Efficacy of Incentive Spirometer Training on Diaphragmatic Excursion and Quality of Life in Hemodialysis Patients

Abstract
Background: The generalized muscle weakness found in Chronic Kidney Diseases (CKD) patients on hemodialysis primarily affects the lower limbs and the proximal muscles. Patients also present decreased endurance and decreased respiratory muscle strength.
Aim of Work: The purpose of this study was to evaluate the effect of incentive spirometer training on diaphragmatic excursion and Quality of Life (QOL) in Hemodialysis (HD) patients.
Subjects and Methods: Sixty HD patients (30 men and 30 women) selected from the National Institute of Urology and Nephrology participated in the study, their ages ranged from 45-55 years from July 2017 to January 2018. They were assigned randomly into two groups equal in number; 30 patients each: Group (A) received incentive spirometer training with hemodialysis for 8 weeks, 3 sessions per week. Group (B) maintained on hemodialysis only for 8 weeks 3 sessions per week with pre and post assessment of diaphragmatic excursion by ultrasonography and QOL questionnaire.
Results: Incentive spirometer training induced a significant improvement in diaphragmatic excursion and quality of life questionnaire in study group with percent of change 24.62% and 55.67% respectively while a deterioration was observed in control group with percent of change 26.49%, and 38.68% respectively.
Conclusions: Incentive spirometer training for 8 weeks in HD men and women results in an improvement of diaphrag-matic excursion and QOL.