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Minimally Invasive Surgery
Volume 2016, Article ID 1967532, 12 pages
http://dx.doi.org/10.1155/2016/1967532
Clinical Study

Comparison of Diaphragmatic Breathing Exercise, Volume and Flow Incentive Spirometry, on Diaphragm Excursion and Pulmonary Function in Patients Undergoing Laparoscopic Surgery: A Randomized Controlled Trial

1Department of Physiotherapy, Kasturba Medical College, Manipal University, Bejai, Mangalore 575004, India
2Department of Surgery, Kasturba Medical College, Manipal University, Mangalore 575004, India
3Department of Pulmonary Medicine, Kasturba Medical College, Manipal University, Mangalore 575004, India
4Department of Radiodiagnosis, Kasturba Medical College, Manipal University, Mangalore 575004, India

Received 5 October 2015; Revised 21 April 2016; Accepted 8 May 2016

Academic Editor: Casey M. Calkins

Copyright © 2016 Gopala Krishna Alaparthi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. To evaluate the effects of diaphragmatic breathing exercises and flow and volume-oriented incentive spirometry on pulmonary function and diaphragm excursion in patients undergoing laparoscopic abdominal surgery. Methodology. We selected 260 patients posted for laparoscopic abdominal surgery and they were block randomization as follows: 65 patients performed diaphragmatic breathing exercises, 65 patients performed flow incentive spirometry, 65 patients performed volume incentive spirometry, and 65 patients participated as a control group. All of them underwent evaluation of pulmonary function with measurement of Forced Vital Capacity (FVC), Forced Expiratory Volume in the first second (FEV1), Peak Expiratory Flow Rate (PEFR), and diaphragm excursion measurement by ultrasonography before the operation and on the first and second postoperative days. With the level of significance set at . Results. Pulmonary function and diaphragm excursion showed a significant decrease on the first postoperative day in all four groups () but was evident more in the control group than in the experimental groups. On the second postoperative day pulmonary function (Forced Vital Capacity) and diaphragm excursion were found to be better preserved in volume incentive spirometry and diaphragmatic breathing exercise group than in the flow incentive spirometry group and the control group. Pulmonary function (Forced Vital Capacity) and diaphragm excursion showed statistically significant differences between volume incentive spirometry and diaphragmatic breathing exercise group () as compared to that flow incentive spirometry group and the control group. Conclusion. Volume incentive spirometry and diaphragmatic breathing exercise can be recommended as an intervention for all patients pre- and postoperatively, over flow-oriented incentive spirometry for the generation and sustenance of pulmonary function and diaphragm excursion in the management of laparoscopic abdominal surgery.