Effects of Inspiration and Expiration Exercise Combined with Upper Extremity Proprioceptive Neuromuscular Facilitation on Forced Volume Vital and Peak Expiratory Flow

Purpose: The purpose of this study was to examine the effects of inhalation and exhalation exercise combined with upper extremity proprioceptive neuromuscular facilitation pattern on two spirometry values: forced volume vital (FVC) and peak expiratory flow (PEF). Methods: Thirty-two healthy adults were divided into two groups: 1) a combined group, which performed upper extremity D2 flexion pattern (shoulder flexed/abducted/external rotated, forearm supinated, wrist radial deviated, and finger extended) during exhalation and D2 extension pattern (shoulder extended/adducted/internal rotated, forearm pronated, wrist ulnar deviated, and finger flexed) during inhalation; and 2) reverse combined group, which performed the D2 flexion pattern during inhalation and the D2 extension pattern during exhalation. The inverse application of upper extremity movements during inhalation and exhalation induced selective resistance or assistance on respiration. FVC and PEF were measured at two time points, before and after four weeks. Results: In both groups, the pre-post intervention comparison showed significant increases in FVC and PEF (p < .05). In the between-groups comparison, the reverse combined group showed a significantly higher PEF than the combined group at four weeks post intervention (p < 0.05). Conclusion: The combined respiration exercise with reverse PNF upper extremity patterns using selective resistance showed an effective increase in PEF in healthy adults. Clinicians and researchers might consider using selective resistance as a widely applicable and cost-effective option for respiratory rehabilitation planning.