Effects of incentive spirometry on cardiopulmonary parameters, functional capacity and glycemic control in patients with Type 2 diabetes.
Happiness Anulika Aweto, Esther Onyinyechi Obikeh, Bosede Abidemi Tella
PMID 33005076WHAT IT FOUND
Incentive spirometry added to medical management for eight weeks did not lower fasting blood sugar more than medical management alone, but improved lung function test scores and six-minute walk distance.
Key findings
01Fasting blood sugar improved within the incentive spirometry group, but the between-group change was not significant.
02Adding incentive spirometry to medical management for eight weeks produced larger mean changes in forced vital capacity, forced expiratory volume in 1 second, peak expiratory flow rate and 6-minute walk distance than medical management alone; the 6-minute walk distance mean change was 28.73 m versus 7.44 m.
03The incentive spirometry group had larger mean changes in systolic blood pressure, heart rate and rate-pressure product than the control group, but not in diastolic blood pressure.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 59 of 64 randomized participants completed the study, and the paper does not report home-session adherence. The groups were not equivalent at baseline: the incentive spirometry group had longer duration of diabetes (10.53 vs 6.66 years), higher diastolic blood pressure (89.20 vs 83.83 mmHg) and longer 6-minute walk distance (200.77 vs 166.31 m). The paper does not name a single primary outcome, so the positive lung and walk findings cannot be read as one pre-specified main result. The 28.73 m mean improvement in 6-minute walk distance was below the 54 m threshold the authors cite for clinical significance. Participants were non-smokers, non-alcoholics, mobile and excluded for recent abdominal surgery, severe diabetic complications, pulmonary infections or trunk deformities, so the study says little about more complicated patients. The paper says single blinded but does not state who was blinded or how outcome assessors were protected from group knowledge.
Declared interests
The authors declare no competing interest, financial or otherwise.
The easy way to misread this
Do not conclude that incentive spirometry alone improves type 2 diabetes outcomes. It was tested as an add-on to medical management, and the between-group change in fasting blood sugar was not significant. The 28.73 m walk-distance gain was below the 54 m threshold the authors cite for clinical importance.