Supervised vs Non-Supervised Incentive Spirometry After CABG

NCT07343921 | Completed

• 2 other identifiers: IKFR-202502.01DP.04.03/D.XIV.6.5/77/2024
• Study Type: interventional
• Target: 38
• Locations: 1 country
• Sites: 1

Brief Summary

This study aims to evaluate the effect of supervised incentive spirometry (SIS) compared to unsupervised incentive spirometry (Non-SIS) on pulmonary function in patients following coronary artery bypass graft (CABG) surgery. Participants perform incentive spirometry exercises twice daily for three days after extubation. Pulmonary function parameters, including forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and peak expiratory flow (PEF), are assessed before and after the intervention period to compare changes between the two groups.

Conditions

Postoperative Pulmonary Function Impairment

Keywords

CABG; incentive spirometry; pulmonary function; supervision; postoperative care

Outcome Measures

Primary Outcomes (1)

• Forced Expiratory Volume in 1 Second (FEV1)

  Measures the volume of air that can be forcibly exhaled in one second to assess pulmonary function in post-CABG patients.

  T1 (24 hours post-extubation) and T2 (after 3 days of incentive spirometry exercise)

Secondary Outcomes (1)

• Forced Vital Capacity (FVC)

  T1 (24 hours post-extubation) and T2 (after 3 days of incentive spirometry exercise)

Other Outcomes (1)

• Peak Expiratory Flow (PEF)

  T1 (24 hours post-extubation) and T2 (after 3 days of incentive spirometry exercise)

Study Arms (2)

Supervised Incentive Spirometry (SIS)

EXPERIMENTAL

Participants perform incentive spirometry exercises twice daily for 3 days under direct supervision. The supervisor observes the technique, provides corrections, answers questions, and ensures adherence to the prescribed exercise regimen.

Procedure: Supervised Incentive Spirometry (SIS)

Non-Supervised Incentive Spirometry (Non-SIS)

ACTIVE COMPARATOR

Participants perform incentive spirometry exercises independently using a provided guideline form. Supervisors provide daily reminders but do not directly observe the exercises. Participants log their activity daily.

Procedure: Non-Supervised Incentive Spirometry (Non-SIS)

Interventions

Supervised Incentive Spirometry (SIS) PROCEDURE

Participants perform incentive spirometry exercises twice daily for 3 days under direct supervision. The supervisor monitors technique, corrects errors, answers questions, and ensures exercises are done accurately. Each session includes 6 sets of 5 breaths, with slow inhalation, 2-second breath-hold, and slow exhalation, separated by rest periods. This intervention is performed in addition to standard cardiac rehabilitation.

Supervised Incentive Spirometry (SIS)

Non-Supervised Incentive Spirometry (Non-SIS) PROCEDURE

Exercises independently using a guideline form with daily reminders. Participants log activity. 6 sets of 5 breaths per session.

Non-Supervised Incentive Spirometry (Non-SIS)

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Adult patients aged ≥18 years.
• Patients who have undergone Coronary Artery Bypass Graft (CABG) surgery.
• Mechanical ventilation \<24 hours post-surgery.
• Physically able to perform incentive spirometry (IS) exercises.
• Signed informed consent to participate in the study.

You may not qualify if:

• Hemodynamically unstable patients.
• Patients with cognitive or communication impairments.
• Oral abnormalities that prevent the use of IS.
• Patients with Chronic Obstructive Pulmonary Disease (COPD).
• Patients with thoracic anomalies.
• Patients who required reintubation.
• History of incentive spirometry use within the last 3 months.

Sponsors & Collaborators

• Universitas Padjadjaran: lead

Study Sites (1)

RSUP Dr. Hasan Sadikin

Bandung, West Java, 40161, Indonesia

Location

Related Publications (5)

• Ababneh QM, Abdelrahman H, Abdelhameed ME. Effectiveness of Incentive Spirometry Versus Deep Breathing Exercises in Preventing Postoperative Pulmonary Complications After Abdominal Surgery: A Comprehensive Review. Cureus. 2025 Mar 6;17(3):e80149. doi: 10.7759/cureus.80149. eCollection 2025 Mar.

  PMID: 40190855 RESULT

• do Nascimento Junior P, Modolo NS, Andrade S, Guimaraes MM, Braz LG, El Dib R. Incentive spirometry for prevention of postoperative pulmonary complications in upper abdominal surgery. Cochrane Database Syst Rev. 2014 Feb 8;2014(2):CD006058. doi: 10.1002/14651858.CD006058.pub3.

  PMID: 24510642 RESULT

• Alwekhyan SA, Alshraideh JA, Yousef KM, Hayajneh F. Nurse-guided incentive spirometry use and postoperative pulmonary complications among cardiac surgery patients: A randomized controlled trial. Int J Nurs Pract. 2022 Apr;28(2):e13023. doi: 10.1111/ijn.13023. Epub 2021 Oct 22.

  PMID: 34676618 RESULT

• Su H, Zhang J, Liu Y, Peng H, Zhang L. Pre and postoperative nurse-guided incentive spirometry versus physiotherapist-guided pre and postoperative breathing exercises in patients undergoing cardiac surgery: An evaluation of postoperative complications and length of hospital stay. Medicine (Baltimore). 2022 Dec 30;101(52):e32443. doi: 10.1097/MD.0000000000032443.

  PMID: 36596066 RESULT

• Melly L, Torregrossa G, Lee T, Jansens JL, Puskas JD. Fifty years of coronary artery bypass grafting. J Thorac Dis. 2018 Mar;10(3):1960-1967. doi: 10.21037/jtd.2018.02.43.

  PMID: 29707352 RESULT

Related Links

• Melly L, Torregrossa G, Lee T, Jansens JL, Puskas JD. Fifty years of coronary artery bypass grafting. J Thorac Dis. 2018;10(3):1960-7.
• Su H, Zhang J, Liu Y, Peng H, Zhang L. Pre and postoperative nurse-guided incentive spirometry vs. physiotherapist-guided breathing exercises in cardiac surgery. Medicine (Baltimore). 2022;101(52):e32443.
• Saja Ahmad Alwekhyan et al. Nurse-guided incentive spirometry use and postoperative pulmonary complications among cardiac surgery patients. Int J Nurs Pract. 2022;28(2):e13023.
• do Nascimento Junior P, Módolo NS, Andrade S, Guimarães MM, Braz LG, El Dib R. Incentive spirometry for prevention of postoperative pulmonary complications in upper abdominal surgery. Cochrane Database Syst Rev. 2014;(2):CD006058.pub3.
• Ababneh QM et al. Effectiveness of Incentive Spirometry Versus Deep Breathing Exercises in Preventing Postoperative Pulmonary Complications After Abdominal Surgery: A Comprehensive Review. Cureus. 2025;17(3):e80149.

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: December 19, 2025
• First Posted: January 15, 2026
• Study Start: July 1, 2024
• Primary Completion: December 1, 2024
• Study Completion: January 1, 2025
• Last Updated: January 15, 2026

Record last verified: 2026-01

Locations

ID (1)