How to use the incentive spirometer

How to use the incentive spirometer

 

As a Home Care Physical Therapist, I see many patients who have just returned home following a surgery.  Many of them have received an Incentive Spirometer from the hospital but do not know how to use it properly, or do not make the effort to use it consistently because they are unaware of its importance.  Here is a quick step-by-step explanation provided by the Cleveland Clinic website on how to properly use an Incentive Spirometer.

 



Using the Incentive Spirometer will keep your lungs clear and will help keep your lungs active throughout the recovery process, as if you were performing your daily activities

1. Sit on the edge of your bed if possible, or sit up as far as you can in bed.
2. Hold the incentive spirometer in an upright position.
3. Place the mouthpiece in your mouth and seal your lips tightly around it.
4. Breathe in slowly and as deeply as possible. Notice the yellow piston rising toward the top of the column. The yellow indicator should reach the blue outlined area.
5. Hold your breath as long as possible. Then exhale slowly and allow the piston to fall to the bottom of the column.
6. Rest for a few seconds and repeat steps one to five at least 10 times every hour.
7. Position the yellow indicator on the left side of the spirometer to show your best effort. Use the indicator as a goal to work toward during each slow deep breath.
8. After each set of 10 deep breaths, cough to be sure your lungs are clear. If you have an incision, support your incision when coughing by placing a pillow firmly against it.
9. Once you are able to get out of bed safely, take frequent walks and practice the cough.

References

• Agency for Healthcare Research and Quality. National Guideline Clearinghouse: Incentive Spirometry, 2011 Accessed 8/29/2013.
• Merck Manual for Home Health Care. Chest Physical Therapy Accessed 8/29/2013.
• Cleveland Clinic Website 

Rehab For ACL Deficiency

Rehab For ACL Deficiency

 

The ACL or Anterior Cruciate Ligament of the knee is commonly injured in sports. 

In the illustration, you can see that the ACL attaches the femur and the tibia.  The purpose of the ACL is to limit the amount of anterior translation of the tibia on the femur.  If the ACL is ruptured, the lower leg bone may move abnormally on the upper bone, causing the sensation of instability and knee buckling.  The ACL can be partially or completely ruptured and may be surgical or non-surgical.  If it is surgical, it may be beneficial to start a rehab program prior to surgery.  This may speed up the recovery process after surgery.  If it is not surgical at this time, your goal will be to maximize knee stability, while protecting the ACL so that you can safely tolerate your daily activities  

 

 

Things to keep in mind when training someone with the diagnosis of ACL Deficiency

Image 1

Image 2

 

In Image 1, you can see the quadriceps muscle inserts into the tibia as the patella tendon.  Upon contracting the quads, the patella tendon will actually translate the tibia anteriorly.  This is further stressing a partially torn ACL.  In Image 2, you can see that the gastrocnemius crosses the knee joint and attaches to the femur posteriorly.  When the calf muscle contracts, it translates the femur posteriorly, which is relative anterior translation of the tibia, which stresses the ACL yet again.  Looking again to Image 1, the hamstring tendons are attached posteriorly to the tibia.  Upon hamstring contraction, the tibia is translated posteriorly.  This actually assists the ACL in its job of stabilizing the knee and minimizing anterior translation of the tibia on the femur.  So, when training a client with ACL deficiency, your goal is to maximize knee joint stability, while minimizing stress on the ACL.  You want to focus training on any weaknesses present and not neglect the quads or calf muscles.  However extra attention to the hamstrings will pick up the slack of the deficient ACL.



ACL Repair

ACL Repair

 

The ACL stands for the Anterior Cruciate Ligament in the knee.  The ACL limits anterior translation of the tibia on the femur. 

This is a very common injury, particularly for athletes.  It may occur upon a direct blow to the knee region from the front, which is common in football.  Sometimes you will hear a "pop" upon ligament tear, and the knee joint swells quickly, making it painful to walk.  A feeling of knee instability may also occur following this injury.  If surgical repair is necessary, you will be facing months of Physical Therapy.  This will be time consuming and may be financially stressful.  To speed up your recovery, you will want to be compliant and persistent with your home exercise program.  To help you with this, www.strengthondemand.com offers a DVD Home Exercise Program that will guide you from Week 1 through Week 12 following your ACL Repair.  This DVD includes the most common ACL Repair Therapeutic Exercises for each time frame during your recovery.  This will speed up your recovery, saving you time and money.  

 

Below is a link to an ACL Repair Surgery video, as well as the link to the S.O.D. ACL Repair Rehabilitation DVD.  Check it out.

 

ACL Repair Surgery

 

ACL Rehabilitation Protocol DVD 

Meniscus Arthroscopic Surgery

Many of my patients have undergone arthoscopic surgery for a meniscus tear.  Upon initiating Physical Therapy, they are usually confused as to what the surgery entailed, and do not really know what or where the meniscus actually is.  This video is a good basic explanation of the knee anatomy and surgical procedure. 

Arthroscopy for Meniscus Tear

Become a member of www.kbfitnessonline.com for access to the step-by-step exercise rehabilitation protocol and follow along treatment sessions following your arthroscopic meniscectomy.  You will also gain access to the full knee exercise video library, which will assist in your progression to a Post-Rehab Fitness Program.