The ubiquitous incentive spirometer for breathing exercise after surgery has often been questioned as lacking evidence. Many prehabilitation programs use structured deep breathing as well as inspiratory muscle strength training, along with aerobic and resistance training. Australian choosing wisely physiotherapy guidelines recommended against incentive spirometry ( link ).
This was a single center randomized trial in coronary artery bypass surgery which aimed to improve adherence by incorporating hourly reminder bells. The results were quite impressive in improved Incentive Spirometer use adherence, atelectasis severity, early postoperative fevers, noninvasive positive pressure ventilation use, intensive care unit length of stay by a day, and 6-month mortality rates.
“Incentive spirometers can be clinically effective, but perhaps only when adherence is high”. Further studies are recommended on incentive spirometry without reminders. As a relatively small trial, further larger studies with balanced patient populations are essential.