The effect of incentive spirometry with early pulmonary rehabilitation on hospital stay of patients with chronic obstructive pulmonary disease exacerbation.

BACKGROUND: Incentive spirometry (IS) is a cost-effective, easy-to-use, and accessible device used peri-postoperative period for prevention or management of complications via maintaining maximum inhalation and open collapsed alveoli and resolving atelectasis. Although early pulmonary rehabilitation (PR) is known to reduce the length of stay (LOS), it is controversial whether the addition of IS provides a further contribution. This study aimed to investigate whether using IS in addition to early PR in patients with chronic obstructive pulmonary disease (COPD) exacerbation reduces LOS and whether it is a safe technique by assessing hemodynamic responses. METHODS: One hundred thirty patients with acute exacerbation of COPD (AECOPD) during hospitalization were randomized to an early PR group and an additional IS group (PR + IS). LOS (days), pre-, and postsession hemodynamic responses were recorded. RESULTS: The LOS was significantly lower in the PR + IS (5.34 days) group than in the PR group (7.17 days) (P = 0.026). Changes in respiratory rate (breaths/min) and oxygen saturation (%) were within the well-tolerated interval in both groups and there was a statistically significant difference in the PR + IS group (P < 0.001). Other hemodynamic changes were also within well-tolerated intervals, with no statistically significant differences between the groups (P > 0.05). CONCLUSION: The usage of IS in addition to early PR in patients with AECOPD reduced LOS by approximately 1 day compared to PR alone. Furthermore, no significant signs of intolerance were observed, suggesting that IS was well-tolerated, similar to PR alone.