My husband just got home from the hospital. He has COPD, but went in for a knee replacement. He has a big bag full of plastic Respiratory Stuff…. an Incentive Spirometer, a PEP therapy device, a vibratory PEP device, and some inspiratory muscle training device. Does he need to do all of these? And, will it improve his lung function, or his spirometry numbers? Also, he doesn’t remember how to do them all- help!
Wow, hospitals are usually quite boring places, but it sounds like they kept your husband very busy with all of this! First, let me tell you what each of these is for.
The Incentive Spirometer is used to help open the lungs after surgery. Since the diaphragm is the main muscle of inspiration, it strengthens the diaphragm while encouraging deep breathing.
PEP therapy is used to open the lungs and keep the small airways from collapsing on exhalation. The patient exhales against a small bit of pressure, and the back-pressure help keep the airways open.
Vibratory PEP is PEP therapy with a ball or flap inside that vibrates, and those vibrations are transmitted through the chest to help loosen secretions.
An Inspiratory muscle trainer has the patient inhale against a resistance. This is thought to strengthen the diaphragm.
Now, a word of caution an all of these: COPD is a disease of the lungs being overinflated. That said, I would caution your husband from being too over-zealous about taking repeated or prolonged inhalations. On the exhalation side, with COPD , the air sacs are often very fragile. I suggest extreme caution when exhaling against a lot of pressure and creating back-pressure in the lung. His Respiratory Therapist should have suggested settings and levels for each of these. If your husband forgot, take the devices with you to your follow-up visit at your doctor’s and have him or her mark levels of volume, pressure, and resistance to use.
As a general rule, gentle inhalations and exhalations, low pressures, and comfortable volumes are the rule.
As for whether these will change his lung capacity, or give him better Pulmonary Function Testing numbers, well… I can’t say definitively no. Lungs are fragile, and once the damage is done, it is irreversible. However, I have seen patients complete Pulmonary Rehab, and start breathing correctly, maximizing the lung’s efficiency, and – their PFT numbers do indeed improve.
Encourage him to keep using these, but gently.