Does an Incentive Spirometer Exercise Regimen Have Utility for Outpatients?

Can clinic patients improve pulmonary function through a 30-day pulmonary exercise regimen monitored via an incentive spirometer?

Ambulatory clinic patients who were prescribed daily breathing exercises with an incentive spirometer, instructions for general cardiopulmonary fitness, and chest postural drainage experienced a significant 16% increase in maximal inspiratory volume over a 30-day period and had no need to contact their primary care physician (PCP) during this time. These were among the results of a study recently published in the journal Cureus.

Researchers conducted a prospective cohort study among patients in a physical medicine and rehabilitation clinic during the COVID-19 pandemic. The researchers sought to establish whether a consistent incentive spirometry regimen can improve lung function in an outpatient setting. All participants received an incentive spirometer, together with hands-on instructions on use of the device and the accurate recording of measurements.

To use the device, participants needed to lie down and inhale/exhale through the tube 10 times, then indicate the highest volume achieved during their 10 breaths. This exercise had to be completed 3 times daily for a total of 30 days. Further, the participants were instructed to carry out light exercises or walking for 20 minutes a day 3 times weekly, along with postural drainage. All participants had to contact their PCP if they noted a decrease of 20% or more from baseline in their breathing score. They also needed to report whether they experienced any new cough, fever, or shortness of breath over their 30-day period of doing the spirometer exercises.

A total of 48 participants were enrolled in the study — 27 male and 21 female. The average patient age was 58.3±9.8 years. None of the participants reported coughing

more than 5 times during their use of the incentive spirometer or the need to contact their PCP for any respiratory issues during the study period and 1 month after study completion.

Prior to initiation of spirometer exercises, the baseline maximal inspiration for study participants was 1885.4 mL, with a subsequent increase in lung capacity seen for all individuals enrolled in the study. At 4 weeks after the initiation of the study, participants’ average maximal inspiratory volume was 2235.4 mL, thus demonstrating a significant difference between baseline and maximum inspiratory volumes (P <0001). Per analysis of variance, no significant difference was observed among the average volumes over the 4 weeks of the study.

No symptoms of fever, coughing, or shortness of breath were reported among any of the participants during the study period. No COVID-19 infection was reported by any of the patients, and no one reported having contacted their PCP.

Findings of the current study demonstrate the efficacy and safety of using an incentive spirometer among ambulatory clinic outpatients, said investigators. They added that a larger prospective study is warranted to evaluate the reliability and reproducibility of the current study results.


Toor H, Kashyap S, Yau A, et al. Efficacy of incentive spirometer in increasing maximum inspiratory volume in an out-patient setting. Cureus. 2021;13(10):e18483. doi:10.7759/cureus.18483