Effectiveness of Modified Flow-oriented Incentive Spirometry Compared with Diaphragmatic Breathing Exercises in Tracheostomized Patients

S Jeba Malar; Anas Ahamed A

doi:10.36948/ijfmr.2026.v08i05.87766

Effectiveness of Modified Flow-oriented Incentive Spirometry Compared with Diaphragmatic Breathing Exercises in Tracheostomized Patients

Author(s)	Ms. S Jeba Malar, Mr. Anas Ahamed A
Country	India
Abstract	Tracheostomy is frequently performed in critically ill patients, particularly in those requiring prolonged mechanical ventilation. Following tracheostomy, impaired cough effectiveness, reduced inspiratory volumes, retained secretions, and shallow breathing may contribute to impaired lung expansion and atelectasis. Incentive spirometry promotes sustained maximal inspiration and may facilitate lung expansion. However, evidence regarding its use in tracheostomized patients is limited. The primary objective of this study is to evaluate the effectiveness of modified flow-oriented incentive spirometry on arterial partial pressure of oxygen (PaO₂), and arterial partial pressure of carbon dioxide (PaCO₂) in tracheostomized patients and to compare its effects with diaphragmatic breathing exercises. A comparative pretest-post-test study was conducted among 20 tracheostomized patients. Participants were allocated into an experimental group receiving modified flow-oriented incentive spirometry and a comparison group receiving diaphragmatic breathing exercises, with 10 participants in each group. The intervention was administered under physiotherapist supervision for 7 days. Both groups performed 10–15 breaths per session, three times a day. Outcome measures included PaO₂, and PaCO₂. Within-group changes were analyzed using the paired t test, while between-group differences were analyzed using the independent t test. Both groups showed significant improvements in PaO₂ and reductions in PaCO₂ following intervention (p < 0.001). However, the modified incentive spirometer group demonstrated significantly greater improvement in PaO₂ (t = 2.197, p = 0.041) and in PaCO₂ (t = −2.571, p = 0.019) compared with the diaphragmatic breathing group. The findings of this study suggest that modified flow-oriented incentive spirometry may be more effective than diaphragmatic breathing exercises alone in improving arterial blood-gas parameters in tracheostomized patients.
Keywords	Tracheostomy, Incentive spirometry, Inspiratory capacity, Atelectasis, PaO₂, PaCO₂, Diaphragmatic Breathing
Field	Medical / Pharmacy
Published In	Volume 8, Issue 5, September-October 2026
Published On	2026-09-14
DOI	https://doi.org/10.36948/ijfmr.2026.v08i05.87766

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Effectiveness of Modified Flow-oriented Incentive Spirometry Compared with Diaphragmatic Breathing Exercises in Tracheostomized Patients

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