Breath-stacking and incentive spirometry in Parkinson's disease: Randomized crossover clinical trial

Respir Physiol Neurobiol. 2018 Sep;255:11-16. doi: 10.1016/j.resp.2018.04.011. Epub 2018 May 1.


Patients with Parkinson's disease often exhibit respiratory disorders and there are no Respiratory Therapy protocols which are suggested as interventions in Parkinson's patients. The aim of this study is to evaluate the effects of Breathing-Stacking (BS) and incentive spirometer (IS) techniques in volume variations of the chest wall in patients with Parkinson's Disease (PD). 14 patients with mild-moderate PD were included in this randomized cross-over study. Volume variations of the chest wall were assessed before, immediately after, then 15 and 30 min after BS and IS performance by optoelectronic plethysmography. Tidal volume (VT) and minute ventilation (MV) significantly increased after BS and IS techniques (p < 0.05). There was greater involvement of pulmonary and abdominal compartments after IS. The results suggest that these re-expansion techniques can be performed to immediately improve volume.

Keywords: Breathing exercises; Optoelectronic plethysmography; Parkinson’s disease; Physical therapy modalities; Pulmonary reexpansion; Respiratory therapy.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Antiparkinson Agents / therapeutic use
  • Breathing Exercises*
  • Cross-Over Studies
  • Dopamine Agents / therapeutic use
  • Female
  • Humans
  • Male
  • Middle Aged
  • Muscle Strength
  • Parkinson Disease / complications
  • Parkinson Disease / physiopathology
  • Parkinson Disease / rehabilitation*
  • Plethysmography
  • Respiration
  • Respiration Disorders / etiology
  • Respiration Disorders / physiopathology
  • Respiration Disorders / rehabilitation*
  • Respiratory Muscles / physiopathology
  • Respiratory Therapy*
  • Spirometry* / methods
  • Tidal Volume
  • Treatment Outcome


  • Antiparkinson Agents
  • Dopamine Agents