar A, et al. Safety and efficacy of pulmonary physiotherapy in hospitalized patients with severe COVID-19 pneumonia (PPTCOVID study): A prospective, randomised, single-blind, controlled trial. PLoS One 2023; 18(1): e0268428.
[http://dx.doi.org/10.1371/journal.pone.0268428] [PMID: 36719885]
[45]
Öner Cengiz H, Ayhan M, Güner R. Effect of deep breathing exercise with Triflo on dyspnoea, anxiety and quality of life in patients receiving COVID‐19 treatment: A randomized controlled trial. J Clin Nurs 2022; 31(23-24): 3439-53.
[http://dx.doi.org/10.1111/jocn.16171] [PMID: 34897869]
[46]
Abodonya AM, Abdelbasset WK, Awad EA, Elalfy IE, Salem HA, Elsayed SH. Inspiratory muscle training for recovered COVID-19 patients after weaning from mechanical ventilation. Medicine 2021; 100(13): e25339.
[http://dx.doi.org/10.1097/MD.0000000000025339] [PMID: 33787632]
[47]
Seyller H, Gottlieb M, Colla J. A breath of fresh air: The role of incentive spirometry in the treatment of COVID-19. Am J Emerg Med 2021; 48: 369.
[http://dx.doi.org/10.1016/j.ajem.2021.01.084] [PMID: 33558097]
[48]
Toor H, Kashyap S, Yau A, et al. Efficacy of incentive spirometer in increasing maximum inspiratory volume in an out-patient setting. Cureus 2021; 13(10): e18483.
[http://dx.doi.org/10.7759/cureus.18483] [PMID: 34754645]
[49]
England Guidance NHS. England Guidance NHS. Managing coronavirus (COVID-19) in general practice (SOP). England Guidance NHS. 2020. Available From: https://www.england.nhs.uk/coronavirus/publication/managing-coronavirus-COVID19-in-general-practice-sop_19-march/
[50]
Shanghai expert consensus for respiratory clinic quality control during the COVID-19 epidemic. Funda University of Medical Sciences 2020; 47(02): 143-50.
[http://dx.doi.org/10.3969/j.issn.1672-8467.2020.02.001]
[51]
Lazzeri M, Lanza A, Bellini R, et al. Respiratory physiotherapy in patients with COVID-19 infection in acute setting: a Position Paper of the Italian Association of Respiratory Physiotherapists (ARIR). Monaldi Arch Chest Dis 2020; 90(1)
[http://dx.doi.org/10.4081/monaldi.2020.1285] [PMID: 32236089]
[52]
Vitacca M, Carone M, Clini EM, et al. Joint statement on the role of respiratory rehabilitation in the COVID-19 crisis: The Italian position paper. Respiration 2020; 99(6): 493-9.
[http://dx.doi.org/10.1159/000508399] [PMID: 32428909]
[53]
Sheehy LM. Considerations for postacute rehabilitation for survivors of COVID-19. JMIR Public Health Surveill 2020; 6(2): e19462.
[http://dx.doi.org/10.2196/19462] [PMID: 32369030]
[54]
Sheth AR, Faraji M, Boparai S, Dhaliwal L, Kulkarni S. Judicious use of incentive spirometry in resource limited times of COVID-19 pandemic. Am J Emerg Med 2021; 47: 290-1.
[http://dx.doi.org/10.1016/j.ajem.2021.05.033] [PMID: 34023182]
[55]
Tyson AF, Kendig CE, Mabedi C, Cairns BA, Charles AG. The effect of incentive spirometry on postoperative pulmonary function following laparotomy: A randomized clinical trial. JAMA Surg 2015; 150(3): 229-36.
[http://dx.doi.org/10.1001/jamasurg.2014.1846] [PMID: 25607594]
[56]
Kumar AS. Comparison of Flow and Volume Incentive Spirometry on Pulmonary Function and Exercise Tolerance in Open Abdominal Surgery: A Randomized Clinical Trial. J Clin Diagn Res 2016; 10(1): KC01-6.
[http://dx.doi.org/10.7860/JCDR/2016/16164.7064]
[57]
Davis SP. Incentive spirometry after abdominal surgery. Nurs Times 2012; 108(26): 22-3.
[PMID: 22866486]
[58]
Sullivan KA, Churchill IF, Hylton DA, Hanna WC. Use of Incentive Spirometry in Adults following Cardiac, Thoracic, and Upper Abdominal Surgery to Prevent Post-Operative Pulmonary Complications: A Systematic Review and Meta-Analysis. Respiration 2021; 100(11): 1114-27.
[http://dx.doi.org/10.1159/000517012] [PMID: 34274935]

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