THE EFFECT OF INCENTIVE SPIROMETRY AND INSPIRATORY MUSCLE TRAINING ONPULMONARY-FUNCTION AFTER LUNG RESECTION

Background: A predicted postoperative forced expiratory volume in 1 se cond (FEV(1)) of less than 800 ml or 40% of predicted is a common crit erion for exclusion of patients from lung resection for cancer, Usuall y, the predicted postoperative lung function is calculated according t o a formula based on the number of lung segments that will be resected , Incentive spirometry and specific inspiratory muscle training are tw o maneuvers that have been used to enhance lung expansion and inspirat ory muscle strength in patients with chronic obstructive pulmonary dis ease and after lung operation, Methods: Thirty-two patients with chron ic obstructive pulmonary disease who were candidates for lung resectio n were randomized into two groups: 17 patients received specific inspi ratory muscle training and incentive spirometry, 1 hour per day, six t imes a week, for 2 weeks before and 3 months after lung resection (gro up A) and 15 patients were assigned to the control group and received no training (group B), Results: Inspiratory muscle strength increased significantly in the training group, both before and 3 months after th e operation, In group B, the predicted postoperative FEV(1) value cons istently underestimated the actual postoperative FEV(1) by approximate ly 70 mi in the lobectomy subgroup and by 110 ml in the pneumonectomy subgroup, In group A, the actual postoperative FEV(1) was higher than the predicted postoperative FEV(1) by 570 ml in the lobectomy subgroup and by 680 ml in the pneumonectomy subgroup of patients, Conclusions: In patients undergoing lung resection the simple calculation of predi cted postoperative FEV(1) underestimates the actual postoperative FEV( 1) by a small fraction, Lung functions can be increased significantly when incentive spirometry and specific inspiratory muscle training are used before and after operation.