Respiratory Physiotherapy for Oxygenation in Hospitalized Covid‑19: A Randomized Trial Publisher



Sayadi L ; Samadi F ; Rasouli D ; Rezaei F ; Dehghan A H ; Rozveh A K
Source: Journal of Holistic Nursing and Midwifery Published:2026

Abstract

Introduction: COVID-19 mainly affects the respiratory system, often leading to hypoxia and acute respiratory failure. In the absence of definitive treatments, respiratory physiotherapy has been widely applied as a supportive measure. Objective: This study aimed to compare the effects of Incentive Spirometry (IS) and Diaphragmatic Breathing (DB) on arterial oxygen saturation (SpO2) in hospitalized COVID-19 patients. Materials and Methods: This is an open-label randomized clinical trial with a pre-test/post-test design. Eighty COVID-19 patients hospitalized at one of teaching hospitals in Tehran, Iran, were selected using a convenience sampling method and randomly assigned to DB (n=40) and IS (n=40) groups. Each intervention consisted of three sets of 10 breaths per minute, with a 30‑second rest interval. The SpO₂ levels and vital signs were measured at baseline, immediately after, and 5 and 10 minutes after the interventions. Data were analyzed using independent t‑test, ANOVA, chi‑square test, and post‑hoc test. Results: Most of participants were male (60%) with lower than high school education (41.2%). The mean age of patients was 54.87±16.713 years in the IS group and 54.25±13.23 years in the DB group. There was no statistically significant difference between the SpO₂ levels over time in any groups; both groups showed a non-significant increase in SpO₂ immediately after and 10 minutes after the intervention. No significant change was observed 5 minutes after intervention. There was no significant differences between the two groups at any time points. However, the IS led to a smaller decline and greater overall improvement in SpO₂. Conclusion: Respiratory physiotherapy techniques, particularly the IS, can enhance oxygen saturation of COVID-19 patients within a short period but these changes were not significant. These techniques offer clinical value for both patients and healthcare providers by facilitating the management of acute respiratory responses and reducing disease-related burdens through non-invasive strategies. Copyright © 2026 The Author(s)