Comparing Incentive Spirometry with the Acapella Device for Physiotherapy after Thoracoscopic Lung Resection Surgery

Abstract

Objective: To compare the efficacy of incentive spirometery with the Acapella device and incentive spirometery combined for physiotherapy in patients undergoing thoracoscopic pulmonary resection surgery.

Material and methods: This Randomized Control Trail was conducted at Nishtar Hospital Multan, from 1st October 2018 to 30th september 2021 in 3 years duration. A total of 268 patients were enrolled in this study. Patients were distributed into two group randomly, incentive spirometery group or Acapella device group. FEV1 and FVC were measured. Visual analogue scale was implied for the assessment of comfort of the patient. Assessment of pain was made by using another visual analogue scale which consisted of a scale from 0 to 10. Primary outcome was the value of FEV1 on the 3^rd day postoperatively. Total analgesia required was also measured. Comparison between the control and case groups was done by using Mann-Whitney U test, independent t-test Chi square test or Fischer exact test. P value of less than or equal to 0.005 was considered as significant.

Results: When all the participants were asked to test both the devices and give their preference, majority of the people in both the groups (a total of 94%) suggested Acapella (p<0.001). The pain level was not significantly different between both the groups at 1^st postoperative hour, 6^th postoperative hour, 1^st postoperative day, 2^nd postoperative day and 3^rd postoperative day (p-value 0.557, 0.943, 0.916, 0.639 and 0.917, respectively). The total dose of morphine used in incentive spirometer group (202.55±28.54mg) was not significantly different from the dose (206.93±22.64mg) used in the Acapella group (p=0.166).

Conclusion: There was no difference between Acapella and incentive spirometery in terms of improving the overall lung function after thoracoscopic surgery for pulmonary resection.