Observational practice of incentive spirometry in stroke patients.

The study included 20 people with stroke and 20 healthy controls, so the result for video versus therapist instruction may not be reliable in a larger or more varied population. Stroke participants were 1 to 7 years after stroke, had mild neurological impairment (NIHSS 4 ± 2.3), and were functionally independent (FIM 86 ± 7.9), so the findings may not apply to people with more recent, more severe, or less independent stroke. The study measured errors and attempts during learning, not whether the technique improved lung expansion. The authors stated they could not correlate the learning process with the affected location, side, or extent of brain injury. The stroke group had fewer years of study and lower cognitive scores than the healthy group (8.67 ± 5 vs. 11.8 ± 3.7 years; MMSE 28 ± 1.2 vs. 30 ± 1.1), which may affect learning comparisons. The video and therapist instruction were not identical: the video showed a patient performing ten repetitions, while the therapist group did not see a patient performing the exercise. The study used non-probability sampling, so participants may not represent all people with stroke or healthy controls.

The authors declare no conflicts of interest.

Do not conclude that video instruction or therapist demonstration is better for teaching incentive spirometry. The study found no significant difference between the two types of observational practice for errors, and it measured learning performance rather than lung expansion.